Autism in eye care: A mixed‐methods study of professional knowledge, confidence and clinical experience

This publication is included in the Autistic Autism Scholarship Project. one author of this publication is identified as autistic in the project.

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Edwards, C., Love, A., Cai, R. Y., Constable, P. A., Love, D. C., Parmar, K. R., 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

Journal or book title
Ophthalmic and Physiological Optics
Publisher
Springer Science and Business Media LLC
Volume
45
Issue
7
Pages
2116-2128
Publication date: 16 Oct 2025 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
Publisher source (DOI) OpenAlex source

This publication is integrated into AutiHub through:

Authors

Publication authors
8
Publication authors identified as autistic
1 / 8 (12.5%)
  1. Chris Edwards *
  2. Abigail Love
  3. Ru Ying Cai
  4. Paul A. Constable
  1. Daniel C. Love
  2. Ketan R. Parmar
  3. Emma Gowen
  4. vicki gibbs

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.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 17:07.

Cited references
53
With a DOI
48
Without a DOI, from raw bibliography text
5
15 / 53 (28.3%) cited references include at least one author identified as autistic.
References with data to complete
1 / 53 (1.9%)
References with detected author names
52 / 53 (98.1%)
Without detected author names
1
Without a structured title
1
Without a stable identifier
4
References with raw author names still to review
0
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
308
From DOI or external metadata
308
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
146 / 308 (47.4%) names are linked to an author already present in AutiHub. 162 / 308 (52.6%) names are not yet linked.
Names linked to a person identified as autistic
32 / 308 (10.4%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 32 / 146 (21.9%). Distinct people identified as autistic: 22 / 276 (8.0%).
  3. Meng-Chuan Lai , Simon Baron-Cohen (2015). Identifying the lost generation of adults with autism spectrum conditions . The Lancet Psychiatry, 2(11), 1013. Elsevier BV.
    Type: Article DOI: 10.1016/s2215-0366(15)00277-1 OpenAlex: https://openalex.org/W2128937542
    Crossref OpenAlex
  4. 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.
    Type: Article DOI: 10.1016/j.lanepe.2023.100626 OpenAlex: https://openalex.org/W4362579857
    Crossref OpenAlex
  5. Hsiu-Fang Hsieh , Sarah E. Shannon (2005). Three Approaches to Qualitative Content Analysis . Qualitative Health Research, 15(9), 1277-1288. SAGE Publications.
    Type: Article DOI: 10.1177/1049732305276687 OpenAlex: https://openalex.org/W2142225512
    Crossref OpenAlex
  6. 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 Surveill Summ 2025, 74(SS-2), 1. Centers for Disease Control MMWR Office.
    Type: Article DOI: 10.15585/mmwr.ss7402a1 OpenAlex: https://openalex.org/W4409458169
    Crossref OpenAlex
  7. Ashley Johnson 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.
    Type: Article DOI: 10.1177/1362361316638786 OpenAlex: https://openalex.org/W2346007298
    Crossref OpenAlex
  8. 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.
    Type: Article DOI: 10.1177/1098300716667604 OpenAlex: https://openalex.org/W2519445202
    Crossref OpenAlex
  10. 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.
    Type: Article DOI: 10.3399/bjgp17x690449 OpenAlex: https://openalex.org/W2614102167
    Crossref OpenAlex
  12. Ashley Johnson 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.
    Type: Article DOI: 10.1007/s10803-017-3242-x OpenAlex: https://openalex.org/W2736484290
    Crossref OpenAlex
  13. Philippa L Howard , Felicity Sedgewick (2021). ‘Anything but the phone!’: Communication mode preferences in the autism community . Autism, 25(8), 2265-2278. SAGE Publications.
    Type: Article DOI: 10.1177/13623613211014995 OpenAlex: https://openalex.org/W3176767872
    Crossref OpenAlex
  14. Emma Gowen , Catherine S. Porter , Peter Baimbridge * , Kelvin Hanratty , James Pelham * , Christine M. 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/W2767382037
    Crossref OpenAlex
  15. 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.
    Type: Article DOI: 10.1016/j.chc.2020.02.006 OpenAlex: https://openalex.org/W3015907530
    Crossref OpenAlex
  16. 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.
    Type: Article DOI: 10.1007/s10803-019-03912-6 OpenAlex: https://openalex.org/W2911241604
    Crossref OpenAlex
  17. Micah O 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.
