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Rueff EM. Visual discomfort and contact lens wear: A review. Cont Lens Anterior Eye 2023; 46:101872. [PMID: 37277259 DOI: 10.1016/j.clae.2023.101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
The purpose of this manuscript is to describe how vision influences contact lens discomfort and review the evidence supporting the hypothesis that contact lens discomfort can be caused by vision and vision-related disorders. Contact lens discomfort is a misunderstood and difficult to manage clinical condition. Most treatments and strategies aimed at alleviating discomfort focus on optimizing the contact lens fit and its relationship with the ocular surface, but these strategies commonly fail at relieving discomfort symptoms. Many vision and vision-related disorders share symptoms with those reported by uncomfortable contact lens wearers. This paper will review evidence and literature that describes how these vision and vision-related disorders may influence comfort in contact lens wearers. Acknowledging how vision influences contact lens discomfort will improve future research intended to better understand the condition, allow for more effective clinical management, and reduce rates of discontinuation.
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Affiliation(s)
- Erin M Rueff
- The Southern California College of Optometry at Marshall B Ketchum University, 2575 Yorba Linda Blvd, Fullerton, CA 92831, USA.
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Wang M, Qi X, Yang X, Fan H, Dou Y, Guo W, Wang Q, Chen E, Li T, Ma X. The pattern glare and visual memory are disrupted in patients with major depressive disorder. BMC Psychiatry 2022; 22:518. [PMID: 35918667 PMCID: PMC9344705 DOI: 10.1186/s12888-022-04167-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 07/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Visual memory impairment is one of the most commonly complained symptoms in patients with major depressive disorder (MDD). Pattern glare is also a distorted visual phenomenon that puzzles patients with MDD. Nevertheless, how these two phenomena interact in MDD remains unknown. This study investigated the association between pattern glare and visual memory in MDD patients. METHODS Sixty-two patients with MDD and forty-nine age-, sex- and education level-matched healthy controls (HCs) were included in this study. The Pattern Recognition Memory (PRM) test and the Brief Visual Memory Test-Revised (BVMT-R) were applied to measure visual memory. The pattern glare test including three patterns with different spatial frequencies (SFs) was used to explore pattern glare levels. RESULTS Patients with MDD scored lower on the PRM-PCi, BVMT-R1, BVMT-R2, BVMT-R3, and BVMT-Rt and higher on the PRM-MCLd than HCs (all p < 0.05). Pattern glare scores for MDD patients were higher with mid-SF (p < 0.001), high-SF (p = 0.006) and mid-high SF differences (p = 0.01) than for HCs. A positive correlation between mid-SF and PRM-MCLd scores in all participants was observed (p = 0.01, r = 0.246). A negative correlation between mid-high difference scores and BVMT-R2 scores (p = 0.032, r = -0.317) was observed in HCs, but no significant correlation was observed in MDD patients. CONCLUSIONS The present study showed that visual memory and pattern glare are disrupted in MDD. Visual memory may be associated with pattern glare and needs to be studied in future work.
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Affiliation(s)
- Min Wang
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | | | - Xiao Yang
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huanhuan Fan
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yikai Dou
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjun Guo
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Eric Chen
- grid.415550.00000 0004 1764 4144Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Tao Li
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China. .,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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Ten Brink AF, Bultitude JH. Visual Sensitivity in Complex Regional Pain Syndrome and Fibromyalgia: An Online Study. Perception 2022; 51:187-209. [PMID: 35236184 PMCID: PMC8958570 DOI: 10.1177/03010066211072641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
Abstract
Perceptual anomalies can provide insights into underlying pathologies even when they are not the main symptom of many clinical conditions. Complex regional pain syndrome (CRPS) and fibromyalgia are chronic pain conditions associated with changes in the central nervous system, possibly leading to enhanced visual sensitivity. It is unclear whether this occurs more than for people with other types of pain. We examined visual sensitivity elicited by different stimuli and in daily life, through an online study of people with CRPS (n = 57), fibromyalgia (n = 74), other pain (n = 50), and no pain (n = 89). Respondents rated changes in pain, discomfort, or distress from viewing patterns with different spatial frequencies (lower-order visual processing), and reversible figures (bistable images; higher-order visual processing). We assessed visual sensitivity in daily life using the Leiden Visual Sensitivity Scale and Visual Discomfort Scale. Respondents with CRPS or fibromyalgia reported more visual discomfort than pain-related and pain-free controls while viewing striped patterns and a circle, with no effect of spatial frequency. They reported more pain while viewing a nonreversible square, but not reversible figures (Necker Cube, Duck/Rabbit). Finally, they reported more daily visual sensitivity than pain-related and pain-free controls. Suppressing visual cortical activity might benefit people with CRPS or fibromyalgia.
