A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress)

Spectrum mapping technology based creation of a color-contrast reading environment to reach comfort and clarity

Reading with a bit of yellowish or greenish paper, as compared to white paper, is thought to be more comfortable and friendly, and can help decrease eye fatigue to some degree. In this work, we try to map the light of different colors on a given paper within a region of interest to alter the colors presented by the paper and consequently influence the reading experience. We conducted an ergonomic experiment to study the comfort and clarity under consistent illuminance levels. We adopted 6 color series(red, yellow, green, cyan, blue, and magenta), 5 chroma levels(0, 10, 20, 30, 40), and 4 types of paper with the same hue(yellow) but different lightness(the white, light yellow, yellow, and dark yellow), and conducted pairwise selection experiments within each light color series. Results show that white and low chroma (≈10) color characteristics contribute to comfort, while higher chroma blue(30∼40) color benefits clarity. Referring to white, low chroma greenish and yellowish color characteristics are preferred in terms of comfort and clarity. This work proposes the spectrum mapping technology to endow the paper with new color effects and verifies that although spectrum compositions might differ, people's preferences and comfort perception are consistent with the same object color.

Is reading rate in digital eyestrain influenced by binocular and accommodative anomalies?

INTRODUCTION

Symptoms experienced when using digital devices are known as digital eyestrain (DES) or computer vision syndrome. They can be categorised as either external (associated with dry eye) or internal (related to refractive, accommodative or binocular vision anomalies). In a large cohort of adults with DES, we investigate the prevalence of binocular and accommodative anomalies, contrasting different diagnostic approaches, to evaluate potential mechanisms for the benefit from +0.75D addition lens that has been previously reported.

METHODS

Participants (20-40y) were selected using the Computer Vision Syndrome Questionnaire (CVS-Q) tool as suffering with DES. A comprehensive eye examination was given to each participant, and this paper concentrates on "internal factors", detected with a refraction and comprehensive testing of binocular and accommodative functions. The effects of low-powered addition lenses (+0.50D, +0.75D, +1.25D; and plano controls) were assessed by double-masked testing with the Wilkins Rate of Reading Test (WRRT) and by subjective preference.

RESULTS

As previously reported, most participants showed a subjective preference for one of the three convex lenses we used, with +0.75D chosen most frequently. Performance at the WRRT was significantly improved with +0.50D and +0.75D, but not +1.25D. Using a variety of diagnostic criteria, there were no strong associations between WRRT results or CVS-Q scores and any binocular or accommodation functions. The one finding of significance is that a disproportionate number of participants who benefited from adds had an eso-fixation disparity on the near Mallett unit, although this only affected 5% of the population.

CONCLUSIONS

DES is a collection of diverse symptoms that have a multifactorial aetiology. In the sample described here, binocular and accommodative anomalies do not seem to be a major cause of DES. Nevertheless, in view of the multifactorial aetiology it is recommended that patients with the symptoms of DES are assessed with a comprehensive eye examination. Patients with an esophoric fixation disparity on the near Mallett unit are particularly likely to benefit from near additions.

An investigation of low power convex lenses (adds) for eyestrain in the digital age (CLEDA)

INTRODUCTION

Digital eye strain (DES; computer vision syndrome) is a common cause of symptoms when viewing digital devices. Low-powered convex lenses (adds) have been recommended for the condition and "accommodative support" designs developed on this premise. The present research reports the extent to which dry eye is present in this population and the effect of convex lenses on symptoms and visual performance.

METHODS

The CVS-Q instrument was used to select pre-presbyopic adults with the symptoms of DES. Participants received a full eye examination including an assessment of dry eye with a modified SANDE questionnaire and using DEWS I criteria. The immediate effect of low-powered convex lenses (low adds: +0.50D, +0.75D, +1.25D) was investigated using subjective preference and a double-masked comparison with plano lenses with the Wilkins Rate of Reading Test (WRRT). Throughout this testing, participants wore their full distance refractive correction, based on non-cycloplegic retinoscopy and subjective refraction.

RESULTS

The signs and symptoms of dry eye were frequently present. Most participants reported a subjective preference for low adds, with +0.75D the most commonly preferred lens. Low adds (+0.50D and +0.75D; but not +1.25D) were associated with significantly improved performance at the WRRT. One quarter of participants read more than 10% faster with these additional convex lenses.

CONCLUSIONS

The study population was aged 20-40y and mostly worked on desktop computers. It is possible that +1.25D add may be more advantageous for people who are older or work more at closer viewing distances. Many symptomatic users of digital devices report a preference for low adds and use of these lenses is often associated with an improvement in reading performance.

Effect of spectral overlays on visual parameters and reading ability: an integrative review

ABSTRACT Purpose: to provide an integrative review of indexed articles published from 2009 to 2019 on the effect of spectral overlays on visual parameters and reading ability. Methods: keywords were used to search seven databases. Duplicate entries, reviews, literature reviews, editor's comments, and congress abstracts were excluded, as well as papers that were not relevant, based on their titles and abstracts. A total of 52 articles, which were read in full, were eligible at this stage. Of these, 12 articles, published in Portuguese or English from 2009 to 2019, were included. Results: all 12 articles included evaluated the effect of overlays on the reading rate. There was an improvement in different visual parameters (ocular accommodation and eye movement), facial recognition, and reading (reading rate, relative efficiency, and comprehension). The use of overlays reduced visual stress regardless of refractive, orthoptic or cognitive disorders. The associated conditions investigated were autism spectrum disorder, Tourette syndrome, stroke, deafness, dyslexia, and auditory temporal processing disorder. Conclusion: the effectiveness of overlays in improving reading quality is consistently demonstrated in the literature. The reviewed articles showed that the overlays’ effect is more expressive when the visual stress is associated with conditions that present sensory alterations and cortical hyperactivity.

