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please remember if you have ADHD or autism and migraines: talk to your optometrist about your eye exam! get it done with your eyes dilated! learn to relax the muscles in your face! if you feel like you try to “win” your eye exam your prescription could be wrong!

Andrew Ducker @andrewducker.bsky.social

A Constellation of Chronic Medical Conditions Commonly Seen in Autistic & ADHD Adults

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I got absolutely read for filth at my last eye exam by the doctor who had met me for all of five minutes “You’ve needed these for decades and you’ve been working way too hard to overcompensate your whole life. You can’t do that forever and you need to learn how to accept help” MA’AM! RUDE

Wait, why should I get my pupils dilated before the exam? Will that help me tell which is better, #1 or #2? Because I'm good at not trying to "win" (ADHD but I've had glasses since I was 3, so I learned not to do that early), but my perception of which is better changes sometimes moment to moment.

Meanwhile, I have the opposite issue: the eye chart is backlit and I get afterimages from it super quickly, making it blurrier. And then my prescription ends up too strong. Which is also a migraine trigger.

i can confirm that trying to "win" my eye exam (aka: "do the best job i could") hurt me. on reflection… obvious. generally when a dr asks you to do something to test something, you ought to do it to the best of your ability, to showcase what your limit is. but not for eyes

I've lost count of how many eye exams i've had the years (worn glasses since 1987) but I still have to tell myself before I go in not to guess the letter enough if I know what they are by the blurry shape

to explain a bit: when you try to win, you are squinting without realizing it, or using context clues, it leads to your Rx being weaker than it needs to be to correct your vision most of us have been squinting so long we don’t realize we are doing it, causing tension to build in the face/jaw/neck

this can lead to a domino effect of migraines, binocular vision disorder (which can cause vertigo/nausea), TMJ, or chronic pain issues once i got my Rx fixed (and got prisms) nearly all of my migraines went away instantly (except hormonal/barometric pressure ones, the bastards)

fyi binocular vision disorder is a physical difference between eyes that usually is lifelong. you can't make it worse unless you do weird stuff to only one eye. just sometimes the brain can compensate until it can't. you need glasses to correct it.

Hmm no one ever diagnosed me with binocular vision disorder but I do have that bc TBI/double vision. Always wondered if my ADHD didn't help anything in the healing process so that all tracks as well- thanks for the new term

I have EDS. I realized I developed an _internal_ squint by using my palatal muscles to focus my eyes when I was a toddler. I had chicken pox scarring below one eyeball screwed up the muscle balance. They didn't correct my myopia/astigmatism till I was six (because 1960s...). 🙄 New glasses yearly.

Shingles, same nerve as the chicken pox scar (eyelid, missed the eye) Visual pathways are off. Teeth are screwed up. Migraine, TMJ, vestibular malfunction, messed up binaural fusion, retinal bleed from rotational stress...

Well this makes sense! Every time I go I get told I have really thick/healthy optic nerves which feels like a 'win' condition in and of itself but I didn't realise I was squinting during the exams til reading this...oops.

i love saying “win your eye exam” to neurodivergent people and they all know what i mean while neurotypicals are like “why would you try to win? it is an exam to help you!”

i spent a long while doing therapy to correct my lazy eye and i think i would have had a lot easier time if i was just doing what they asked me to do instead of trying to figure out what the correct answer was but i think i would’ve needed normal therapy to figure that out

this thread is old but I need to share that my neuropsych started visibly laughing and had to cover his mouth and leave the room real fast when I started doing the directions/practice stage of the click/don’t click test bc my finger was uncontrollably impulsively clicking already

me: ok I may not show up as ADHD because I get really locked in and competitive with tests sometimes, like I just get obsessed. unless it's a boring test. therapist: yes I know, that is why I'm making you take this test, bree 😭

I love this thread. You are my people. A really cool eye doc once told me that when I went to grad school my nearsightedness would get worse, then better once I wasn't reading as much. She also said nearsighted eyes are greedy, and so tend to ask for the stronger lens on comparisons.

I went for a neuropsych. To unmask, I stayed up really late and had a fasting blood draw first thing; showed up tired, fretful, & they put memory and IQ tests in front of me. Somehow I did too well on the spacebar test. Flubbed IQ, then failed to show ADHD. Double facepalm.

I was going to say this is one thing I haven’t done because my eyes aren’t even that bad but no I have totally tried to win my eye exam before

this list mentions migraines but my glasses prescription turned out to be the cause of 80% of my migraines binocular vision disorder was mimicking vestibular migraines, causing vertigo and nausea

oh shit that makes sense. the number of migraines I get went down significantly after I got LASIK. I didn't realize the connection until now

sounds like when I started getting massive headaches when i was 15. all kinds of neurology stuff, an MRI, no obvious cause. then some nurse looking at my chart asked when the eye exam had been. uh, never? i had extremely good vision?? (it was astigmatism, lol, and looking at the board in school)

damn. yeah. after I got the eye surgery it took me like 3 months to retrain my eyes to not be pulling really hard on the lens all day. literally felt like eye workouts. they had me go outside and look at the horizon and then the ground over and over for like 15 minutes a few times a day

I got special lenses for BVD and my migraines went away completely! I was having them daily. I was also getting motion sick from first person video games and thats gone too

I learned this the autistic way in 7th grade - i had a math class with assigned seats, and some kid in the class made fun of me squinting all the time. Once he did that, I was like "oh damn I do squint; and in all my other classes I sit up front so I can see." Also fuck that kid, he was an asshole.

I find eye exams SO HARD. I don't mean to cheat, really. But... I can't *see* that it's a letter M but I can tell it has to be an M because of the width and where the white space is.

But I CAN read it!! Just like I can make out the text on all those road signs and billboards using context clues plus word length and word shape! I'm trying to get better about saying "it's fuzzy," at least.

...But surely a well-designed test would take into account the fact that people will try their best and remove as much ambiguity as possible! I think, having forgotten every other medical assessment I have ever had.

Wait, what? Not everyone tries to win the exam? I feel like I look bad if I can't read it......Huh.....HUH............. A lot to think about here.

A big problem I always have isn't necessarily the "winning" aspect, but I end up reading the lines and inexplicably memorizing them so when I switch eyes I have to consciously remember to read what I'm actively seeing and not just rattle off what I consciously know is there