Irlen Syndrome and the Irlen Method. Irlen Syndrome (sometimes referred to in the literature as Meares-Irlen Syndrome, Scotopic Sensitivity Syndrome, or Visual Stress) is a problem with the brain, not the eye. It is a perceptual processing disorder, not a visual problem, a finding that the most current brain imaging research supports. In simplistic terms, when an individual suffers from Irlen Syndrome, their brain has difficulty or an inability to process certain wavelengths of light. In this way, light (especially bright and fluorescent lighting) becomes a stressor on the brain. This stress causes certain parts of the brain (e.g., the visual cortex) to become overactive. It is this over-activity and inability to effectively process visual stimuli that creates a variety of visual, physical, cognitive, emotional, and neurological symptoms.
There is currently a body of research related to Irlen Syndrome, Colored Overlays and Colored Filters that spans more than 30 years. The Irlen Method and the efficacy of colored overlays and colored lenses has been the subject of over 200 research studies encompassing the disciplines of education, psychology, and medicine. To date, more than 100 of these studies supporting the use of colored overlays and lenses to treat the perceptual processing difficulties associated with Irlen Syndrome are published in peer-reviewed academic and scientific journals, including the Journal of Learning Disabilities, Australian Journal of Special Education, Perceptual and Motor Skills, Australian Journal of Learning Disabilities, Journal of Clinical & Experimental Neuropsychology, Journal of Research in Reading, Behavioral Optometry, and Ophthalmological and Behavioral Optics, among others. A recent review of 62 studies published in peer-reviewed journals found 56 studies with positive findings, 45 with positive results for particular reading skills, and 11 showing improvements in accommodation facility, eye movements while reading, and reduced headaches/migraine. Independent research projects are ongoing at various universities in the United States, England, Australia, Switzerland, Brazil, Italy, and New Zealand. Research conducted over the last 15 years has addressed critiques about earlier methodology and offers empirically designed, placebo-controlled research resulting in positive results.
Notably, the most current research utilizes brain-mapping technology to show actual changes and normalization of brain functioning that is not achieved through ophthalmological treatments (plain lenses, prisms, or vision therapy). Researchers have utilized functional magnetic resonance imaging (fMRI), visual evoked responses (VER), and single photon emission computed tomography (SPECT) scans to objectively document the profound effects of visual sensory overload on the brain and the normalization of brain activity when individually-prescribed, precision-tinted colored filters are worn. In one study by Amen and colleagues, comparing the brains of 42 people with Irlen syndrome to 200 age-matched individuals without any evidence of Irlen syndrome, SPECT showed increased activity in the brain’s emotional and visual processing centers and decreased activity in the cerebellum (an area that helps to integrate coordination and new information).
WITHOUT IRLEN SPECTRAL FILTERS
WITHOUT IRLEN SPECTRAL FILTERS
SPECT scans courtesy of the Amen Clinic
Yellen and Schweller (2009) utilized state-of-the-art Visual Evoked Responses (VER), a portion of their comprehensive neuroelectrical evaluation of patients called the DESA®, and discovered that individuals with Irlen Syndrome have early hyper reactivity to visual stimuli somewhere between 30-60 milliseconds, and it is 3-9 standard deviations above normal (the Yellen-Schweller Effect). Irlen Spectral Filters reduce the standard deviation abnormalities of the Yellen-Schweller Effect, lessening of the delay of the brain coming back “online” and allowing it to clear sooner. Lewine et al. (1997) utilized magnetoencephalography (MEG) to characterize visual responses in conditions with and without lenses. In all cases, the evoked magnetic signal reflected a complicated pattern of bilateral activation of multiple cortical generators. A major difference in with and without lens conditions was seen between 170 and 200 msec post-stimulus. The data suggest that the coloured Irlen lenses provide for normalization and crystallization of visual information processing in individuals with Irlen Syndrome.
Chouinard et al. (2011) compared the neurological characteristics of a person with Irlen Syndrome with control subjects who were participating in a language. The descriptive results indicated that there are numerous significant differences in many areas of the brain cortex between the control subjects and the individual with Irlen Syndrome, providing evidence of a neurobiological foundation to Irlen Syndrome.
Huang et al. (2011) used fMRI to investigate differences between individuals suffering visual stress and controls in relation to migraine and to determine the effectiveness of precision-tinted colored filters for individuals suffering from visual stress. The research showed a normalization of cortical activation and spatial frequency tuning in the migraineurs by precision tinted filters that suggests a neurological basis for the therapeutic effect of these lenses in reducing visual cortical hyperactivation in migraine.
