Eugene Helveston M.D.
Reprinted with Permission From:
International Dyslexia Association (info)
Printed Date: Summer 2001
Date Posted on this Website: October 03 2002
Scotopic Sensitivity Syndrome and Tinted Lenses
Few medically related conditions have launched more speculation as to cause or have spawned more diversity in recommendations for treatment than the learning-reading deficit, dyslexia. Prominent in an eclectic group of proposed treatments is the use of tinted lenses. These lenses are offered to treat a condition called scotopic sensitivity syndrome (Irlen, 1983). This syndrome is said to be a visual defect which, according to its describer, is, "related to difficulties with light source, glare, luminance, wave length, and black/white contrast" (Irlen, 1983). These difficulties are said by Irlen to lead to reading problems that can be alleviated by the use of colored lenses that are, "not just the random selection of color but individualized color selection based on standardized diagnostic procedures" (Irlen, 1983).
Irlen reported six areas of difficulty characteristic of this syndrome: 1) photophobia; 2) eye strain; 3) poor visual resolution; 4) a reduced span of focus; 5) impaired depth perception; and, 6) poor sustained focus. She noted that this syndrome was seen in some individuals with dyslexia.
The diagnostic procedures for assessing scotopic sensitivity syndrome begins with a detailed history, including a series of direct questions to the client asking if he or she experiences any of the following: eye fatigue, blinking, blurred vision, difficulty with concentration, skipping words, words "running off the page," etc. After these questions, the individual is asked a series of questions regarding general health problems. The individual is then asked to respond to certain visual tasks. These include interpretation of figure-ground relationships in several geometric figures, reading selected printed material for content, judgment about relative positioning of figures such as musical notes, and interpretation of a series of stylized figures. Results of these tests are used to determine if an individual has scotopic sensitivity syndrome.
Two of the staff from my department underwent training to become certified Irlen screeners. They were told that in order to maintain the program, 50 percent of those screened should be diagnosed as having scotopic sensitivity syndrome. This incidence, 5O percent, was also found in two screenings reported in a recent Irlen Institute International newsletter (Irlen, 2001).
If the individual is screened to have scotopic sensitivity syndrome, he or she is asked to read text through a series of tinted overlays used singly or in combination. There are seven tints ranging from yellow through blue to green (Helveston, 1990). After using these overlays, the client is asked to select the tint that affords the most comfortable vision. The results of this screening examination are then interpreted at an Irlen Center that is separate from the site where the screening is done. It is at this Center that the final tint is selected. This selection may not be the same tint selected by the client because the final tint can be determined only after analysis of the entire evaluation. Ultimately, the tinted glasses are fabricated at the Irlen Institute in Long Beach, California and sent to the client. After receiving the tinted glasses, clients are urged to wear them as much as possible. Clients are urged to undergo reevaluation after wearing tinted glasses for a specific period on the basis that the tint they require may change.
In addition to helping individuals read better, tinted lenses have been credited by Irlen with helping individuals suffering from, alight sensitivity, discomfort, and distortions [associated with] a wide variety of different problemsn (Irlen, 2001). Some of these widely diverse problems said to be treated successfully with tinted lenses include, head injuries, concussions, whiplash, perceptual problems, neurologic impairment, memory loss, language deficits, headaches (including migraine), autoimmune disease, fibromyalgia, macular degeneration, cataracts, retinitis pigmentosa, complications from LASIK and radial keratotomy, depression, chronic anxiety, and others (Irlen, 2001). A further claim is that a number of incarcerated individuals and delinquent children suffer from scotopic sensitivity syndrome and would benefit from treatment with tinted lenses. (A similar idea was considered and then discounted in the late nineteenth century when some ophthalmologists attempted to establish a cause and effect relationship between eye muscle imbalance and criminality.)
The perspective afforded by observing the evolution of the concept of scotopic sensitivity syndrome and the treatment with tinted lenses leads to the conclusion that this effort has resulted in classic group behavior. The concept has a strong charismatic personality as originator and sustained leader. The supporting evidence is almost entirely anecdotal. The syndrome is becoming associated with an even more diverse array of maladies, tinted lenses now being offered for relief of problems far removed from reading difficulty. The procedure for determining the specific tint has not been divulged and remains a type of "trade secret." Finally, a financially rewarding franchise activity is at the basis of the Irlen Institute activity.
Traditional diagnostic and treatment methods have not yet offered sufficient answers for the alleviation of reading problems/dyslexia. This inability to find an answer to reading difficulties does not justify a scientifically unproven activity as represented by the use of tinted lenses to treat an unproven syndrome, the scotopic sensitivity syndrome (Helveston, 1990).
Helveston E.M., (1990). Scotopic sensitivity syndrome. Arch Ophthalmology, 108.
Irlen H., (1983). "Successful treatment of learning disabilities." Presentation at the 91st Annual Convention of the American Psychological Association, Anaheim, CA.
Irlen H., (2001). Irlen Institute for Perceptual and Learning Development International Newsletter. X (No.2), August 2000- January 2001.