Information for optometrists

Visual Anomalies and Dyslexia
DSA Briefing Paper

Introduction

People with learning difficulties associated with conditions such as dyslexia are predisposed to experience certain types of visual problem, and these may contribute to reading difficulty. The most common visual anomalies are:

Meares-Irlen Syndrome/Visual Stress, a condition helped by coloured filters/lenses

poor or unstable co-ordination of the two eyes (binocular instability)

a reduced ability to focus close to

The Institute offers a Full Colorimetry session for students to deal with these anomalies and determine their requirements for coloured lenses.

The Institute's Clinic

The Specific Learning Difficulties and Visual Stress Clinic manages visual problems associated with specific learning difficulties.¹

The Institute pioneered work in the field of visual anomalies and dyslexia and the Institute research and clinical teams have produced many peer-reviewed publications in this field.

As visual stress is more widely recognized nowadays, the clinic is increasingly receiving referrals of adult students who have already received a diagnosis of visual stress. The Institute has therefore established a special type of appointment, "DSA Full Colorimetry", for these students.

Guidance on what constitutes a diagnosis of visual stress is given in Appendix A.

¹ The clinic caters for patients who have specific learning difficulties, dyslexia, dyspraxia, ASD, and those who suffer from migraine, pattern glare, light sensitivity, flickering lights, Meares-Irlen Syndrome and Scotopic Sensitivity Syndrome.

DSA Full Colorimetry

This is a 1.5 hour appointment, which involves:

detailed symptomatology
confirmatory testing to validate the need for colorimetry (as required by the professional guidelines of the College of Optometrists)
assessing sensitivity to colour
testing with the Intuitive Colorimeter
testing with precision tinted lenses
checking of the benefit from precision tinted lenses

Guidance is also given on computer screen tinting, using a free screen tinting programme available for computer users (see Appendix A).

For most students who receive DSA Full Colorimetry testing only one appointment is required. On rare occasions other visual conditions may be detected which may require a follow-up appointment (for which the cost will not be eligible for DSA funding).

Fees

DSA Full Colorimetry

The costs involved are as follows:

Consultation Fee : £155
Coloured overlays, if required: £16
Specific Precision Tinted Spectacles : £170 upwards, as itemised below:
- Specific Precision Tinting and UV Coating: £90
- Non-Prescription or Prescription Single Vision Spectacle Lenses: approximately £50
- Spectacle Frames: ranging from £30 to £400

The funding required would therefore be in the region of £325 upwards.

Subsidies & funding for students

Students in Further or Higher Education may be eligible for financial support in different ways:

Through the Disabled Students Allowance (DSA), administered by Student Finance England or, in some cases by local education authorities, the NHS or the Open University.

Directly by the university or college attended.

In each case a needs assessment is required and a diagnosis of visual stress (see Appendix A).

Further information

Contact the Institute's Practice Manager at:
56-62 Newington Causeway, London SE1 6DS
Tel: 0207 7234 9641
Email:admin@ioo.org.uk
www.ioo.org.uk

Appendix A: Diagnostic signs of visual stress in adults

Visual stress is also known as pattern-related visual stress, Meares-Irlen Syndrome, Meares-Irlen syndrome/visual stress (MISViS), Irlen syndrome, or scotopic sensitivity syndrome (a misnomer).
The main diagnostic signs ofvisual stress are listed below. The best intervention for correcting visual stress is individually prescribed coloured lenses following testing with the MRC Intuitive Colorimeter. Higher education students with any of these diagnostic indicators would benefit from DSA Full Colorimetry.

1. The student has experienced a benefit from colour when reading

Most commonly, the person has tried a coloured overlay or coloured lenses and found these to be helpful.
Visual stress is also indicated by a benefit from changing the background colour of a computer monitor or from using a coloured light source. To maximise the chance of identifying visual stress, the colour should be selected from a wide range of colours in a systematic way. Software is freely available that can be used by students to investigate the effect of changing the background colour of computer monitors (www.thomson-software-solutions.com/screen_tinter.html).

2. Improvement in visual performance from colour. The person has been tested and has demonstrated significantly better performance with colour than without.

The tester may be a teacher, needs assessor, educational psychologist, special needs educator, optometrist, optician, or orthoptist.
The colour may be presented using a coloured overlay or coloured lenses, or changing the background colour on a computer monitor.
The test of visual performance that is most commonly used is the Wilkins Rate of Reading Test, but other tests (e.g., the DEM test) can demonstrate a similar effect

3. Positive response to the Lucid ViSS computer programme test.

4. Positive response to a Pattern Glare Test, typically the Wilkins and Evans Pattern Glare Test.

5. Classic symptoms of visual stress. This is the least convincing diagnostic indicator of visual stress because many of the symptoms of visual stress can be caused by other conditions in addition to visual stress. But experienced practitioners can recognise the classic symptoms of visual stress, which would be confirmed by colorimetry (including confirmatory tests).