In addition, it is worth mentioning that Irlen Syndrome has been recognized by a number of organizations around the world. Colored overlays and/or colored filters are recognized as a standard accommodation for standardized testing in many states in America, including California, Arkansas, Florida, Oklahoma, Nevada, Massachusetts, New Mexico, and Washington. The SAT, LSAT, ACT, Recording for the Blind, Illinois Department of Rehabilitation, Indiana Office of Vocational Rehabilitation, Michigan Rehabilitation Services, Texas Commission for the Blind, Nevada Vocational Rehabilitation Services, and Wisconsin Vocational Rehabilitation all officially recognize Irlen Syndrome. In Australia, the following are a sampling of agencies which have officially recognized Irlen Syndrome: Department of Employment, Education & Training, Departments of Army, Navy, and Air Force, Board of Studies – NSW, Board of Secondary Education – WA, Department of Children’s Services – WA, Commonwealth Employment Service (CES), Department of Rehabilitation, Geelong Medical Fund, and Technical and Further Education (TAFE).
From its discovery 35 years ago, Irlen has been the subject of scrutiny and criticism from a number of groups, particularly optometrists, who have sometimes suggested that the Irlen Method is not supported by scientific research and that the problems associated with Irlen Syndrome can be corrected through standard optometric interventions. Research has shown that binocular and accommodative anomalies may occur in conjunction with the syndrome, but are not considered to be the underlying physiological basis of the condition (Evans, Patel, Wilkins, Lightstone, Eperjesi, Speedwell et al., 1999; Evans, Wilkins, Brown, Busby, Wignfield, Jeanes, & Bald, 1996; Evans, Wilkins, Busby, & Jeanes, 1996; Scott, McWhinnie, Taylor, Stevenson, Irons, Lewis et al., 2002). Irlen has also been reviewed by various USA Boards of Optometry and the USA Medical Board and was found not to be either the practice of optometry or medicine. As a perceptual problem, it is similar to other processing problems (both visual and auditory) that are diagnosed by psycho-educational testing and treated within the educational system.
Over the years, there have also been a few studies that offered negative results, and these limited studies have often been cited as the support for dismissing the validity of Irlen. However, these negative studies have been critiqued in the literature for their methodological flaws (Robinson, 1994; Robinson, Foreman, & Dear, 2000), which include not controlling for uncorrected optometric problems, utilizing inappropriate outcome measures, and, the most egregious error, not screening for Irlen Syndrome to ensure they have selected an appropriate sample for the study.
When it comes to research often individuals who say Irlen is not supported by research are uninformed, citing second-hand positions based on research that is more than 20 years old. Specifically, early critics of the research have said that it does not control for placebo effects or experimenter bias, and that it lacks validity and reliability. However, as we have indicated earlier in this letter, there are more than 60 scientific research studies on the topic of Irlen Syndrome that are published in peer-reviewed scientific journals. These studies have most often been conducted by independent researchers with no financial investment in the method. This research has established a hereditary component of the disorder (Loew & Watson, 2012; Robinson, Foreman, & Dear, 2000; Robinson, Foreman, Dear & Sparkes, 2004), a number of biochemical markers for problems associated with Irlen Syndrome (Robinson, Roberts, McGregor, Dunstan, & Butt, 1999; Robinson, McGregor, Roberts, Dunstan & Butt, 2001; Sparkes, Robinson, Dunstan, & Roberts, 2003), and differences between both the anatomy and functioning of brains of individuals with Irlen Syndrome (Chouinard, Zhou, Hrybousky, Kim, & Commine, 2012; Huang, Zong, Wilkins, Jenkins, Bozoki, & Cao, 2011; Lewine, Davis, Provencal, Edgar, & Orrison, 1997; Riddell, Wilkins, & Hainline, 2006; Yellen & Schweller, 2009). The research has repeatedly documented efficacy of both colored overlays and spectral filters, as measured by improvements in a variety of reading skills (Bouldoukian, Wilkins, & Evans, 2002; Nobel, Orton, Irlen & Robinson, 2004; Park, Kim, Cho, Joo, 2012; Robinson & Foreman, 1999; Tyrrell, Holland, Dennis, & Wilkins, 1995; Williams, LeCluyse, & Rock Faucheux, 1992; Wilkins, Evans, Brown, Busby, Wingfield, Jeanes & Bald, 1994), reduction in physical symptoms that include headaches, migraines, eye strain, fatigue, and light sensitivity (Barbolini, Lazzerini, Pini, Steiner, Del Cecchio, Migaldi, & Cavallini, 2009; Bulmer, 1994; Chronicle & Wilkins, 1991; Huang et al., 2011; Wilkins & Wilkinson, 1991), and improved functioning and success in both academia and the workplace (Bulmer, 1994; Irlen & Robinson, 1996; Robinson & Conway, 1994; Robinson & Conway, 2000; Whiting & Robinson, 1988; Whiting, Robinson, & Parrot, 1994).
