“There is not a one-size-fits-all sight test”

Optometrist Kiran Sangha works part-time for Vision Express in Ayr on the west coast of Scotland.

Sangha, whose three sons have autism, has gained a reputation locally for providing quality eye care to neurodiverse patients.

She talks to OT about how her own experience as a parent has informed the care she provides to patients.

Can you tell me about your sons?

I have three boys – an eight-year-old and seven-year-old twins. When lockdown hit, the children were at home, and I was able to build a structured routine for them. There wasn’t that expectation of having to interact with other people. We would wake up, go for a walk, do some crafting. There was a lot of structure. I noticed a change in them. It made me think that there was something more going on here.

The twins were diagnosed with autism in 2021 and my eldest son received the same diagnosis last summer. We talk about neurodiversity quite openly in our house. The children know they have autism and they talk about it.

What do you consider when taking your own children for a sight test?

The first consideration is, how easy is it to make an appointment? Is the appointment going to be long enough to accommodate my child’s needs? Is there flexibility involved – could it be a longer or shorter appointment? Are we going to be able to arrange a pre-visit to familiarise ourselves with the practice?

The next thing is staff awareness – how disability-aware is the practice? Is my child going to treated with compassion and understanding? Will the practice be accommodating and put reasonable adjustments in place for my child? The sight test is an incredibly sensory experience – if you have sensory differences, that can be a challenge within itself.

What guidance would you give to optometrists about providing care to neurodiverse patients?

It is important to know that there is not a one-size-fits-all sight test. Every patient is going to present with a unique set of circumstances so you have got to be prepared to streamline your sight test, modify the patient journey, and make adaptations.

Find out as much as you can about the patient before the appointment. What is their preferred method or style of communication? Do they have any sensitivities that you should be aware of? What are their interests and how could these interests be incorporated into the sight test to enable them to feel a bit more comfortable? It is quite good to have a phone call with the parent or the carer before the appointment to touch base and introduce yourself.

The greatest reasonable adjustment is the adjustment of mindset

Inviting the patient in for a pre-visit is always good. I tend to walk them through the customer journey and show them which order they will be doing things in. On the day I tend to avoid a busy time so there are not too many sensory distractions in place. I try to maintain consistency, making sure I am there to greet the patient. I will take them through the whole customer journey rather than swapping between different members of staff.

Why do you believe it is important for practices to be accessible to neurodiverse patients?

Good vision is life-changing. If a child is unable to access eye care, it can affect their education, their attainment, their confidence and even their mental wellbeing. I think everyone deserves an equal start in life. If I can create that positive experience for that child, it is going to affect their perception of accessing other healthcare appointments.

Being able to reach these people it makes your job more fulfilling. It can be mundane doing the same thing over and over again, but when you do something like this, it is very rewarding.

What advice would you give to practice staff?

The greatest reasonable adjustment is the adjustment of mindset. It is making sure that your staff are aware of these issues. I would advise staff to take a walk through their practice with a hypersensitive lens on. What do you see? What do you hear? What do you feel? Keep the practice clutter free, limit background noise and look at your waiting room – is there a quieter space in there? Can you offer a more private room?

As a parent with children who have additional needs, it is very difficult and it is not an easy journey. If you can offer an inclusive environment, it makes a difference – not only to the child, but to the family as well.