Autism in eye care: A mixed‐methods study of professional knowledge, confidence and clinical experience
Edwards, C., Love, A. M., Cai, R. Y., Constable, P. A., Love, D. C., Parmar, K., Gowen, E., & Gibbs, V. (2025). Autism in eye care: A mixed‐methods study of professional knowledge, confidence and clinical experience. Ophthalmic and Physiological Optics, 45(7), 2116-2128. https://doi.org/10.1111/opo.70029
This publication is integrated into AutiHub through:
Authors
Abstract
Abstract Purpose Autistic people face significant barriers when accessing healthcare, which contribute to health disparities and unmet needs. While emerging research has described the experiences of autistic individuals accessing eye care, little is known about the perspectives of eye care professionals. This study aimed to examine autism‐related knowledge, self‐efficacy and attitudes among a sample of eye care professionals, and to explore their clinical experiences, perceived challenges and support needs when providing care to autistic patients. Methods A mixed‐methods design was used, combining quantitative survey data and qualitative content analysis. A total of 198 eye care professionals (optometrists, n = 107; ophthalmologists, n = 52) predominantly from Australia ( n = 84), the USA ( n = 79) and the United Kingdom ( n = 20) completed an online survey. Regression analyses examined whether professional role, country, age, experience, personal connection to autism and frequency of contact predicted autism knowledge, self‐efficacy and disability attitudes. Correlations explored relationships among these three variables. Open‐ended responses were analysed using conventional content analysis. Results Participants reported moderately high levels of self‐efficacy, autism knowledge and positive disability attitudes, yet only 14% perceived they had received formal autism‐specific training. Frequent clinical contact with autistic individuals was the strongest predictor of higher self‐efficacy ( p < 0.001). Qualitative analysis identified common challenges (e.g., sensory sensitivities, time constraints and communication barriers) and practical strategies (e.g., flexible testing, sensory accommodations and clear communication). Participants expressed a strong desire for further training and system‐level supports to provide more accessible, person‐centred care. Conclusions Eye care professionals in this sample appeared motivated to support autistic patients, but often perceived a lack of structured training and identified systemic constraints that limited their capacity to provide accessible services. Practical, autism‐informed resources, developed in collaboration with autistic people, alongside changes in clinical policy and workflow, may help address these challenges.
Bibliography cited by this reference
Cited references are imported from external metadata sources when they are available. The list may be partial.
Bibliography inclusion overview
These indicators describe the cited bibliography imported for this publication. Cited-reference metrics use the cited-reference total as denominator. Cited-author metrics state whether they use all cited-author occurrences or only occurrences linked to authors already integrated in the AutiHub database. They use cached links between cited authors and authors integrated in the AutiHub database. Last computed: 16 Aug 2026 11:30.
-
Damian Milton *Autistic author. Learn more… (2012). On the ontological status of autism: the ‘double empathy problem’ . Disability & Society, 27(6), 883-887. Informa UK Limited.
-
Josephine Barbaro , Nancy Sadka , Melissa Gilbert , Erin Beattie , Xia Li , Lael Ridgway et al. (2022). Diagnostic Accuracy of the Social Attention and Communication Surveillance–Revised With Preschool Tool for Early Autism Detection in Very Young Children . JAMA Network Open, 5(3), e2146415. American Medical Association (AMA).Crossref OpenAlex
-
Meng-Chuan Lai , Simon Baron-Cohen (2015). Identifying the lost generation of adults with autism spectrum conditions . The Lancet Psychiatry, 2(11), 1013-1027. Elsevier BV.Crossref OpenAlex
-
Elizabeth O’Nions , Irene Petersen , Joshua E.J. Buckman , Rebecca A. Charlton , Claudia Cooper , Anne Corbett et al. (2023). Autism in England: assessing underdiagnosis in a population-based cohort study of prospectively collected primary care data . The Lancet Regional Health - Europe, 29, 100626. Elsevier BV.Crossref OpenAlex
-
Hsiu-Fang Hsieh , Sarah E. Shannon (2005). Three Approaches to Qualitative Content Analysis . Qualitative Health Research, 15(9), 1277-1288. SAGE Publications.Crossref OpenAlex
-
Kelly A. Shaw , Susan Williams , Mary E. Patrick , Miguel Valencia-Prado , Maureen S. Durkin , Ellen M. Howerton et al. (2025). Prevalence and Early Identification of Autism Spectrum Disorder Among Children Aged 4 and 8 Years — Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022 . MMWR. Surveillance Summaries, 74(2), 1-22. Centers for Disease Control MMWR Office.Crossref OpenAlex
-
Ashley J Harrison , Mylissa M Slane , Linh Hoang , Jonathan M Campbell (2017). An international review of autism knowledge assessment measures . Autism, 21(3), 262-275. SAGE Publications.Crossref OpenAlex
-
Laura L. Corona , Kristin V. Christodulu , Melissa L. Rinaldi (2017). Investigation of School Professionals’ Self-Efficacy for Working With Students With ASD . Journal of Positive Behavior Interventions, 19(2), 90-101. SAGE Publications.Crossref OpenAlex
-
Mary Doherty *Autistic author. Learn more… , Stuart Neilson , Jane O’Sullivan , Laura Carravallah *Autistic author. Learn more… , Mona Johnson *Autistic author. Learn more… , Walter Cullen et al. (2022). Barriers to healthcare and self-reported adverse outcomes for autistic adults: a cross-sectional study . BMJ Open, 12(2), e056904. BMJ.