Spectral Overlays for Reading Difficulties: Oculomotor Function and Reading Efficiency Among Children and Adolescents With Visual Stress

This study analyzed the effects of spectral overlays on ocular motility during reading among a clinical group of children and adolescents experiencing visual–perceptual distortions of text. We reviewed the records of 323 eye-hospital patients diagnosed with visual stress and divided this participant sample into two age-based cohorts: children ( n =  184; Mean [ M] age = 10.1, standard deviation [ SD]  =  1.3 years) and adolescents ( n =  139; M age = 14.6, SD = 1.5 years). We used a Visagraph III Eye-Movement Recording System to record ocular motor efficiency while reading with and without spectral overlays, and we examined the following parameters: (a) Fixations, (b) Regressions, (c) Span of Recognition, (d) Reading Rate, (e) Relative Efficiency, and (f) Comprehension. Our results showed that using one or some combination of 10 participant-selected spectral overlays immediately and significantly ( p <  .001) reduced the number of Fixations and Regressions per 100 words, while there were significant ( p <  .001) gains in positive factors such as Span of Recognition, Reading Rate, Relative Efficiency, and Comprehension. Our findings indicate that spectral filtering can be an effective tool for helping many young patients who experience visual–perceptual distortions while reading. Future expanded research employing eye-tracking technology is clearly needed.

Association between auditory temporal and visual processing in reading skill

ABSTRACT Purpose: to verify whether students screened with altered auditory temporal processing are more likely to present altered visual processing. Methods: the sample consisted of 68 children, aged from 9 to 12 years, 53% males, from the 5th and 6th grades of a public school. All children with alterations in the audiological or ophthalmological evaluation were excluded. The Duration Pattern Test (screening for auditory temporal skill), the Reading Perceptual Scale (visual stress symptom questionnaire and colored overlays selection) and the Rate of Reading Test (number of words correctly read per minute) were used. Appropriate statistical tests were applied adopting the significance level lower than 0.05. Results: participants screened with abnormal auditory processing had higher visual stress symptoms and lower reading rate, with a significant and moderate effect (p< 0.05; d< 0.71), when compared to their peers with normal auditory processing. Among the children with altered Duration Pattern Test, 58% improved the reading rate with the use of colored overlays, whereas 29% did so in the control group (Odds Ratio = 3.4, p = 0.017). Conclusion: children screened with altered auditory temporal processing presented a three times higher possibility of association with visual processing alterations, due to shared magnocellular system.

Practice makes the deficiency of global motion detection in people with pattern-related visual stress more apparent

Aims

Pattern-related visual stress (PRVS) refers to the perceptual difficulties experienced by some individuals when exposed to high contrast striped patterns. People with PRVS were reported to have reduced sensitivity to global motion at baseline testing and the difference disappears at a second estimate. The present study was to investigate the effect of practice on global motion threshold in adults with and without PRVS.

Methods

A total of 101 subjects were recruited and the Wilkins & Evans Pattern Glare Test was used to determine if a subject had PRVS. The threshold to detect global motion was measured with a random dot kinematogram. Each subject was measured 5 times at the first visit and again a month later. Receiver operating characteristic (ROC) curve analysis was applied to show the agreement between the two tests.

Results

Twenty-nine subjects were classified as having PRVS and 72 were classified as normal. At baseline, the threshold to detect global motion was significantly higher in subjects with PRVS (0.832 ± 0.098 vs. 0.618 ± 0.228, p < 0.001). After 5 sessions, the difference between the normal and subjects with PRVS increased (0.767 ± 0.170 vs. 0.291 ± 0.149, p < 0.001). In ROC analysis, the area under the curve (AUC) improved from 0.792 at baseline to 0.964 at the fifth session. After a one-month break, the difference between normal and subjects with PRVS was still significant (0.843 ± 0.169 vs. 0.407 ± 0.216, p < 0.001) and the AUC was 0.875.

Conclusion

The ability to detect global motion is impaired in persons with PRVS and the difference increased after additional sessions of practice.

Computer Vision Syndrome: Implications for the Occupational Health Nurse

Computers and other digital devices are commonly used both in the workplace and during leisure time. Computer vision syndrome (CVS) is a new health-related condition that negatively affects workers. This article reviews the pathology of and interventions for CVS with implications for the occupational health nurse.

A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter

Claims that coloured filters aid reading date back 200 years and remain controversial. Some claims, for example, that more than 10% of the general population and 50% of people with dyslexia would benefit from coloured filters lack sound evidence and face validity. Publications with such claims typically cite research using methods that have not been described in the scientific literature and lack a sound aetiological framework. Notwithstanding these criticisms, some researchers have used more rigorous selection criteria and methods of prescribing coloured filters that were developed at a UK Medical Research Council unit and which have been fully described in the scientific literature. We review this research and disconfirm many of the more extreme claims surrounding this topic. This literature indicates that a minority subset of dyslexics (circa 20%) may have a condition described as visual stress which most likely results from a hyperexcitability of the visual cortex. Visual stress is characterised by symptoms of visual perceptual distortions, headaches, and eyestrain when viewing repetitive patterns, including lines of text. This review indicates that visual stress is distinct from, although sometimes co-occurs with, dyslexia. Individually prescribed coloured filters have been shown to improve reading performance in people with visual stress, but are unlikely to influence the phonological and memory deficits associated with dyslexia and therefore are not a treatment for dyslexia. This review concludes that larger and rigorous randomised controlled trials of interventions for visual stress are required. Improvements in the diagnosis of the condition are also a priority.