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mumble_rocks

Eye Tests!

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Hi,

 

I haven't been on here is soo long and as a result was reluctant to post!

 

I need to advice- I am living away from home, living where I work and have a few very close friends. I am waiting to book an eye test as its been 4 years and my vision is getting worse! However I know the reson its been 4 years, eye tests and me dont really go hand in hand! One of my closest friends very understanding has already spoke to the optiiton and said that I have aspergers syndrome and they said no problem. My friend is going to come with me, but what I do or suggest that will make the visit as pain free for myslef as well as my friend and option any ideas please!!!

 

Thanks!

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Hi, welcome back >:D<<'>

I had an eye test just yesterday - I'm NT & I struggled with how very, very close the (rather attractive) young optician had to get (and I also realised, far too late, that wearing a low cut top probably wasn't one of my better ideas :lol: ) - is that the kind of thing you mean? (the closeness, not the low cut top)

 

Might be worth your friend explaining to him & asking him to tell you in advance what he is about to do & give you a little while to acclimatise - I'm sure Ian Jordan will be along with something more helpful.

 

Good luck :thumbs:

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Please I really need some advice, I am sooo nervous and the appointment is on Friday! My concerns are that I am not going to be able to communicate the issues I am experiencing in the optitcions and what if I pass the test but I know I cant see!!! (Is that possible!) I am soooooo unsure about this that part of me is remembering why it has been 4 yrs since going to them!

 

Any ideas!?

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Hi Mumble rocks,

 

Can you sit down with your friend and go through different things that you're experiencing and they write them down for you before you go - i.e. is your friend good at coaxing out and explaining what you mean - I guess this is a little bit like what I have to do with my daughter I try to think of lots of questions associated with her problem to try and get specific answers (if you know what I mean).

 

Hope this makes sense - I'm sure you'll be ok.

Take care,

Jb

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I would do what Jb suggested too, write it all down. You could make numbered list. Give the list to the optition and say this is what is going on or say I'm so nervous that I can't speek, or read this and shove the list at him/her. Don't worry what they think, they don't know you and you don't know them and you probably won't see them for another 4 years - if ever so you could even do the can can in front of them and it will make do difference in the long run.

 

I had a very important meeting recently to do with my son and I was so scared I would waffle on about unrelated things or get stuck on one small point that I wrote a bullet pointed list and just gave it to the lady involved and told her I would probably forget what I was supposed to be saying so please read this and ask me questions. I was fine with this prop and actually felt confident and didn't forget what I was there for which is rare, it was almost as if writing it down meant I had already told her what I wanted to say - does that sound odd?

 

Hope this helps

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Mumble one thing you dont have to worry about is passing an eye test if you cant see. There will be questions you simply couldnt answer if you cant see correctly.

 

I know that in a Dr's they are aware of certain phobias and are able to deal with any they encounter (i.e needlephobia) as necessary but i'm not sure if the same accounts for Optitians? I'm sure there is someone there that will be in a position to put you at ease.

 

Perhaps telephoning the Optitians to explain the situation and ask for a call back from the actual person doing your eye test may be of some use? If they are aware before you get there they may be able to ease things.

 

Firstly maybe by limiting your waiting time, perhaps they have another room you can wait in that is away from others?

 

Its just a guess as i'm not sure what exactly it is that makes you personally nervous.

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As an optician it may interest you to know that most optical professionals have little or no training in ASD or the potential problems that can be experienced.

There are a lot of things that may be necessary as adjustments to the "normal" eye test. In children for instance "recommended practice" will often include using eye drugs during the eye test. This can be abusive in ASD (and is rarely necessary).

 

There are simple questions to ask the optometrist to detemine whether they would be sympathic and empathetic to ASD e.g.

 

1 How do you deal with prosopagnosia and metamorphopsia? (simply put - facial recognition and distortion)

2 How do you deal with sensory integration and processing problems?

3 How long does your eye examination take for a person with ASD?

 

Most people on the spectrum have significant visual processing problems - a simple eye test will not address them in any way - and consequently you should understand that most eye tests are of limited use in visual problems in ASD.