-
Silvana Unigwe , Carole Buckley , Laura Crane , Lorcan Kenny , Anna Remington , Elizabeth Pellicano (2017). GPs’ confidence in caring for their patients on the autism spectrum: an online self-report study . British Journal of General Practice, 67(659), e445-e452. Royal College of General Practitioners.Crossref OpenAlex
-
Sebastian Charles Keith Shaw *Autistic author. Learn more… , Laura Carravallah *Autistic author. Learn more… , Mona Johnson *Autistic author. Learn more… , Jane O’Sullivan , Nicholas Chown *Autistic author. Learn more… , Stuart Neilson et al. (2024). Barriers to healthcare and a ‘triple empathy problem’ may lead to adverse outcomes for autistic adults: A qualitative study . Autism, 28(7), 1746-1757. SAGE Publications.
-
Ashley J. Harrison , Laine P. Bradshaw , Nilofer C. Naqvi , Madison L. Paff , Jonathan M. Campbell (2017). Development and Psychometric Evaluation of the Autism Stigma and Knowledge Questionnaire (ASK-Q) . Journal of Autism and Developmental Disorders, 47(10), 3281-3295. Springer Science and Business Media LLC.Crossref OpenAlex
-
Philippa L Howard , Felicity Sedgewick (2021). ‘Anything but the phone!’: Communication mode preferences in the autism community . Autism, 25(8), 2265-2278. SAGE Publications.Crossref OpenAlex
-
Emma Gowen , Catherine Porter , Peter Baimbridge , Kelvin Hanratty , James Pelham , Christine Dickinson (2017). Optometric and orthoptic findings in autism: A review and guidelines for working effectively with autistic adult patients during an optometric examination . Optometry Pract, 18(3), 145.Type: Article OpenAlex: https://openalex.org/W2767382037Crossref OpenAlex
-
Connor Tom Keating , Jennifer Louise Cook (2020). Facial Expression Production and Recognition in Autism Spectrum Disorders . Child and Adolescent Psychiatric Clinics of North America, 29(3), 557-571. Elsevier BV.Crossref OpenAlex
-
Rae Morris , Andrea Greenblatt , Michael Saini (2019). Healthcare Providers’ Experiences with Autism: A Scoping Review . Journal of Autism and Developmental Disorders, 49(6), 2374-2388. Springer Science and Business Media LLC.Crossref OpenAlex
-
Micah Mazurek , Eleonora Sadikova , Nancy Cheak‐Zamora , Amber Hardin , Kristin Sohl , Beth A. Malow (2023). Health Care Needs, Experiences, and Perspectives of Autistic Adults . Autism in Adulthood, 5(1), 51-62. SAGE Publications.Crossref OpenAlex
-
Meng-Chuan Lai , Caroline Kassee , Richard Besney , Sarah Bonato , Laura Hull , Will Mandy et al. (2019). Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis . The Lancet Psychiatry, 6(10), 819-829. Elsevier BV.Crossref OpenAlex
-
Maria Strömberg , Lina Liman , Peter Bang , Kajsa Igelström (2022). Experiences of Sensory Overload and Communication Barriers by Autistic Adults in Health Care Settings . Autism in Adulthood, 4(1), 66-75. SAGE Publications.Crossref OpenAlex
-
Raoul Kanav Khanna , Klara Kovarski , Sophie Arsene , Marine Siwiaszczyk , Pierre-Jean Pisella , Frédérique Bonnet-Brilhault et al. (2020). Ophthalmological findings in children with autism spectrum disorder . Graefe's Archive for Clinical and Experimental Ophthalmology, 258(4), 909-916. Springer Science and Business Media LLC.Crossref OpenAlex
-
Chloe Walsh , Sinéad Lydon , Emily O’Dowd , Paul O’Connor (2020). Barriers to Healthcare for Persons with Autism: A Systematic Review of the Literature and Development of A Taxonomy . Developmental Neurorehabilitation, 23(7), 413-430. Informa UK Limited.Crossref OpenAlex
-
Ketan Parmar , Catherine S. Porter , Christine M. Dickinson , James Pelham , Peter Baimbridge , Emma Gowen (2021). Visual Sensory Experiences From the Viewpoint of Autistic Adults . Frontiers in Psychology, 12, 633037-633037. Frontiers Media SA.Crossref OpenAlex
-
Ketan Parmar , Catherine S. Porter , Christine M. Dickinson , Peter Baimbridge , James Pelham , Emma Gowen (2022). Autism‐friendly eyecare: Developing recommendations for service providers based on the experiences of autistic adults . Ophthalmic and Physiological Optics, 42(4), 675-693. Springer Science and Business Media LLC.Crossref OpenAlex
-
Shenae Calleja , Fakir M. Amirul Islam , Jonathan Kingsley , Rachael McDonald (2020). Healthcare access for autistic adults . Medicine, 99(29), e20899. Ovid Technologies (Wolters Kluwer Health).Crossref OpenAlex
-
