A review of the management of 323 consecutive patients seen in a specific learning difficulties clinic

Abstract

Visual correlates of specific learning difficulties (SpLD) include: binocular instability, low amplitude of accommodation, and Meares-Irlen Syndrome. Meares-Irlen Syndrome describes asthenopia and perceptual distortions which are alleviated by using individually prescribed coloured filters. Data from 323 consecutive patients seen over a 15 month period in an optometric clinic specialising in SpLD are reviewed. Visual symptoms and headaches were common. 48% of patients were given a conventional optometric intervention (spectacles, orthoptic exercises) and 50% were issued with coloured filters, usually for a trial period. 40% of those who were given orthoptic exercises were later issued with coloured overlays. 32% of those who were issued with coloured overlays were ultimately prescribed Precision Tinted lenses. Approximately half the sample were telephoned more than a year after the last clinical appointment. More than 70% of those who were prescribed Precision Tints were still wearing them daily, and results for this intervention compared favourably with data for non-tinted spectacles. The data suggest that many people with SpLD need optometric care and that the optometrist needs to be skilled in orthoptic techniques and cognisant of recent research on coloured filters.

Use of Visual Search in the Assessment of Pattern-Related Visual Stress (PRVS) and Its Alleviation by Colored Filters

“…24,34,35,54,62 We found that introduction of an individualized colored overlay improved reading rate significantly in the high-PRVS group but not in the low-PRVS group (Fig. 3), providing further validation of the idea that rate-of-reading improvement with overlay may serve as a "proxy" diagnostic test for the existence of visual stress.…”

Accommodative function in school children with reading difficulties

“…Our mean MAA values did not differ statistically among the school grades examined, neither for the poor readers or the control children, despite the steady reduction with age observed by Jimenez et al [18] (Table 2). Significant correlation between reading problems and a low amplitude of accommodation have been reported [4,5]. Thus, Evans et al [24] detected a significantly lower amplitude of accommodation in a group of dyslexic children (n = 39) than in their control group (n = 43).…”

“…Even if a child shows subjective symptoms when reading, this is often not the primary function tested in an examination. Significant correlation between reading problems and low amplitude of accommodation [4,5] and accommodative facility have been reported [6][7][8]. On the other hand, several authors have observed no statistical relationship between accommodative function and academic performance [9][10][11][12][13].…”

The relationship between dyslexia and Meares‐Irlen Syndrome

“…An audit of a clinical population found that one-and-a-half years after patients had been prescribed precision tinted lenses, 73% were still using them on a daily basis (Evans et al, 1999). In the open trial of precision tints by Maclachlan et al (1993), a similar figure of 81% was obtained.…”

“…In the open trial of precision tints by Maclachlan et al (1993), a similar figure of 81% was obtained. Patients' perceptions of the benefit they received from their precision tints compared favourably with other interventions, with nearly 80% reporting that tints improved their problems or difficulties (Evans et al, 1999).…”