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Abstract
Photophobia is one of the most common symptoms in migraine, and the underlying mechanism is uncertain. The discovery of the intrinsically-photosensitive retinal ganglion cells which signal the intensity of light on the retina has led to discussion of their role in the pathogenesis of photophobia. In the current review, we discuss the relationship between pain and discomfort leading to light aversion (traditional photophobia) and discomfort from flicker, patterns, and colour that are also common in migraine and cannot be explained solely by the activity of intrinsically-photosensitive retinal ganglion cells. We argue that, at least in migraine, a cortical mechanism provides a parsimonious explanation for discomfort from all forms of visual stimulation, and that the traditional definition of photophobia as pain in response to light may be too restrictive. Future investigation that directly compares the retinal and cortical contributions to photophobia in migraine with that in other conditions may offer better specificity in identifying biomarkers and possible mechanisms to target for treatment.
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Affiliation(s)
| | - Sarah M Haigh
- Department of Psychology and Integrative Neuroscience, University of Nevada, Reno, USA
| | - Omar A Mahroo
- Institute of Ophthalmology, University College London, London, UK and Retinal Service, Moorfields Eye Hospital, London, UK
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Vieira A, van der Linde I, Bright P, Wilkins A. Preference for Lighting Chromaticity in Migraine With Aura. Headache 2020; 60:1124-1131. [DOI: 10.1111/head.13801] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ian van der Linde
- School of Computing and Information Science Anglia Ruskin University Cambridge UK
| | - Peter Bright
- Division of Psychology Anglia Ruskin University Cambridge UK
| | - Arnold Wilkins
- Department of Psychology University of Essex Colchester UK
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Qi X, Fan H, Yang X, Chen Y, Deng W, Guo W, Wang Q, Chen E, Li T, Ma X. High level of pattern glare in major depressive disorder. BMC Psychiatry 2019; 19:415. [PMID: 31864335 PMCID: PMC6925875 DOI: 10.1186/s12888-019-2399-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/09/2019] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Visual deficits have been reported in abundance by recent studies on major depressive disorder. Pattern glare manifests as visual distortions, such as the symptoms of headache, glare, eyestrain, illusions of shapes, colors, and motion when viewing repetitive striped patterns, of which some can be observed in major depressive disorder. Inspired by what mentioned, the present study aims to explore whether there exists association between pattern glare and major depressive disorder and further attempts to explore possible clinical diagnostic value of pattern glare in major depressive disorder. METHODS Twenty-four patients diagnosed with major depressive disorder (MDDs group) were compared with 30 age-, gender- and education level-matched healthy control subjects (HCs group) on their visual stress with black-and-white gratings of different spatial frequencies-0.3 (low-SF), 2.3 (mid-SF), and 9.4 (high-SF) cycles per degree (c/deg)-which was named pattern glare test. The MDDs group divided into first episode medication-free group (fMDD) and recurrent medicated group (rMDD), comparisons of pattern glare scores (PGS) were performed within the MDDs group. We used Pearson and Spearman analysis to explore the relationship between some clinical indexes and pattern glare scores. ROC (receiver operating characteristic) curve was used to evaluate whether pattern glare test was able to discriminate patients and healthy controls. RESULTS The mid-SF pattern glare score significantly elevated in patients with major depressive disorder compared to control subjects. No differences of pattern glare scores were found between fMDD and rMDD. A significant negative correlation between mid-high difference and age in HCs group was found. There were no correlations between other variables and pattern glare scores. The mid-SF score has limited value in the diagnosis of major depressive disorder. CONCLUSIONS We observed an increased level of pattern glare in patients with major depressive disorder, reflecting the existence of cortical hyper-excitability in major depressive disorder. The mid-SF score may have a value in understanding cortical excitability in major depressive disorder.