Hessam Sadatsafavi , Lena Vanable , Pam DeGuzman , Mark Sochor (2023). Sensory-Friendly Emergency Department Visit for Patients with Autism Spectrum Disorder—A Scoping Review . Review Journal of Autism and Developmental Disorders, 10(4), 684-698. Springer Science and Business Media LLC.Crossref OpenAlex
-
Olivia J Lindly , James Chan , Rachel M Fenning , Justin G Farmer , Ann M Neumeyer , Paul Wang et al. (2021). Vision care among school-aged children with autism spectrum disorder in North America: Findings from the Autism Treatment Network Registry Call-Back Study . Autism, 25(3), 840-853. SAGE Publications.Crossref OpenAlex
-
Tonia Babalola , Giulia Sanguedolce , Lucy Dipper , Nicola Botting (2025). Barriers and Facilitators of Healthcare Access for Autistic Children in the UK: a Systematic Review . Review Journal of Autism and Developmental Disorders, 12(4), 780-808. Springer Science and Business Media LLC.Crossref OpenAlex
-
Christina Nicolaidis , Gavin Schnider , Junghee Lee , Dora M Raymaker *Autistic author. Learn more… , Steven K. Kapp *Autistic author. Learn more… , Lisa A. Croen et al. (2021). Development and psychometric testing of the AASPIRE Adult Autism Healthcare Provider Self-Efficacy Scale . Autism, 25(3), 767-773. SAGE Publications.
-
Mark W. Swanson , Sarah Dille Lee , Marcela G. Frazier , Annette Bade , Rachel Anastacia Coulter (2020). Vision Screening among Children with Autism Spectrum Disorder . Optometry and Vision Science, 97(11), 917-928. Wiley.Crossref OpenAlex
-
Sarah Radev *Autistic author. Learn more… , Megan Freeth , Andrew R. Thompson (2024). How healthcare systems are experienced by autistic adults in the United Kingdom: A meta-ethnography . Autism, 28(9), 2166-2178. SAGE Publications.
-
David Mason , Barry Ingham , Heather Birtles , Cos Michael , Clare Scarlett , Ian A. James et al. (2021). How to improve healthcare for autistic people: A qualitative study of the views of autistic people and clinicians . Autism, 25(3), 774-785. SAGE Publications.Crossref OpenAlex
-
Kirsten Corden , Rebecca Brewer , Eilidh Cage (2022). A Systematic Review of Healthcare Professionals’ Knowledge, Self-Efficacy and Attitudes Towards Working with Autistic People . Review Journal of Autism and Developmental Disorders, 9(3), 386-399. Springer Science and Business Media LLC.Crossref OpenAlex
-
Laurence Forsyth , Marc McSorley , Ewelina Rydzewska (2023). All-cause and cause-specific mortality in people with autism spectrum disorder: A systematic review . Research in Autism Spectrum Disorders, 105, 102165. Elsevier BV.Crossref OpenAlex
-
Daniel Gilmore , Morgan Krantz , Lindy Weaver , Brittany N. Hand (2022). Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis . Autism, 26(2), 317-331. SAGE Publications.Crossref OpenAlex
-
Youho Myong , Hyung-Ik Shin , Jeong-Eun Lee , Woosup Cho , You Gyoung Yi (2021). Development and Validation of a New Scale to Assess Attitudes and Perspectives Toward Persons With Disabilities . Annals of Rehabilitation Medicine, 45(4), 331-340. Korean Academy of Rehabilitation Medicine.Crossref OpenAlex
-
John H. Ward , Elizabeth M Weir , Carrie Allison , Simon Baron-Cohen (2023). Increased rates of chronic physical health conditions across all organ systems in autistic adolescents and adults . Molecular Autism, 14(1), 35-35. Springer Science and Business Media LLC.Crossref OpenAlex
-
Zain Ali Nadeem , Umar Akram , Talha Bin Khalid , Muhammad Asfandyar Nadir , Muhammad Hasnat Akhtar (2024). Refractive Errors Linked to Autism Spectrum Disorders in the Pediatric Population and Young Adults: A Systematic Review and Meta-Analysis . Review Journal of Autism and Developmental Disorders. Springer Science and Business Media LLC.Crossref OpenAlex
-
John Perna , Alessio Bellato , Preethi S. Ganapathy , Marco Solmi , Andrea Zampieri , Stephen V. Faraone et al. (2023). Association between Autism Spectrum Disorder (ASD) and vision problems. A systematic review and meta-analysis . Molecular Psychiatry, 28(12), 5011-5023. Springer Science and Business Media LLC.Crossref OpenAlex
-
Belinda O’Hagan , Shari Krauss , Alexander Friedman , Lauren Bartolotti , Oluwatobi Abubakare *Autistic author. Learn more… , Sarabeth Broder‐Fingert et al. (2023). Identifying Components of Autism Friendly Health Care: An Exploratory Study Using a Modified Delphi Method . Journal of Developmental & Behavioral Pediatrics, 44(1), e12-e18. Ovid Technologies (Wolters Kluwer Health).
