Scotopic sensitivity syndrome
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Irlen syndrome, occasionally referred to as scotopic sensitivity syndrome (SSS) or Meares–Irlen syndrome, is a postulated disorder of vision or image-processing in the brain. Irlen syndrome is also sometimes referred to as asfedia or visual stress. Many mainstream professionals are skeptical of the concept. Research on Irlen syndrome has produced mixed results, finding a possible neurological basis for the condition but little or no evidence supporting the most commonly proposed treatment using tinted eyeglasses or overlays to aid reading.


History

In 1980, New Zealand teacher Olive Meares described the visual distortions some individuals reported when reading from white paper. In 1983, American psychologist Helen Irlen wrote a paper about the use of coloured overlays aiding the reading abilities of some people. Similar symptoms were separately described by Meares and Irlen, each unaware of the other's work. Irlen, who was the first to systematically define the condition, named her findings "
scotopic In the study of human visual perception, scotopic vision (or scotopia) is the vision of the eye under low-light conditions. The term comes from Greek ''skotos'', meaning "darkness", and ''-opia'', meaning "a condition of sight". In the human eye, ...
sensitivity", though in the discussions and debates over the following years, some referred to it as Meares-Irlen
syndrome A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. The word derives from the Greek language, Greek σύνδρομον, meaning "concurrence". When a sy ...
. The Irlen Institute, founded by Helen Irlen, describes scotopic sensitivity as "a perceptual processing disorder" related to brain interpretations of colours and light. It remains controversial whether non-Irlen-certified Meares-Irlen syndrome and the original Irlen syndrome are the same condition. Irlen syndrome, for example, seems to include a broader array of symptoms, including severe variants of the core condition. Basic testing for
scotopic In the study of human visual perception, scotopic vision (or scotopia) is the vision of the eye under low-light conditions. The term comes from Greek ''skotos'', meaning "darkness", and ''-opia'', meaning "a condition of sight". In the human eye, ...
sensitivity was tried by optometrists, opticians and orthoptists in UK hospitals, and by optometrists and opticians in private practice employing a technique that used the Intuitive Colorimeter, developed under Medical Research Council licence. An alternative approach to correct Irlen syndrome was tried by Orthoscopics franchise in the UK, with wide colour coverage and tints manufactured by Hoyato match. Other commercial organisations have produced sets of therapeutic tints, although most have not received scientific evaluation. Studies investigating Irlens' syndrome as a treatable condition have been criticised for having a biased and subjective approach to their research. Treatments offered by Irlens' practitioners have not been found to be effective in improving reading ability.


Classifications

Irlen divides Irlen syndromes into six types: photophobia, distortion of the fundus, graphical distortions during reading, decreased visual field, difficulty in ocular fixation during reading and change in depth perception.


Research

The disorders have been studied in several institutions, including the Psychology Department at
Essex University The University of Essex is a public research university in Essex, England. Established by royal charter in 1965, Essex is one of the original plate glass universities. Essex's shield consists of the ancient arms attributed to the Kingdom of Ess ...
, the former Applied Psychology Unit,
Cambridge University The University of Cambridge is a Public university, public collegiate university, collegiate research university in Cambridge, England. Founded in 1209 and granted a royal charter by Henry III of England, Henry III in 1231, Cambridge is the world' ...
in England, and in the case of Meares-Irlen syndrome
Visual Unit
at
Glasgow Caledonian University Glasgow Caledonian University ( gd, Oilthigh Chailleannach Ghlaschu, ), informally GCU, Caledonian or Caley, is a public university in Glasgow, Scotland. It was formed in 1993 by the merger of The Queen's College, Glasgow (founded in 1875) and G ...
in Scotland. the Visual Stress Unit offered non-commercial diagnostic and therapeutic services to individuals, and provided advice to the
Scottish National Health Service NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, ...
. In Australia, Irlen syndrome was researched by Paul Whiting at the
University of Sydney The University of Sydney (USYD), also known as Sydney University, or informally Sydney Uni, is a public research university located in Sydney, Australia. Founded in 1850, it is the oldest university in Australia and is one of the country's ...
. Whiting set up the first Irlen Dyslexia Centre in Australia, which operated in the Children's Centre at Sydney University for more than 15 years. Irlen syndrome was also studied in Australia by Greg Robinson (1944–2008) at the University of Newcastle. He was director of the Special Education Centre at the School of Education. In the US, peer-reviewed literature on the topic suggests that much is unknown about the cause of these disorders, ranging from the 2011 study in a journal of the American Academy of Pediatrics, "Irlen Colored Overlays Do not Alleviate Reading Difficulties" and the 2012 study in the journal ''Brain Topography'', "A Functional Neuroimaging Case Study of Meares–Irlen Syndrome". The first, purely in relation to Meares-Irlen syndrome, finds that there is no evidence for one of the fundamental claims of therapeutic benefit. The second, which focused primarily on Irlen syndrome, found compelling evidence of unique brain function linked to the syndrome.


Treatment

The College of Optometrists (UK) has specified guidelines for optometrists who use the colorimeter system. A society for coloured lens prescribers has been established to provide a list of eye-care practitioners with expertise in the provision of coloured lenses for the treatment of visual stress.


Irlen Method

The Irlen Method uses coloured overlays and tinted lenses in the form of glass or contact lenses. The method is intended to reduce or eliminate perceptual processing errors; it is claimed the resultant retiming of visual signals in the brain improves the reading difficulties associated with scotopic sensitivity syndrome.


Scientific repudiation

Skepticism relating to scotopic sensitivity syndrome's exact pathology has evolved on several fronts: # Whether it exists as a distinct, predictably identifiable disease with a reasonable pathophysiological mechanism, or whether a range of symptoms from other conditions are being placed under this convenient heading; # Whether it is causally or incidentally related to dyslexia, autism, or other conditions; and # Whether existing methods of scotopic sensitivity syndrome treatment are appropriate and effective. A 2009 report by the American Academy of Pediatrics (AAP) does not find that there is conclusive scientific evidence for the use of coloured lenses (one treatment used to relieve symptoms of scotopic sensitivity syndrome) although it acknowledges anecdotal evidence in support of customized colored lenses. When discussing its scientific basis, the AAP mentions that " e method used to select the lens or filter color has been highly variable, the color selection has also shown considerable variability, and the test-retest consistency has been poor" (p. 843). The association of scotopic sensitivity syndrome and dyslexia has been challenged by many authors in the optometric and ophthalmologic communities. Furthermore, many special education departments at universities challenge the validity of coloured lenses as an effective treatment for the condition as outlined by the Macquarie University Special Education Centre. Critics claim that the symptoms of those with Scotopic Sensitivity Syndrome are related to already known visual perceptual and neurological disorders. According to a statement released by the
American Optometric Association The American Optometric Association (AOA), founded in 1898, represents approximately 37,000 doctors of optometry, optometry students and para-optometric assistants and technicians in the United States. Overview The AOA states that: The American O ...
in 2004: As outlined by Hyatt, Stephenson and Carter (2009):


See also

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References


Further reading

* * {{DEFAULTSORT:Scotopic Sensitivity Syndrome Vision Dyslexia Syndromes Alternative diagnoses Alternative therapies for developmental and learning disabilities