    Type: Article DOI: 10.1089/aut.2021.0069 OpenAlex: https://openalex.org/W4311844611
    Crossref OpenAlex
  18. 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 . Lancet Psychiatry, 6(10), 819. Elsevier BV.
    Type: Article DOI: 10.1016/s2215-0366(19)30289-5 OpenAlex: https://openalex.org/W2936336589
    Crossref OpenAlex
  19. 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.
    Type: Article DOI: 10.1089/aut.2020.0074 OpenAlex: https://openalex.org/W3205684935
    Crossref OpenAlex
  20. 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.
    Type: Article DOI: 10.1007/s00417-019-04594-7 OpenAlex: https://openalex.org/W2999669974
    Crossref OpenAlex
  21. 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.
    Type: Article DOI: 10.1080/17518423.2020.1716868 OpenAlex: https://openalex.org/W3004472967
    Crossref OpenAlex
  24. 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).
    Type: Article DOI: 10.1097/md.0000000000020899 OpenAlex: https://openalex.org/W3043350455
    Crossref OpenAlex
  25. 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.
    Type: Article DOI: 10.1007/s40489-022-00318-6 OpenAlex: https://openalex.org/W4224307943
    Crossref OpenAlex
  26. Olivia J Lindly , James Chan , Rachel M Fenning , Justin 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.
    Type: Article DOI: 10.1177/1362361320942091 OpenAlex: https://openalex.org/W3044006808
    Crossref OpenAlex
  27. 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. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s40489-023-00420-3 OpenAlex: https://openalex.org/W4390614416
    Crossref OpenAlex
  29. 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.
    Type: Article DOI: 10.1097/opx.0000000000001593 OpenAlex: https://openalex.org/W3097631675
    Crossref OpenAlex
  32. 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. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1007/s40489-021-00263-w OpenAlex: https://openalex.org/W3163025874
    Crossref OpenAlex
  33. 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.
    Type: Article DOI: 10.1016/j.rasd.2023.102165 OpenAlex: https://openalex.org/W4367556742
    Crossref OpenAlex
  34. 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.
    Type: Article DOI: 10.1177/13623613211060906 OpenAlex: https://openalex.org/W4200018858
    Crossref OpenAlex
  35. 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.
    Type: Article DOI: 10.5535/arm.21046 OpenAlex: https://openalex.org/W3198174504
    Crossref OpenAlex
  36. John H. Ward , Elizabeth Weir , Carrie T. 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. Springer Science and Business Media LLC.
    Type: Article DOI: 10.1186/s13229-023-00565-2 OpenAlex: https://openalex.org/W4386892471
    Crossref OpenAlex
  37. 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.
    Type: Article DOI: 10.1007/s40489-024-00468-9 OpenAlex: https://openalex.org/W4400610025
    Crossref OpenAlex
  38. 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.
    Type: Article DOI: 10.1038/s41380-023-02143-7 OpenAlex: https://openalex.org/W4385277623
    Crossref OpenAlex
  40. Margaret Reynolds , Susan M. Culican (2023). Visual Autism . Children, 10(4), 606. MDPI AG.
    Type: Article DOI: 10.3390/children10040606 OpenAlex: https://openalex.org/W4360613766
    Crossref OpenAlex
  42. 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.
    Type: Article DOI: 10.1002/aur.3019 OpenAlex: https://openalex.org/W4386189870
    Crossref OpenAlex
  44. Parmar K (2023). Autism and eyecare accessibility . Disp Opt, 1.
    Type: Other
    Crossref
  46. University of Manchester (n.d.). Autism, vision and eyecare [Internet] . Autism, vision and eyecare [Internet].
    Type: Other
    Crossref
  47. 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.
    Type: Article DOI: 10.1111/scd.12921 OpenAlex: https://openalex.org/W4386506729
    Crossref OpenAlex
  48. 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: Other
    Crossref
  49. 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.
    Type: Article DOI: 10.7759/cureus.64108 OpenAlex: https://openalex.org/W4400476647
    Crossref OpenAlex
  51. 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.
    Type: Article DOI: 10.1007/s10803-025-06781-4 OpenAlex: https://openalex.org/W4408625000
    Crossref OpenAlex
  52. (n.d.). e_1_2_13_52_1
    Type: Other DOI: 10.12968/hmed.2023.00
    Crossref
  53. den Houting J (2021). Participatory and Inclusive Autism Research Practice Guides . Participatory and Inclusive Autism Research Practice Guides, 192236536X.
    Type: Other
    Crossref