-
Margaret Reynolds , Susan M. Culican (2023). Visual Autism . Children, 10(4), 606. MDPI AG.Crossref OpenAlex
-
Connor Tom Keating , Lydia Hickman , Joan Leung , Ruth Monk *Autistic author. Learn more… , Alicia Montgomery , Hannah Heath et al. (2023). Autism‐related language preferences of English ‐speaking individuals across the globe: A mixed methods investigation . Autism Research, 16(2), 406-428. Wiley.
-
Chi‐Shin Wu , Tzu‐Hsun Tsai , Wei‐Li Chen , Hui‐Ju Tsai , Yi‐Ling Chien (2023). Ophthalmologic diagnoses in youths with autism spectrum disorder: Prevalence and clinical correlates . Autism Research, 16(10), 2008-2020. Wiley.Crossref OpenAlex
-
Chris Edwards *Autistic author. Learn more… , Abigail M.A. Love , Ru Ying Cai , Paul A. Constable , Daniel C. Love , Ketan Parmar et al. (2026). Understanding eye care access for autistic adults and families: A convergent mixed-methods study . Autism, 30(1), 122-133. SAGE Publications.
-
Parmar K (2023). Autism and eyecare accessibility . Disp Opt, 1.Type: OtherCrossref
-
Elizabeth Pellicano , Dawn Adams , Laura Crane , Calliope Hollingue , Connie Allen , Katherine Almendinger et al. (2024). Letter to the Editor: A possible threat to data integrity for online qualitative autism research . Autism, 28(3), 786-792. SAGE Publications.
-
University of Manchester (n.d.). Autism, vision and eyecare [Internet] . Autism, vision and eyecare [Internet].Type: OtherCrossref
-
Lindsey G. Hesse , Irina Smilyanski , Linda D. Boyd , Jared Vineyard (2024). Effect of dental hygienists’ self‐efficacy on intention to provide dental care to autistic individuals . Special Care in Dentistry, 44(3), 823-836. Wiley.Crossref OpenAlex
-
Garg P (2014). An exploratory survey for understanding perceptions, knowledge and educational needs of general practitioners (GPs) regarding autistic disorders in New South Wales (NSW), Australia . J Clin Diagn Res, 8, PC01.Type: OtherCrossref
-
Samar Z Hamdan , Amanda Bennett (2024). Autism-Friendly Healthcare: A Narrative Review of the Literature . Cureus, 16(7), e64108-e64108. Springer Science and Business Media LLC.Crossref OpenAlex
-
Abigail M.A. Love , Chris Edwards *Autistic author. Learn more… , David Dueber , Ru Ying Cai , Kana Grace , Michael D. Toland et al. (2026). Measuring Loneliness in Autistic Adults: A Collaborative Approach to Refining the UCLA Loneliness Scale . Autism in Adulthood, 8(3), 329-344. SAGE Publications.
-
Sarah C G Davenport , Mohammed Alshawsh , Cameron Lee , Alice Garrick , Amanda Brignell , Alexandra Ure et al. (2026). The Meaning of Autism Friendly in Hospital Settings: A Scoping Review of the Autism Community’s Perspectives . Journal of Autism and Developmental Disorders, 56(8), 3055-3070. Springer Science and Business Media LLC.Crossref OpenAlex
-
(n.d.). e_1_2_13_52_1Crossref
-
den Houting J (2021). Participatory and inclusive autism research practice guides . Participatory and Inclusive Autism Research Practice Guides, 192236536X.Type: OtherCrossref