RESEARCH FOR SPECIFIC GROUPS
NOTE: JA = Journal Article; SS= Support Statement; SP= Scientific Paper.
JA Noble J., Orton M., Irlen S., Robinson G. 2004. A Controlled Field Study of the use of Coloured Overlays on Reading Achievement. Australian Journal of Learning Disabilities 9, 2.
JA Boyle, C., Jindal-Snape, D. 2012. Visual Perceptual Difficulties and the impact on children’s learning: are teachers missing the page? British Journal of Learning Support. 27, 4.
SS Amen, D.G, Assistant Clinical Professor of Psychiatry and Human Behaviour. (Neuropsychiatrist) Brain in the News Newsletter.
JA O’Connor PD., Sofo F., Kendall L., Olsen G. Reading disabilities and the effects of coloured filters. Journal of Learning Disabilities 23, 10, 1990.
SP Loew, SJ & Watson, K: The Prevalence of Symptoms of Scotopic Sensitivity/Meares-Irlen Syndrome in subjects diagnosed with ADHD:- Does misdiagnosis play a significant role? Original Scientific paper. UDK 616:89
JA Harbaugh, Rick. Incidence of Irlen Syndrome in the General Population.
This is a compilation of the results of several studies into the incidence of Irlen Syndrome in the general population. Many of the studies show a higher percentage affected than the generally accepted figure of 15%.
SS Eye Spy: Decoding Dyslexia. This reports the early research of Margaret Livingstone, and the effects of light on the magnocellular and parvocellular vision systems. Livingstone, M. Eye Spy: Decoding Dyslexia. Focus January 31 1994. A Publication of Harvard Medical School
SS How Well Could You Read if the Print Looked Like This? A sample of what the print looks like for some Irlen Sufferers.
SS Irlen Syndrome – A Screener’s Perspective. Words of Wisdom from an Irlen Screener.
SS Irlen Alphabet. How wearing a set of Irlen Spectral Filters sorted out the alphabet for one boy.
SS Daniel Amen – neuropsychiatrist. “Light in the Brain”. The brain is involved in everything we do and light can affect it’s functioning.
SS Annibali – psychiatrist. How wearing Irlen Spectral can alleviate Migraines. Annabali, Joseph. Psychiatrist. Letter 2013. To whom it may concern. Amen Clinics.
SP Grattan Institute: Their Report “Engaging Students..” suggests that up to 40% of students in Australian Classrooms are disengaged – mostly just passively sitting there not listening or engaging with learning.
SS “Once Upon a Time..”. Shows the difference writing on coloured paper can make.
SS. WJF Richards, 2013 Campaspe College. lrlen – Visual Perceptual Dyslexia. Diagnostic lmpact on Learning Outcomes Speech Pathologist , Irlen Trained. Made a huge difference.
SS. Dobrin, Robert. Psychiatrist. 2006. Toward an authentic diagnostic impression using clinical composites and functional brain imaging for an improved understanding of Irlen Syndrome.
JA. Loew, S J and Watson K. The prevalence of symptoms of Scotopic Sensitivity/Meares-Irlen Syndrome in subjects diagnosed with ADHD:- does misdiagnosis play a significant role? Scientific Paper UKD: 616.89
JA. Allen PM, Evans BJW, Wilkins AJ. 2012. The uses of colour in optometric practice to ameliorate symptoms of visual stress. Optometry in Practice 13, 1, 1-8
SP. Guimares MR, Guimares RQ, Diniz CAF, Silva AF, Alencar CCG. 2013.The effects of spectral filter intervention in the oculomotor coordination profile of children with reading and learning difficulties. Hospital De Olhos.
JA. Barbolini G, Lazzerini A, Pini LA, Steiner F, Del Vecchio G, Migaldi M, Cavallini GM. 2009 Malfunctioning Cones and Remedial Tinted Filters. Ophta. 2, 101-105.
SS Guimarais Letter. Dr Marcia (an ophthalmologist) explains the difference between optometry and Irlen Syndrome. She has done precise measuring to show that Irlen is related to cortical visual processing, so the eye exam is normal, and doesn’t show this.
