Investigating eye examination-related anxiety in autistic adults.

Researchers studied whether autistic adults feel more anxious about eye tests than other people. They surveyed 322 autistic adults using a standard anxiety questionnaire. Surprisingly, they found similar anxiety levels between autistic and non-autistic people. However, the questionnaire might not capture all the specific things that make eye tests stressful for autistic people. This matters because autistic people may be more likely to have eye problems but might avoid getting proper eye care.

This study investigated eye examination anxiety in autistic adults using the Optometric Patient Anxiety Scale (OPAS) with 322 UK participants. Rasch analysis validated the OPAS for autistic populations, showing good statistical properties. Surprisingly, no significant difference in optometric anxiety was found between autistic adults and the general population. However, the researchers note this may underestimate true anxiety levels as the OPAS doesn't capture autism-specific anxiety triggers identified in their previous qualitative work.

The study addresses an important healthcare access issue, given evidence that autistic individuals have higher rates of eye problems.

Clinicians should use validated tools like OPAS to assess optometric anxiety in autistic patients. However, they should also consider autism-specific factors that may cause anxiety during eye examinations, as standard measures may not fully capture the autistic experience.

Single study design with potential measurement limitations. The OPAS may not capture autism-specific anxiety triggers identified in previous qualitative research. Sample limited to UK-based adults. No comparison of actual eye care utilization rates or barriers beyond anxiety measurement.

It is important to investigate whether anxiety is a barrier to accessing eye examinations for autistic adults, because existing research suggests this population are more likely to develop ophthalmic abnormalities. Anxiety influences healthcare accessibility for autistic people without learning disabilities. Previous qualitative studies by the research team, with a small sample of autistic adults, have indicated several aspects of eyecare services which cause anxiety. Considering the limited existing research suggesting autistic individuals are more likely to develop ophthalmic abnormalities, this study explored whether this population more widely experiences anxiety when accessing eye examinations.

A total of 322 UK-based autistic adults completed the Optometric Patient Anxiety Scale (OPAS) online, between July and December 2020. Rasch analysis was used to validate this questionnaire for an autistic adult population, and compare optometric anxiety levels to the general population. Item infit (0.77 to 1.39) and outfit (0.78 to 1.33) values, the person separation index (2.64), and item (0.99) and person (0.97) reliability coefficients suggested that all 10 items in the OPAS are useful to assess optometric anxiety in an autistic adult population. Item probability curves confirmed the response scale to be appropriate.

A comparison of optometric anxiety between the autistic population in the current study and a general population in previous work found no statistically significant difference. The OPAS is a statistically valid tool for use in the autistic adult population. It appears to suggest no significant difference in optometric anxiety between the autistic adult and general population. However, it is possible that it underestimates the true optometric anxiety of autistic adults since the items do not include some of the anxiety provoking factors for this population which have been indicated in previous studies by the research team.