Understanding Eye Care Access for Autistic Adults and Families: A Convergent Mixed-Methods Study

Autistic people face persistent barriers to accessing healthcare, yet little is known about their experiences receiving eye care, despite elevated rates of vision conditions. This convergent mixed-methods study explored the eye care experiences of 127 autistic adults and 69 parents of autistic children living in Australia and Aotearoa New Zealand. Through an online survey incorporating both structured and open-ended items, we examined access patterns, perceived barriers and enablers, and unmet needs. Quantitative data revealed widespread challenges, including sensory discomfort, communication difficulties, and financial costs, while qualitative responses foregrounded how provider interaction, clinical pacing, and environmental conditions shaped overall experience. Although participants valued clearer communication and sensory-informed adjustments, these were described as insufficient in the face of structural barriers such as affordability and inaccessible service locations. These findings align with emerging models of autism-informed healthcare that advocate for systemic, rather than ad hoc, approaches to accessibility. Our results underscore the need for proactive, cross-sector solutions developed in partnership with autistic people, which embed neurodiversity-affirming principles into eye care design, delivery, and policy. Addressing these inequities is both an ethical and practical imperative if we are to ensure that eye care services are inclusive, sustainable, and responsive to diverse ways of being.