 

Choose VERY carefully - If they say they understand - ask"how will you deal with echolalia in the eye test?" Important in ASD (even if not for you or your child) and anyone with knowledge should be able to answer these questions without thinking. If they can,t answer even these simple questions - walk away.

 

The differences can be massive! There are some excellent people around - but very few nationally that have the instrumentation and training necessary to address all the likely problems in ASD.

 

Oh - its not an eye test (what you say does not concern the optician - don't worry about being "wrong" - it really won't matter, if the you give inconsistant answers they can be dealt with easily - if necessary it is possible to test the refraction (strength of lenses) and make sure the eyes are healthy) in the noncooperative, or non verbal) It is even possible to get a fair idea of visual processing problems in these cases - but most optical professionals would not be able to do this.

 

Hope this helps

Edited by Ian Jordan

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I'm sorry, Ian, but I am also an Optometrist and I'm getting increasingly annoyed at some of your comments regarding care of patients. To say that the use of eye drops is rarely necessary and to insinuate that their use is abusive is very insulting, and entirely untrue. I, and most practitioners I know, would never ever do anything to a patient without their co-operation or without a need for that action. Neither is it the case that we "often" use eye drops in children. We use them if, and when, the situation calls for their use. ....In hospital practice I used them more often, in high street practice, very rarely....all due to the types of patients and conditions I was dealing with.

 

Most of us would, honestly, answer your first 2 questions by saying that it is not their field of expertise. Please stop putting us down over this. If I went to my GP with something which was outside his experience I would be pleased to be referred on by him, I would not consider him inferior because he was not a specialist. Most Optometrists are "general practitioners" too. Referral by your own Optometrist to a specialist in visual processing is a far better way to go than walking out of the shop. ....Isnt it better to work together??

 

The answer to your third question is easy........An examination takes as long as that person requires. I dont chuck people out after 20 minutes just cos their time is up!!

 

I agree absolutely that a standard NHS eye test is of limited help in dealing with particular processing problems in people with ASD's (I do have one, remember) but that is not its purpose, and neither is that the Optometrist's fault. It is, however, a good starting point.

 

Pippin climbs down off her high horse and goes to drink her milk!!

 

 

 

 

 

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As an optician it may interest you to know that most optical professionals have little or no training in ASD or the potential problems that can be experienced.

 

 

There are simple questions to ask the optometrist to detemine whether they would be sympathic and empathetic to ASD e.g.

 

 

Ian I dont think for one minute that knowledge in something is what holds people back from being sympathetic people or not. What holds people back is their 'Will' to learn. If they think they know everything but know nothing they are of far less use than someone that knows nothing but is prepared to listen & learn.

 

I dont think asking questions like that will help anyone.

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In children for instance "recommended practice" will often include using eye drugs during the eye test. This can be abusive in ASD.

I have had regular eye tests since the age of six and never had any eye drugs :unsure:

I don't think this is part of a standard eye test, and I don't think that scaring people by telling them that they are going to be forcibly drugged at the opticians is terribly helpful.

I think that most children would object to being given any kind of eye drops, not just ASD children. I can't imagine many professionals forcibly give unnecessary eye drops.

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My youngest had eye drops at the age of 3, they were to dilate the pupils....but then again, I had taken him to get his eyes tested because of his headaches. The optician wanted to be as thorough in ruling out nasty possible causes for the headaches as he could be. (Turned out to be migraines at 3- I was speechless....for once!)

I've had iodiney type drops once, and dilatingy drops another time, but they were necessary for checking out possible damage.

Must admit, I get a bit uncomfy when the optician gets right up close too, but so did my Mum. She used to hold my hand at this point...she had slight tendencies towards claustrophobia, and this helped her to stay calm. Me, I'm just fretting that I might have stinky breath and gas the poor fella....or that HE might have bad breath and gas me!!! :sick:

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I have had regular eye tests since the age of six and never had any eye drugs :unsure:

I don't think this is part of a standard eye test, and I don't think that scaring people by telling them that they are going to be forcibly drugged at the opticians is terribly helpful.