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Affiliation(s)
- Xiongwei Qi
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Huanhuan Fan
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Xiao Yang
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Yayun Chen
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China
| | - Wei Deng
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjun Guo
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Eric Chen
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Tao Li
- 0000 0004 1770 1022grid.412901.fPsychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan 610064 People’s Republic of China ,0000 0004 1770 1022grid.412901.fWest China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, 610064, People's Republic of China. .,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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Elliot DB, Wood JM. Coloured filters show gender differences and poor repeatability. Ophthalmic Physiol Opt 2017; 37:635-639. [PMID: 29044671 DOI: 10.1111/opo.12417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- David B Elliot
- Ophthalmic& Physiological Optics and Professor of Clinical Vision Science, University of Bradford, Bradford, UK
| | - Joanne M Wood
- School of Optometry and Vision Science and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Evans BJW, Allen PM, Wilkins AJ. A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress). JOURNAL OF OPTOMETRY 2017; 10:161-168. [PMID: 27890547 PMCID: PMC5484780 DOI: 10.1016/j.optom.2016.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 08/26/2016] [Accepted: 08/28/2016] [Indexed: 05/12/2023]
Abstract
PURPOSE Visual stress (VS) is characterised by symptoms of visual perceptual distortions and eyestrain when viewing text, symptoms that are alleviated by individually prescribed coloured filters. A recent review supports the existence of VS and its treatment, but noted that controversy remains, in part due to inconsistencies in the diagnosis of the condition. The present paper reviews the diagnostic criteria for VS in the literature and reports a Delphi analysis of the criteria currently used in clinical practice. METHODS Twenty-six eyecare practitioners were invited to participate in a Delphi study. They were selected because they were frequent prescribers of precision tinted lenses. In the first round they were sent a list of the indicators for which there is literature to suggest a relevance in the diagnosis of VS. The practitioners were invited to rank the indicators and add any additional criteria they use in diagnosis. In the second round a revised list was circulated, including items added from the responses in the first round. RESULTS The respondents included optometrists, orthoptists and opticians. In the first round the response rate was 85%. Ninety-one percent of those who participated in the first round also responded in the second round. Strong indicators in the second round included the symptom of words moving when reading, voluntary use of an overlay for a prolonged period, improved performance of ≥15% with an overlay on the Wilkins Rate of Reading test, and an abnormally high score on the Pattern Glare Test. CONCLUSIONS The strongest diagnostic criteria are combined in a diagnostic tool. This is proposed as a guide for clinical practice and further research.
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Affiliation(s)
- Bruce J W Evans
- Institute of Optometry, London, UK; Division of Optometry & Visual Science, City, University London, UK.
