Eye Exams for Neurodivergent Patients

Why Accessible Vision Care Matters

For many people, an eye test is a routine healthcare appointment. For some neurodivergent patients, however, bright lights, unfamiliar equipment, unexpected physical proximity, communication demands and changes in routine can make the experience more challenging.

Neurodivergence includes a wide range of neurological differences, such as autism, ADHD, dyslexia, dyspraxia and sensory processing differences. Every neurodivergent person is different, so eye care should be based on the individual’s communication preferences, sensory needs and personal circumstances. With thoughtful accommodations and understanding from eye care professionals, eye tests can become more comfortable, accessible and person-centred.

Why are Regular Eye Tests Important?

A comprehensive eye test assesses more than whether someone needs glasses or contact lenses. It may include tests of visual acuity, eye pressure, peripheral vision, retinal health and eye coordination. These assessments can help identify common eye conditions while also providing valuable insights into overall health.

Regular eye examinations can help detect conditions such as glaucoma, cataracts and age-related macular degeneration, while sometimes identifying early signs of wider health issues including diabetes, high blood pressure and high cholesterol. Eye tests are particularly important when a person finds it difficult to recognise, interpret or communicate changes in their vision. Signs that an eye test may be needed include blurred/double vision, frequent headaches, eye strain/fatigue, increased sensitivity to light or glare, difficulty seeing at night and persistent eye discomfort/irritation. These symptoms can affect daily activities, learning, work performance and overall quality of life.

Autism and Vision

While neurodivergence encompasses many conditions, much of the current research on eye health focuses specifically on autistic individuals.

A large prospective study involving 344 autistic patients found that refractive errors, including long-sightedness and astigmatism, were present in nearly half of participants. Researchers also found higher rates of eye movement and alignment issues, such as strabismus, compared with the general population. The authors concluded that regular ophthalmological assessments are important for autistic individuals.

Many autistic children can successfully complete comprehensive eye tests when visual, sensory and communication supports are incorporated into the testing process. These supports may include adapted instructions, visual prompts and a more flexible approach to testing. These findings reinforce the importance of accessible and inclusive eye care that adapts to the needs of the individual patient.

Why Might an Eye Test feel Challenging?

Although eye tests are generally straightforward, several aspects of the experience can be difficult for some neurodivergent patients.

Sensory Differences

Eye tests often involve:

• Bright lights.
• New sounds and equipment.
• Close physical proximity to the optometrist.
• Eye drops or air-puff tests.
• Frequent movement between testing stations.

For people with sensory sensitivities, these experiences can be uncomfortable or overwhelming.

Communication and Processing Differences

Some patients may require additional time to process questions or instructions. Others may prefer visual demonstrations or written information rather than verbal explanations. Questions that seem simple, such as comparing different lenses during a vision test, can sometimes be difficult to answer if the difference is subtle or the patient is unsure how to describe what they are seeing.

Uncertainty and Changes in Routine

Unexpected events, longer waiting times or not knowing what happens next can increase stress and anxiety. Having a clear understanding of the appointment process beforehand can often help reduce uncertainty.

Attention and Focus Challenges

For individuals with ADHD or other attention-related differences, remaining focused through multiple tests and instructions may be more difficult. This can sometimes make longer appointments feel tiring or overwhelming.

Creating More Inclusive Eye Care

Every neurodivergent person experiences the world differently. What helps one patient may not help another. The key to inclusive eye care is recognising individual needs and being willing to adapt. There is benefits to personalised, flexible healthcare approaches that consider sensory preferences, communication styles and individual comfort levels. By doing so, eye care professionals can help create a more positive experience and support better long-term vision health outcomes for neurodivergent patients.