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Vision issue: Looking at Irlen syndrome through a different lens

December 1, 2014


Call it motherís intuition, but Maria Hill knew something was up with her son.

He was having headaches, struggling academically and missing words when reading. When he read aloud, he would make up words to replace ones he didnít see. He also claimed the words would move.

"He would see one word, and the rest would run off the page," she said.

As second grade at Petty Elementary in Antioch, Ill., drew to a close with her son Reinoís grades slipping, Hill wanted to get to the bottom of what was going on.

Months later, she got an answer. He was diagnosed with Irlen syndrome, a perceptual-processing disorder that is said to be caused by the brainís inability to process wavelengths of light and ultimately visual information.

The condition is considered controversial, drawing criticism from some in the medical and academic communities who question its very existence.

For 10-year-old Reino and others, the solution was as simple and inexpensive as a colored overlay.

For most people, reading black characters on a white background isnít a problem. But for people with Irlen syndrome, or scotopic sensitivity, reading can be disorienting or even painful. In severe cases, words can transform into a confusing, disorganized sea of letters. Others see objects as closer or farther away than they actually are, or in different locations entirely. Symptoms compare with those of sports-related concussions.

Until Helen Irlenís research at California State University at Long Beach in the 1980s, remedies were largely unidentified.

Using a federal grant to test a dominant-eye theory with red and green lenses, she discovered that individuals showed a marked improvement in reading when words were covered with colored acetate sheets or overlays. Further testing led to the use of precision-tinted filters and to development of screening methods to identify the disability and determine the color that provides maximum relief.

"I was going beyond what was considered a reasonable theory," Irlen said.

The basic principle is that specific wavelengths of light disrupt visual processing. The condition, primarily hereditary, usually manifests itself in early childhood and is caused by a defect in one of the visual pathways that carries messages from the eyes to the brain. Itís a timing fault.

"Itís like static on a radio," Irlen said. "It causes visual distortions like optical illusions."

Thatís why children and adults diagnosed with the disorder also can have spatial difficulties, depth-perception problems or poor coordination. Milder symptoms include distractibility, drowsiness, headaches, fatigue and nausea.

According to Irlen, filtering out disruptive wavelengths on the visual spectrum allows pathways to function normally, and information is processed efficiently and accurately. Irlen symptoms are most evident indoors when reading on white paper, on illuminated computer screens or under fluorescent lighting.

With initial screenings between $75 and $100 and colored overlays a few dollars apiece, the decision to give it a try was a no-brainer for Hill.

"Why not?" she said. "I think the cost is well worth the try. Thereíre no needles, no medications."

Severe cases often require a secondary evaluation to fit individuals with glasses or contacts with precision-tinted lenses. Assessments to identify the optimal color, hue and saturation are performed by certified diagnosticians, and lenses are dyed to suit individual specifications. The cost of comprehensive evaluation and to have lenses dyed by technicians at the Irlen Institute runs $500 to $600.

Preliminary self-tests to see if Irlen syndrome might be a factor are available free online at irlen.com.

Michelle Ruminski, also of Antioch, tried for years to find a remedy to help son Tom with his struggles with reading and "crazy calculation errors" in math. Like Reino, Tomís troubles began in second grade and included headaches, but Tomís writing also was affected.

"He would stare at the page," she said. "He had great ideas and expressed them beautifully. However, when he would try to write them on the page, itís like he couldnít get them out. They were stuck in translation."

He also had trouble with widely used Scantron answer sheets for standardized tests. The rules and bubbles were distracting.

For years they visited psychologists and optometrists, and eventually he was prescribed vision therapy, an expensive alternative that can cost thousands of dollars. For the Ruminskis, it was not covered by insurance because it was considered "experimental treatment," so they paid out of pocket.

After fourth grade, Tom was screened for Irlen syndrome and given a turquoise-tinted overlay. It had an immediate impact. His reading rate improved by more than 60 words a minute in less than a week.

"We were all absolutely astonished," Michelle Ruminski said.

A year later he was fitted with tinted-lens glasses.