I think that most children would object to being given any kind of eye drops, not just ASD children. I can't imagine many professionals forcibly give unnecessary eye drops.

 

There seems to be a lot being said about what may or may not be included in a eye test.

 

As for eye drops the last time I had my eyes tested eye drops were used, was told by optician that it was now standard practise for that part of the test, a new way of doing it, couldn't now tell you which part it was other than at the end.

 

As for my son who has ASD the optician could do what he likes and my son just sits there and doesn't give a fig. Same with the dentist, doctor, but it I as much as get the comb out he runs a mile.

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To say that the use of eye drops is rarely necessary and to insinuate that their use is abusive is very insulting, and entirely untrue. I, and most practitioners I know, would never ever do anything to a patient without their co-operation or without a need for that action. Neither is it the case that we "often" use eye drops in children.

 

Eye drops in ASD

 

Children on the spectrum often present with symptoms that are "difficult" and would in normal development children indicate the need for dilation / cycloplegia. However, these symptoms are often indicative of sensory processing problems in ASD. Sensory problems that can mimic normal optometric difficulties are common and need to be differentiated. The 1st problem is therefore a recognition of application problem (particularly in binocular vision anomalies). The need to consider non standard causes for visual symptoms is particularly important in ASD as drug reactions can be abnormal, the effects of the drug may be considerably different, pain may be intense and persistent. This persistence is common and can last days, be referred (pain may appear in a different part of the body), or be time delayed (or a combination). There always has to be a balance of when drug instillation is critical (and sometimes it is essential - regardless of discomfort / pain / side effects) - but unless the optometrist has knowledge of ASD sensory problems, they are likely to treat children on the spectrum in the same way as NT children.

 

Most of us would, honestly, answer your first 2 questions by saying that it is not their field of expertise. Please stop putting us down over this. If I went to my GP with something which was outside his experience I would be pleased to be referred on by him, I would not consider him inferior because he was not a specialist. Most Optometrists are "general practitioners" too. Referral by your own Optometrist to a specialist in visual processing is a far better way to go than walking out of the shop. ....Isnt it better to work together??

 

Yes - of course its better to work together- but the public expect when they go to an optometrist that they do exactly what you've said - that they know the limits of their expertise, and then refer (but who to?) - and that the optometrist is trained to recognise when a problem could be a processing difficulty, whether there is a cross sensory problem involving vision / visual processing.

 

The answer to your third question is easy........An examination takes as long as that person requires.

 

Should a person on the spectrum expect that the optometrist has sufficient time in the eye test (assuming sufficient training and instrumentation etc) to determine which factors are contributing to visual and other sensory processing problems caused by the visual system. Should an optometrist be expected to ask the right questions of the child (where possible), the parent - to analyse an act on the results? A standard history and symptoms will inevitably miss many of the problems experienced by someone on the spectrum. The public however, expects the optometrist to be knowledgable and take appropriate action to determine whether a problem is present. Standard eye examinations cannot possibly do this for a high proportion on the spectrum, and it is extremely rare that the optometrist advises appropriate extra testing.

 

I agree absolutely that a standard NHS eye test is of limited help in dealing with particular processing problems in people with ASD's (I do have one, remember) but that is not its purpose, and neither is that the Optometrist's fault. It is, however, a good starting point.

 

If an optometrist can recognise visual processing problems and their comorbidities - I agree without reservation that a standard eye test is the best starting point. But is this really the case for the majority of optometrists?

I suspect that what we would both agree to is optometrists training taking into account ASD - and because of ASD being a hetergenous group - to be trained to determine optimum interventions - perhaps in the future?

 

But until then - is the present system acceptable to the parents of those children on the spectrum? - what percentage of children on the spectrum get optimum visual assessments (including visual processing)? - should optometrists tell parents of children with ASD to check visual (and other sensory ) processing - perhaps we need to get all ASD children to have both a straightforward eye exam + a visual and other sensory processing test as standard. In this economic climate I suspect that those on the spectrum will have a long wait.

