Making light work for people living with Parkinson’s: the business (and human) case for reasonable adjustments
Close to home
I always thought of Parkinson’s disease as a condition of twilight years. But as two dear friends and colleagues come to terms with their diagnosis of Early Onset Parkinson’s Disease (or EOPD), the stats about the startling rise of this condition among younger adults feel very close to home – Global burden of early-onset Parkinson’s disease, 1990–2021: results from the Global Burden of Disease Study 2021.
Those affected by early-onset Parkinson’s are, in many cases, in the middle of their careers, their mortgages, and their most productive years. They are managers and mums, designers and dads. The case for supporting them to remain in meaningful work is not just about equity – although that’s reason enough. It is also grounded in solid evidence about how this basic everyday activity helps them stay healthier for longer – and stay financially independent too.
Why Staying in Work Matters: the Health and Economic Case
The Parkinson’s Outcomes Project, the largest-ever clinical study of the condition, found that depression and anxiety are the number one factors affecting overall health for people living with Parkinson’s. These symptoms are not just an understandable reaction to a devastating diagnosis. They’re also a result of the changes to the dopamine regulating pathways caused by the disease itself.
For many, these neurological changes are compounded by reduced confidence at work related to stigma and performance and insecurity about job retention, which are in turn associated with increased financial hardship and severity of symptoms. This study noted that, although they were within just five years of diagnosis of PD, subjects were experiencing the same level of medical financial toxicity (a combination of objective financial hardship and subjective emotional distress) as individuals living with advanced cancer – Financial hardship is associated with employment challenges and reduced quality of life in early Parkinson’s disease. The Michael J. Fox Foundation’s 2019 economic burden study noted that 37% of working age people with Parkinson’s retired early because of their diagnosis, leading to increased reliance on informal carers and a downward spiral of accelerated disease progression – Economic Burden and Future Impact of Parkinson’s Disease Final Report.
Against this backdrop, finding ways to support people living with condition to keep working as long as they wish to is a win-win – Meaningful Work, Well-Being, and Health: Enacting a Eudaimonic Vision.
The Business Case: The Purple Pound and the Value of Inclusion
For organisations trying to decide whether they can afford to invest in the reasonable adaptations required by law, the commercial incentive of the ‘Purple Pound’ — the spending power of disabled people and their households —might be worth a second look.
According to data collated by the disability inclusion organisation We Are Purple and referenced in a 2023 report to the House of Commons Women and Equalities Committee, the spending power of disabled households in the UK is estimated at £274 billion per year – Accessibility of products and services to disabled people. Research by Accenture published in 2023 and cited by Charity Digital found that businesses leading on disability inclusion generate 1.6 times more revenue and twice the economic profit of those that do not – GETTING TO EQUAL: THE DISABILITY INCLUSION ADVANTAGE.
In the tourism sector alone, VisitEngland has estimated the annual Purple Pound at £14.6 billion; disabled visitors tend to stay longer, spend more per trip, and exhibit higher loyalty to venues that meet their needs – Section 2: The benefits of providing an inclusive experience.
There is also the matter of brand loyalty and the extended network effect.
For a person diagnosed with Parkinson’s at 45, their partner, parents, adult children, colleagues and social circle will all form views about the employers and brands that either stood by them or quietly managed them out.
Mental health charity Scope’s research found that 75% of disabled people and their families have clicked or walked away from a UK business because of poor accessibility or customer service – Why is this research important to Business Disability Forum?
There is a third commercial argument, less often articulated but arguably the most powerful: people with lived experience of a health condition are uniquely positioned to ensure that products and services are genuinely useful to others who share that experience. An employee with Parkinson’s working in product development, patient communications, assistive technology, healthcare, financial services, or retail is not a liability to be accommodated — they are an asset with first-hand insight that no amount of research or consultancy can fully replicate.
The Legal Framework: What UK Employers Must Do
Under the Equality Act, employers are under a duty to make reasonable adjustments to remove disadvantages faced by a disabled employee – Reasonable adjustments for workers with disabilities or health conditions.
A growing number of successful employment tribunal claims for disability discrimination relating to Parkinson’s disease suggest that companies who fail to accommodate their needs run significant financial and reputational risk.
So what do ‘reasonable adjustments’ mean in practice?
The focus tends to fall on tremor, mobility, fatigue, and medication timing. These are all important. But the visual and lighting environment is a dimension that receives far less attention than the evidence warrants, and it can make a profound practical difference to the working day.
Parkinson’s disease causes changes throughout the visual system — from the retina to the cortex — and these changes are more prevalent and more functionally significant than is commonly appreciated.