| | - Peter M Allen
- Department of Vision and Hearing Sciences and Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
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Suttle CM, Barbur J, Conway ML. Coloured overlays and precision-tinted lenses: poor repeatability in a sample of adults and children diagnosed with visual stress. Ophthalmic Physiol Opt 2017; 37:542-548. [PMID: 28656668 DOI: 10.1111/opo.12389] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/08/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Visual stress consists of perceived distortions or discomfort while reading. It is claimed that these symptoms are alleviated by viewing through coloured lenses or overlays, with a specific colour required for each individual. This has been explained on the basis of altered visual cortex excitation as affected by the spectral content of the viewing light. If symptoms are indeed alleviated by a particular colour that has an impact on the individual's visual system, we would expect that selection of the most beneficial colour would be repeatable. The aim of this study was to determine whether this is the case. METHODS Twenty-one participants (mean age 26 years (range 8-55 years); 12 female, nine male) with visual stress and no other uncorrected ocular or visual anomaly were recruited. Each participant selected the colour most beneficial in alleviating their symptoms from a standard set of 10 coloured overlays, and underwent intuitive colorimetry in which the most beneficial of a wide range of chromatic illuminance settings was selected. Without prescribing an overlay at the first appointment, this process was repeated on a second occasion at a mean of 25 days later. RESULTS About half of the participants (n = 10) chose the same (n = 7) or similar (with one common colour in both choices; n = 3) coloured overlay on the two occasions, while 11 participants chose a completely different overlay colour. Across all participants, the colorimetry setting shifted by, on average, 9.6 just noticeable differences, indicating that the colours were perceptually very different. CONCLUSION These findings suggest that people with visual stress are unlikely to find exactly the same colour to be optimal on different occasions, and raise questions about the need for precise colour specification in tinted lenses for visual stress.
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Affiliation(s)
- Catherine M Suttle
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - John Barbur
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - Miriam L Conway
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
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Griffiths PG, Taylor RH, Henderson LM, Barrett BT. The effect of coloured overlays and lenses on reading: a systematic review of the literature. Ophthalmic Physiol Opt 2017; 36:519-44. [PMID: 27580753 DOI: 10.1111/opo.12316] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 07/19/2016] [Indexed: 01/29/2023]
Abstract
PURPOSE There are many anecdotal claims and research reports that coloured lenses and overlays improve reading performance. Here we present the results of a systematic review of this literature and examine the quality of the evidence. METHODS We systematically reviewed the literature concerning the effect of coloured lenses or overlays on reading performance by searching the PsychInfo, Medline and Embase databases. This revealed 51 published items (containing 54 data sets). Given that different systems are in use for issuing coloured overlays or lenses, we reviewed the evidence under four separate system headings (Intuitive, Irlen, Harris/Chromagen and Other), classifying each published item using the Cochrane Risk of Bias tool. RESULTS Although the different colour systems have been subjected to different amounts of scientific scrutiny, the results do not differ according to the system type, or whether the sample under investigation was classified as having visual stress (or a similarly defined condition), reading difficulty, or both. The majority of studies are subject to 'high' or 'uncertain' risk of bias in one or more key aspects of study design or outcome, with studies at lower risk from bias providing less support for the benefit of coloured lenses/overlays on reading ability. While many studies report improvements with coloured lenses, the effect size is generally small and/or similar to the improvement found with a placebo condition. We discuss the strengths and shortcomings of the published literature and, whilst acknowledging the difficulties associated with conducting trials of this type, offer some suggestions about how future trials might be conducted. CONCLUSIONS Consistent with previous reviews and advice from several professional bodies, we conclude that the use of coloured lenses or overlays to ameliorate reading difficulties cannot be endorsed and that any benefits reported by individuals in clinical settings are likely to be the result of placebo, practice or Hawthorne effects.
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Affiliation(s)
- Philip G Griffiths
- Department of Ophthalmology, St Bernard's Hospital, Gibraltar, Gibraltar
| | - Robert H Taylor
- Department of Ophthalmology, York Teaching Hospital Foundation Trust, York, UK
| | | | - Brendan T Barrett
- School of Optometry & Vision Science, University of Bradford, Bradford, UK
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Evans BJW, Allen PM. A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter. JOURNAL OF OPTOMETRY 2016; 9:205-18. [PMID: 27425262 PMCID: PMC5030324 DOI: 10.1016/j.optom.2016.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/24/2016] [Accepted: 04/03/2016] [Indexed: 05/25/2023]
Abstract
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.
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Affiliation(s)
| | - Peter M Allen
- Department of Vision and Hearing Sciences and Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
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