 

And because I consider the visual processing problems experienced by those on the spectrum to be more common and more often mush more profound than refractive difficulties - I must question whether it is not essentail that parents are aware that it is unlikely that it is even considered as a difficulty in the eye test - surely that is of critical importance - and that therefore they should know how to find an appropraiye practice.

 

The question is therefore

 

How does a parent choose a good optical practice for a child on the spectrum - from high functioning to non verbal / non cooperative?

What questions should they ask? What criteria should be considered?

All practices are not the same - and recommendation should be based on knowledge - how would you recommend?

 

 

 

 

 

Pippin climbs down off her high horse and goes to drink her milk!!
Edited by Kathryn
to fix quotes

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Ian would it be possible for you to edit your post & make it easier to read. Its difficult to figure out which bits are yours and which bits arent since it all came out as a quote :blink:

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The question is therefore

 

How does a parent choose a good optical practice for a child on the spectrum - from high functioning to non verbal / non cooperative?

What questions should they ask? What criteria should be considered?

All practices are not the same - and recommendation should be based on knowledge - how would you recommend?

 

I don't think that is the question at all. The OP has already selected her optician and booked the appointment. mumble_rocks is quite clear about the advice she would like.

I am living away from home, living where I work. My friend is going to come with me, but what I do or suggest that will make the visit as pain free for myself as well as my friend and option any ideas please!!!

 

As an adult, mumble_rocks is not going to be forcibly medicated at the opticians without her consent . . . which kind of takes the force out of it. Why do you think that going on and on about being forcibly given painful eye drops is helpful advice for a person who is nervous about her opticians appointment?

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T has had eye drops a few times in the last few months, she didn't find having the drops painful, it's the effect after they are put in your eyes, she became senitive to bright light/day light etc.. found it easier to go to bed when we got back from the hospital and just close and rest her eyes and after a few hour's she felt ok. Hope it goes well for you Mumble_Rocks.

 

Teresa :)

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Um....well it went kinda okish!

 

Went in saw receptionist and she was very helpful, then I saw on guy who checked for colour blindness and asked me to put on these 3d glasses (one red one green lens and look at a book, I couldnt see anything!) then there was the accusal eye test! She spoke to me like I was 5, didn't explain anything she was going to do, told my friend not to talk when my friend tried to explain not touching and the rest, claimed she has many yrs of working with SN but failed me badly to the extent, she started of with a slit lamp test, which was a complete sensory overload which aborted the whole appointment instead going to Boots on Friday with the same friend and she has already spoken to the lady who's assessing me!

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the bit i struggle with is the 'which is clearer' bit. i can never remember from one picture to the next, then feel bad for asking to go back and forth until i can work it out.

in my experience, just take your time and be honest. if you dont understand say so. you cant really fake it because your answers would be inconsistant.

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instead going to Boots on Friday with the same friend and she has already spoken to the lady who's assessing me!

Hi MR (this is going to get confusing with too many Mumbles!! :unsure: (double vision, (un)clearly B) B) ),

 

I was wondering how your second attempt at an eye test had gone - I hope it went well. I had my eye test yesterday. It happened rather quickly as I saw my GP and she sent me straight for an urgent eye test so I didn't have time to think/worry about it but I thought my experience might help/reassure you and others.

 

I was quite worried going for the test, particularly as I was aware my eyes were pretty bad and the symptoms needed checking out. Also I have all the sensory issues you mentioned - difficulty with touch and particularly light sensitivity - not good when they shine a bright torch in your eye and ask you to look at it!

 

Anyway, it went well :thumbs: I told the ophthalmologist at the outset about my ASD and what the issues might be with this. No, she didn't have experience/training but she was more than willing to ask questions, talk to me about it and learn. She had to learn quickly as the second test she did involved puffs of air in my eyes (can't remember the technical term!) and I literally jumped out of the seat (very sore when your head is against a metal headrest! :oops:) but she then really explained everything carefully and I felt completely at ease. With the torch in the eyes thing it was very clear by the way my eyes reacted that I'm extremely sensitive to light at a scale well above the norm - now she was surprised by this but worked with it, doing what she could with a dimmer light :thumbs: She kept asking if I was in any pain and reminding me I could stop at any time.