A comprehensive 2020 study of 848 Parkinson’s patients published in Neurology found that 82% reported visual symptoms — more than double the rate in age-matched controls – Management of Visual Dysfunction in Patients with Parkinson’s Disease. A recent large-scale review of self-reported visual complaints noted significant issues for people living with Parkinson’s, including reduced contrast sensitivity, colour vision disturbances, impaired eye movements, altered depth perception, reduced ability to adjust to rapid changes in light, and slower visual processing speeds – Prevalence and nature of self-reported visual complaints in people with Parkinson’s disease—Outcome of the Screening Visual Complaints questionnaire.
Visual hallucinations, which are reported by approximately 30% of people with Parkinson’s and affect up to 60–80% over a lifetime according to a review in PMC, are strongly associated with poor lighting conditions. Research has consistently shown that they are more common and more intense in low-light environments and in high-glare situations – Visual dysfunction in Parkinson’s disease.
Practical Adjustments
- Bright, even, glare-free illumination will improve visual performance and comfort, while uneven lighting, especially dark spaces next to bright zones — place extra demands on the adaptation mechanisms that compromised in Parkinson’s disease.
- Avoid fast-changing visual stimuli such as animated screen content. Where possible, video content, animated interfaces or presentation formats should be configured with the option to pause or reduce motion.
- Natural light and circadian rhythm considerations. The disease compromises the pathways that signal from the eye to the central body clock, with one recent study noting almost three-quarters of people living with the condition suffer from sleep disorders – Sleep disorders in Parkinson’s disease, an early and multiple problem.
- Access to natural daylight during the working day, and avoidance of high-intensity blue-spectrum lighting in the late afternoon, may support better sleep quality and mood regulation. Flexible working arrangements can also allow employees to schedule their most demanding cognitive tasks during medication ‘on’ periods when function is at its best.
Beyond Adjustment: Towards a New Model of Working
The Parkinson’s UK 2025 prevalence study flagged that around 20,000 people in the UK are currently waiting for a Parkinson’s diagnosis — and that the fall in diagnosis rates following the pandemic has not recovered to pre-2020 levels – Parkinson’s prevalence in the UK.
This means that in workplaces across the country, there are thousands of people whose difficulties remain unexplained and unaddressed because they have not yet received a formal diagnosis.
The workforce of 2026 and beyond will include more people with this diagnosis than at any previous point in history. The question is not whether employers need to respond to this reality, but whether they will do so wisely and willingly — or reluctantly and belatedly.
Those who proactively invest in co-designed accessible environments and flexible cultures will not only fulfil their legal obligations, they will attract and retain people with extraordinary resilience, adaptability, and lived experience. And they will build successful, human-centred businesses that stand the test of time.
Your Brain on the Blink
I love cycling, but I avoid wearing sunglasses while I ride when I can – I don’t like the feeling of plastic on my skin, the way the lenses flatten and filter the colours and the clutter and confusion in my peripheral vision.
The downside is getting flies in my eyes.
But I’m always amazed how I manage to blink before the unhappy creature crashes into my cornea – and long before my sluggish brain saw it coming.
That’s my trigeminal nerve doing its job – The blink reflex and its modulation – Part 1: Physiological mechanisms.
The defensive blink reflex bypasses the visual cortex entirely, routing threat signals through a subcortical pathway that triggers a protective blink in as little as 10 milliseconds (the eyelid itself slams shut at a speed of up to 50cm/second!) – High-Speed Imaging of Eyelid Blinking Motion using Digital Image Correlation — well ahead of the ~40 – 100ms it takes for you to become ‘consciously’ aware of a visual event. The blink reflex is a sign that your central nervous system is taking the strain behind the scenes so you can enjoy the ride – Usefulness of the Blink Reflex in Diagnosing Isolated Infraorbital Neuropathy following Midface Augmentation with AlloPlastic Facial Implants: A Case Report. You are, quite literally, reacting to something you haven’t seen yet – Subjective and objective measures of visual awareness converge.
So what’s that got to do with the lights?
If your visual systems can detect and respond to stimuli at around 10 milliseconds (or 100 Hz), then it’s not surprising that LEDs that flicker (or Temporal Light Modulation/TLM) at these speeds trigger a neural response, even when we aren’t consciously aware of it. This recent paper confirms that TLM at 100Hz does indeed activate the visual cortex – Temporal Light Modulation Activation in Visual Cortex – A 7T fMRI Study on Healthy Subjects. That translates into measurable differences in visual comfort and performance, as this excellent review explains – Flicker: A review of temporal light modulation stimulus, responses, and measures.
But as this piece from MIT points out, ‘gamma frequency’ light pulses (or sound or transcranial stimulation) at 40hz might be just the gentle workout your brain needs to keep the wheels turning, improving synaptic health and even slowing the development of degenerative diseases such as Alzheimers and Parkinson’s disease – Evidence that 40Hz gamma stimulation promotes brain health is expanding.
So next time you find yourself irritated, blinking away a gnat, take a moment to thank your trigeminal nerve for keeping your eyes on the road.