Performing exams for patients with Autism can vary in level of difficulty. Understanding what to do with the data collected during the exam can also be tricky.
In this post, we will talk about nuances when prescribing spectacles for patients with autism spectrum disorder.
First and foremost it's important to understand that no two patients are going to be the same. For example, developing a rule-of-thumb might not be as handy in these types of scenarios compared in other clinical recommendations. The best advice I have for anyone getting used to prescribing spectacle lenses for patients with autism spectrum disorder is to allow observations from the exam to lead your recommendations and prescriptions.
I like to look at responsiveness when deciding on what I want to do with my spectacle Rx. If your patient is responsive and cognitively aware, ask them about their responsibilities, day-to-day schedule, and other tasks that will help guide you to understand what type of vision is the most important.
For example, if your patient drives, it’s important for them to have the best distance correction possible. If your patient does not drive and spends minimal time looking at things at distance, you might get away with cutting down on the RX if they happen to be experiencing sensory overload.
The most important thing to keep in mind, especially for patients getting glasses for the first time, is the sensory overload they will experience with the glasses. Patients with autism tend to have high astigmatic prescriptions, which can be tricky to prescribe for the first time.
If the patient already wears glasses, I always use the glasses prescription as a starting point, to make sure the patient is comfortable. If you are making a dramatic change, talk to the patient and/or guardian about expectations, things to watch out for and follow up as needed. Also, don’t forget to experiment with prism to allow for better posture and balance, if necessary.
Contact Lens Prescriptions
Some practitioners don't recommend contact lenses to anyone with autism spectrum disorder. This is where it’s important to not generalize and get to know each and every patient and their capabilities. Have conversations about responsibilities with the patient or their parent/guardian.
I immediately extend this option to patients depending on the level of responsibility I notice on examination. Always remember not to group your patients together, but look at your patient's needs on an individual basis. Just like any other patient, my first recommendation is always daily disposable lenses to maintain the health of the eye.
~ Dr. Amadian