 

With the history she was incredibly thorough - not just the typical history but wanted details on possible ASD issues, and she did know about some of these whether or not she knew about them being related to Autism - she knew for instance about prosopagnosia. I'd quickly printed a list of symptoms along with my medical history and medical details to take with me and this was really helpful to both of us as I wasn't worried about remembering/forgetting any details and she had a structure to ask from.

 

As an optician it may interest you to know that most optical professionals have little or no training in ASD or the potential problems that can be experienced.

I'm not sure this is a problem. I think someone made a comparison with GPs and I think that sensible. Maybe ASD optical specialists should be just that and specialise, leaving the GP-ness side to the general ophthalmologist (so like a GP/consultant hierarchy and referral system). It would mean everyone at the basic (high street optician) level could receive the same standard of diagnostic tests - I have to say I've been surprised by how different the tests available/offered in different places are as I had a really thorough eye-health exam today (with the results explained visually and verbally :thumbs:) which I've not had before. If there was that specialism it would make roles more distinct perhaps.

 

Most people on the spectrum have significant visual processing problems - a simple eye test will not address them in any way - and consequently you should understand that most eye tests are of limited use in visual problems in ASD.

But to add to the above, do you not need the baseline, i.e. the basics covered first. If you can't actually see because your eye-health is poor or your prescription needs changing, then something tinted on top of that to address the processing side won't help. I guess it's a case of which do you sort first - I'm no expect though.

 

There are some excellent people around - but very few nationally that have the instrumentation and training necessary to address all the likely problems in ASD.

Surely a reason to have generalists and specialists if the equipment would be too expensive/a waste of resources to have everywhere. In the same way I would expect my GP to refer me to an appropriate specialist/hospital department rather than expecting the GP to have every scanner, probe, camera, and diagnostic tool in their little room. Wouldn't be much room left for the doctor!

 

The answer to your third question is easy........An examination takes as long as that person requires. I dont chuck people out after 20 minutes just cos their time is up!!

I thought this was an important point, because I know some things can take me more time than they do for other people. Whenever I see my GP for instance I always have a double appointment and the practice manager has agreed to this because it can take me longer to process/understand. It means I'm not rushed/stressed, the GP doesn't get behind and everyone is happy. I was worried having read the 20 minutes thing on here, but I shouldn't have been. I was there just over two hours! Don't worry, this isn't normal as I had specific issues they wanted to look at closely and the optician I saw wanted her colleague to take a look for a second opinion, plus she re-did some of the tests as I had high readings. But what it does show is that, where necessary, the time is there. Thank goodness it's a flat rate and they don't charge by the hour!!

 

Yes - of course its better to work together- but the public expect when they go to an optometrist that they do exactly what you've said - that they know the limits of their expertise, and then refer (but who to?) - and that the optometrist is trained to recognise when a problem could be a processing difficulty, whether there is a cross sensory problem involving vision / visual processing.

I'm not so sure. How many members of the public know about these issues themselves? People who do know will have done some research, will probably have a close link to autism, and will be in a position to get a referral to a specialist. I certainly didn't know all the things the optician was testing me for today (and I have more knowledge than others with my family history) so I couldn't expect her to have knowledge of things I didn't know about.

 

 

Sorry MR, I've rambled on a bit - it's late night ramblings as I'm clearly not doing sleep tonight. I hope you did get on OK and that if not there's something above to reassure you. I have to say I've been really impressed (I don't think my bank manager will be at the new designer frames I've chosen!! :whistle: but they look groovy B)) and I've come away feeling a lot better. They were able to identify issues, take into account my needs and I'm also aware of issues to be on the look out for that could indicate the problem is getting worse. Hey, they even got the phone thing when they said they'd call to let me know they were ready!! :notworthy:

 

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Hello - If you haven't had the eye test yet, can I make a suggestion?

 

Is it possible for your friend to have his/her eyes tested first, with you watching what goes on ?

 

That way you can "see" (excuse pun) what goes on, rather than trying to imagine what might, or might not happen.

 

Carol

 

 

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