Neurodiversity Celebration Week: Making eye care more inclusive – Dr Paul Constable explains why neuroaffirming optometry matters

by Katie Quirk - Communications Coordinator, Optometry Australia with Dr Paul Constable

To acknowledge Neurodiversity Celebration Week (17th to 23rd March), we have put together a series of stories to highlight and champion optometrists, academics, parents and patients across the country who are working to make eye care more accessible, affirming and inclusive for autistic* and other neurodivergent Australians.

We spoke with Dr Paul Constable, who is a Senior Lecturer at the College of Nursing and Health Sciences, Flinders University as well as a parent of an autistic child, to discuss why neuroaffirming optometry matters.

In addition to his tertiary standing and personal experiences, Dr Constable is also part of the research team leading a survey which, in collaboration with Aspect and with input from autistic voices, their families and eye care professionals, is aiming to identify and address challenges in optometry and how eye care services can be adapted to ultimately improve health outcomes and experiences for neurodivergent people.

How would you define neuroaffirming practice in an optometric setting?

Optometrists and practice staff should be able to accommodate neurodivergent individuals by making adjustments to suit their needs.

This may include allowing for longer testing times, scheduling repeat visits, booking appointments during quieter times and ensuring staff understand that additional time, supports or behavioural accommodations may be required.

Communication preferences should also be considered—some individuals may prefer text messages over phone calls.

What does current research suggest about the unique eye care needs of neurodivergent individuals?

There is a gap in the literature regarding eye care for neurodivergent populations.

While healthcare practitioners have some understanding of neurodivergent individuals' needs, each person requires a different approach.

Without clear evidence, optometrists often rely on personal experience to develop strategies, but this can result in inconsistent care.

Existing research tends to focus on perceived deficits—such as increased refractive errors or poor eye movement control—rather than strengths, like enhanced visual search and memory.

How do sensory processing differences impact standard eye examination procedures?

Significantly. Standard eye exams involve unfamiliar equipment, dark rooms, bright lights and close physical proximity.

Procedures like eye drops, bright lights and keeping the eyes open for extended periods can be uncomfortable or distressing.

Decision-making elements—such as “Which is better, one or two?”—can heighten anxiety, particularly for individuals who feel pressure to give a "correct" answer.

Complex instructions can also be overwhelming, increasing stress and making the experience more challenging.

What emerging research has the potential to make optometric care more neuroinclusive?

Awareness of neurodiversity has improved significantly, both in education and broader society.

When I was a student, terms like ASD, ADHD and neurodiversity weren’t commonly discussed—now, most students have at least some familiarity with them.

This awareness should lead to more inclusive care.

Larger studies are needed to assess optometrists' current understanding and needs so that education and resources can be developed to support a more neuroinclusive approach.

A final thought

As awareness of neurodiversity grows, so too should our approach to healthcare to support individuals across their lifespan.

While society still tends to think of autism and ADHD as childhood disorders, adult and ageing neurodivergent populations will also need access to neuroaffirming care when it comes to the management and treatment of conditions like cataracts and glaucoma.

There’s already greater awareness and understanding of neurodivergence than ever before—but for many optometrists, there’s still uncertainty around how to provide the best care.

More training and resources will help bridge that gap, ensuring that neurodivergent individuals feel safe, understood and supported in accessing the eye care they need.

The ASPECT eye care survey for autistic adults and parents/guardians/caregivers can be accessed here.

*Amplifying autistic voices is crucial because it ensures that conversations about neurodivergence are led by those with lived experience.

Too often, discussions about autism are dominated by non-Autistic perspectives, which can overlook or misunderstand the real needs and strengths of the community.

Listening to and elevating autistic voices not only helps break down stereotypes but also drives meaningful change in policies, practices and perceptions.

It’s about shifting from a “for them, without them” mindset to a collaborative, inclusive approach that respects neurodivergent experiences.

 

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