SS. Amen DG. Light and the Brain. Brain in the News Newsletter. 06/30/2004. www.amenclinic.com
SP. Lewine JD, Davis J, Provencal S, Edgar J, Orrison W. 1997 A Magnetoencephalographic investigation of Visual Information Processing in Irlen’s Scotopic Sensitivity Syndrome. Universities of Utah and New Mexico.
SS. Lewine JD, 2013 To whom it may concern The Mind Research Network for Neurodiagnostic Discovery.
SP Yellen Visual Evoked Responses – Yellen-Schweller Effect. Measures early hyperactivity to visual stimuli.
JA Kim et al.2015. Functional Magnetic Resonance Imaging Findings in Meares-Irlen Syndrome: A Pilot Study. Korean J Ophthalmol. 29, 121-125.
SP Chouinard et al. 2011. A Functional Neuroimaging Case Study of Meares Irlen Syndrome/Visual Stress (MIS/ViS). DOI 10.1007/s 1054-011-0212-2.
JA. Loew S J, Marsh NV and Watson K. 2014 Symptoms of Meares-Irlen/Visual Stress Syndrome in subjects diagnosed with Chronic Fatigue Syndrome. International Journal of Clinical and Health Psychology. 14. 87-92.
JA. Wilkins AJ, Evans BJW. 2010. Visual Stress, its treatment with spectral filters and its relationship to visually induced Motion Sickness. Applied Ergonomics. 41 509-515.
JA. Loew S J and Watson, K. 2012. A Prospective Genetic Marker of the Visual Perceptual Disorder Meares-Irlen Syndrome. Perceptual and Motor Skills 114, 3, 870-882
JA. Robinson GL, McGregor NR, Roberts TK, Dunstan RH, Butt H. 2001 A Biochemical Analysis of people with Chronic Fatigue who have Irlen Syndrome: speculation concerning immune system dysfunction. Perceptual and Motor Skills 93. 486-504.
SP. Robinson GL, Sparkes DL, Roberts DK, Dunstan H, 2004 Biochemical Anomalies in people with Irlen Syndrome. Paper presented at the Eighth International Irlen Conference, Brugge, Belgium, 7-11 July 2004.
JA Wilkins et al 1999. Treatment of photosensitive epilepsy using coloured glasses. Seizure, 1999, 8, 444-449.
SS Anderson, Professor Adam. Neuroscience Research on Irlen Syndrome at Cornell University. Report on the current research into the visual pathways in the brain.
SS Evans, Professor Bruce. Critique of “Learning Disabilities, Dyslexia and Vision”. Professor Evans gives an explanation of why the Ophthalmologists are opposed to Irlen.
SP. Irvine J, 1997 Naval Warfare Center – Case Study.
Whichard, JA; Feller, RW; Kastner, R. The Incidence of Scotopic Sensitivity Syndrome in Colorado Inmates. Journal of Correctional Education. 51, 3.
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SP. Whiting P. Assessment for Dyslexia Paper presented at the sixth International Conference of Irlen Clinicians, Mudjimba Qld 2000.
SP. Miles The Bangor Dyslexia Test Miles Dyslexia Centre, Bangor University, Bangor, Gwynedd LL57 2DG
SS. Speld The power of Language
SS. Edelson SM. 2013 Letter To whom it may concern Executive Director, Autism Research Institute.
JA. Robinson GL, and Whiting PR. 2003. The Intrepretation of Emotion from Facial Expression for children with Visual Processing Problems. The Australasian Journal of Special Education. 27, 2, 50-67.
JA. Irlen H. A Sensory Intervention for Visual Processing Deficits using Precision Colored Filters. Autism Science Digest: The Journal of Autismone. 4, 94-102.
SP. Havas, M. 2008 Health Concerns associated with Energy Efficient Lighting and their Electromagnetic Emissions. Scientific Committee on Emerging and Newly Identified Health Risks. Request for an opinion in “Light Sensitivity”.
JA. Loew S J, Fernandez E, Watson, K. 2013 Incidence of Meares-Irlen/Visual Stress Syndrome in reading and learning disorders: does fluorescent lighting in classrooms affect literacy and numeracy? Aula Abierta 41, 3, 23-32.
JA. Wilkins AJ, Evans BJW. 2010. Visual Stress, its treatment with spectral filters and its relationship to visually induced Motion Sickness. Applied Ergonomics. 41. 509-515. (This article is also mentioned in General Medical category above.)
RESEARCH FOR SPECIFIC GROUPS
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