Michelle and her husband, Ron, didnít stop there. They removed all fluorescent lighting in their house and made sure Tom could wear his tinted glasses in school and get a seat assignment that minimized glare and distractions. They also requested that classwork be printed on colored paper if he doesnít have his glasses.

"I know there are many skeptics about the validity of Irlen filters and their effectiveness. Let them doubt," Ruminski said. "I have seen what a huge difference that this simple intervention has made for my child and I am a believer."

In 2011, researchers at the University of Edinburgh performed trials on children ages 7-12 with reading difficulties using the Irlen method and said their data suggests "overlays do not have any demonstrable immediate effect on reading in children with reading difficulties."

Dr. Stuart Ritchie, a researcher who worked on the study, said using colored lenses is a classic example of "cart before the horse," a treatment on sale for a disorder that is not well defined. He added that itís also difficult to test in a controlled environment because of the placebo effect.

"Itís very difficult to do research on a subjective phenomenon, like the removal of distortions," Ritche said by email. "Iíd want to see large-scale, placebo-controlled, longitudinal studies in reading ability across time.

Irlen, a graduate and former instructor at Cornell University, refutes the criticism, saying her method is designed to relieve perception problems that can diminish reading skills. She points to more than 60 studies in academic and scientific journals that support the use of colored filters.

In 2004, independent research by Dr. Daniel Amen at the Amen Clinic in Irvine, Calif., used brain scans to demonstrate differences in the brainís ability to function using colored filters. The brain-mapping technology showed that areas of the brain were significantly overstimulated and activity in the cerebellum (the area that helps integrate information) was decreased in untreated individuals with the disorder. Scans from individuals using colored filters showed more balanced activity and "normalization" of brain function.

Irlen, whose Irlen Institute is based in Long Beach, Calif., and has 170 affiliated clinics in 46 countries, said she isnít surprised that more people in the medical community havenít embraced her methods.

"When youíre doing something outside the establishment, they think itís a gimmick," she said. "They think all (reading) problems are solved with practice and repetition. (But) we have 30 years and millions of kids as proof."

Professional athletes in the NFL and NHL who have suffered concussions have endorsed the use of Irlen filters, and school districts in California, Florida and Texas have added Irlen testing and training programs to their curriculums.

Nicole Kirby, a first-grade teacher at St. Stanislaus Kostka School in Chicago, had a student who was diagnosed with Irlen syndrome, and she wasnít sure what to make of it when approached by the parent to use colored paper for class assignments.

"I was a little skeptical at first," she said. "It almost sounds silly that a colored page can make a difference, but it does. Itís definitely something Iíll keep in mind and be aware of. If a student is struggling, it could be something like this."

Bonnie Bartels, an education counselor in Des Moines, Iowa, became an Irlen diagnostician about 10 years ago after her college-aged sons were diagnosed with the syndrome. She now conducts screenings and tint assessments with clients across five states.

Lately, Bartels said, she has seen more cases with veterans who served in Iraq and Afghanistan. Often they take medications to curb light sensitivity and other Irlen-like symptoms after traumatic brain injuries. Some turn to drugs or alcohol to dull the symptoms, Bartels said. For them, the Irlen filters often become a lifeline to normalcy.

"Itís the ultimate (tool)," she said. "My office seems to be their last hope."

(EDITORS: STORY CAN END HERE)

Reino Hill isnít sure exactly when he started having trouble reading, it just kind of crept up on him.

He started experiencing "ping-pong" headaches, with pain ricocheting back and forth in his head, and his reading was becoming choppy. Words were disappearing. He stopped playing sports because he was having trouble seeing the ball.

Maria attended a seminar by Julie Yepsen, a certified Irlen diagnostician in Gurnee, Ill., and decided to have Reino evaluated. After testing positive, they visited Bartels, and he was fitted for blueish-tinted lenses. His symptoms began to fade almost immediately.

"It was a life changer," Maria Hill said. "If it wasnít for those glasses, heíd be in big trouble."

"Iím able to concentrate with what Iím looking at," said Reino, pausing, "And I can play more video games."

 

 


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