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What does “visual stress” mean? It appears to be a new term for what has also been called Irlen syndrome (described by Steve Novella in 2013 as an “alternative medicine zombie”), Meares-Irlen syndrome, and scotopic sensitivity syndrome. It is a proposed visual disorder that remains highly controversial. It is said to cause reading difficulties and to be treatable with colored overlays or tinted glasses. The Opticalm Visual Stress Clinic in Ontario offers evaluations and products to treat it.

Visual stress is said to cause

  • Sensitivity to bright and fluorescent lighting and glare
  • Slow or inefficient reading
  • Poor reading comprehension
  • Poor attention and concentration
  • Eye strain
  • Fatigue
  • Headaches and migraines
  • Poor depth perception

Is visual stress real? Is it a meaningful term?

The Wikipedia article conveniently reviews the research and has a section on “scientific repudiation” that asks:

  1. 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;
  2. Whether it is causally or incidentally related to dyslexia, autism, or other conditions; and
  3. Whether existing methods of scotopic sensitivity syndrome treatment are appropriate and effective.

It goes on to review statements by several professional organizations that question the diagnosis, attribute the symptoms to other diagnoses, and discourage the use of colored lenses

Opticalm

The Opticalm clinic estimates that Visual Stress affects 20% of poor readers and 15% of the general population. It promises to:

  • Reduce: Symptoms of migraine, photophobia, post-concussion symptoms, visual sensory processing disorder, ADHD and post-stroke vision problems.
  • Relieve: Headache, eye pain and strain, light and screen sensitivity, nausea from movement, visual sensory overload and cognitive fatigue.
  • Improve: Learning, reading, attention, mood, visual perception, balance, confidence, general health, behaviour, recovery time and the effectiveness of other therapies.

Their online store sells non-LCD computers, screen tinting software, lighting solutions, colored overlays, paper and pens, and more. Their website offers a self-test; I took it to see what would happen. The test asks a variety of questions such as whether you have light sensitivity, headaches, difficulty with balance, ADHD, autism, Tourette syndrome, etc. I filled it out as honestly as I could, and received an email in response. It consisted of a more detailed questionnaire and a list of their services and pricing. Assessment services cost $485.00 and a formal report, $125.00. I would think most customers would want a formal report.

They use a device called the Intuitive Colorimeter to present different colors to patients to determine the specific color that will benefit them the most, based on the hypothesis that the optimal color needs to be specifically prescribed, with precision.

Eye strain? Migraine?

The term “eyestrain” is a nonspecific term that means different things to different people: dry eyes, fatigue, headaches, double vision, eye discomfort, and more. Migraine is not known to be caused by “visual stress”.

Conclusion: I am skeptical

This clinic offers to assess and treat a vague, questionable diagnosis. I’m not convinced that their services are worth $485 of my money. I don’t doubt that some conditions may be improved by colored lenses or overlays; but we need better, more specific evidence, and it doesn’t make sense to prematurely rush into treatments that may or may not work. Needless to say, the “research” they list does not include any controlled studies to evaluate whether their clients experience objective benefits.

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  • Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.

Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.