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153
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Chapter 6
Coloured filters for visual stress
– early studies
Chapter abstract
The historical background to the use of colour in assisting with
reading is summarised in this chapter. Recent developments in the
optometric use of coloured filters were facilitated by modern
techniques for tinting plastic ophthalmic lenses. These techniques
permit the selection of coloured lenses defined by a spectral
transmission that suits an individual. The two new systems developed
to use this technology in the 1980s for precision tinted lenses are
described, together with associated developments in the Intuitive
Colorimeter system, Intuitive Overlays, and Wilkins Rate of Reading
Test.
History
As noted in Chapter 1, the term coloured filters is used generically to
describe both coloured lenses and coloured overlays (tinted
transparent sheets placed on the page when reading). The use of
coloured filters to help with reading has a long history. Coloured
lenses, usually blue or green, were used “to ease eyestrain from heavy
reading” from the end of the eighteenth century1 (see Figure 6.1 for
examples from the British Optical Association Museum).
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2024 A. J. Wilkins and B. J. W. Evans, Vision, Reading Difficulties and Visual Stress,
https://doi.org/10.1007/978-3-031-65568-5_6
155
Figure 6.1. Examples of coloured reading lenses from the British Optical
Association Museum. Reproduced with permission from the College of
Optometrists.
The first scientific report of the use of colour to assist patients with
specific reading difficulty is probably that by Jansky in 1958:2
“When reading aloud Dick found it hard to hold to the line...Dick was able to
recognize a word printed on a yellow sight card, but not the same word when printed on a white one…”
This isolated report was regarded as a rarity until 1980, when Olive
Meares, a school teacher from New Zealand, published a paper in the
journal Visible Language.3 This paper described her pupils' reports of
visual perceptual difficulties, and how these difficulties could be
reduced by using coloured paper or covering the page with sheets of
plastic such as x-ray film, or Perspex.
Three years later, Helen Irlen, a psychologist from California, read a
paper to the American Psychological Association4 describing how her
students reported fewer visual distortions when aided by coloured
filters. In her book "Reading by the Colours"5 she describes 37
Vision, Reading Difficulties and Visual Stress
156
individuals with visual perception problems, 31 of whom were helped
by a coloured sheet. For each individual helped, certain colours could
make things better and other colours could make things worse. But for
each person helped, there was one colour that worked best. Initially,
Irlen called the condition scotopic sensitivity syndrome (SSS), which is
now deprecated because “scotopic” refers to night vision. Irlen also
referred to Irlen syndrome and others later used the terms Meares-
Irlen syndrome, pattern-related visual stress, or nowadays just visual
stress.
Irlen went on to investigate whether the benefit of coloured sheets
could be replicated by the use of coloured lenses. The advent of plastic
(CR39 resin) spectacle lenses had recently simplified the manufacture
of coloured lenses. Previously it had been necessary to create a batch
of glass tinted to a particular colour, an expensive process that was
justifiable only if a large number of lenses were to be made in a
particular colour. With plastic lenses it was possible to tint an
individual’s spectacle lens any required shade simply by dipping it into
hot dye for a few minutes.
Irlen made a set of trial lenses that could be combined by placing
one on top of another to provide a large range of colours, and
discovered that she could often obtain a tint that was beneficial. She
established Irlen Institutes, later called Centres, in which she licensed
treatment with the specially coloured filters that she had devised. Irlen
claimed, controversially, that the coloured filters needed to be
prescribed using her methods. Despite the anecdotal evidence of their
success,
6–8
her claims and commercial activities aroused scepticism,
suspicion and ultimately the opposition of many established
practitioners of ophthalmic care.9 Without her initiative and drive
however, the discovery would have been submerged in a swamp of
scepticism and might have sunk without trace. That being said, for a
Chapter 6 Coloured filters for visual stress– early studies
157
new treatment to make progress there needs to be scientific evidence
that the treatment works and ideally some idea as to why. The
development of the Intuitive Colorimeter was important in facilitating
such evidence. First, the scientific principles underlying the way colour
Vision, Reading Difficulties and Visual Stress
158
is perceived and measured will be briefly summarised.
Photoreceptors in the eye
The visible spectrum consists of electromagnetic radiation with
wavelength between about 400nm and about 700nm. Some of this
light is captured by photoreceptors in the eye. The retina at the back of
the eye contains two main classes of light receptor, named after their
shape: cones and rods. There are three categories of cones each
sensitive to different ranges of wavelengths. L-cones are sensitive to a
wide range of long-wavelength light and are maximally sensitive at
564nm. M-cones are also sensitive to a wide range of mid wavelengths
but are maximally sensitive at 534nm. The S-cones are maximally
sensitive at about 420nm, see Figure 6.2
Figure 6.2 Sensitivity of the L, M and S cones, rods and melanopic
intrinsically photosensitive retinal ganglion cells from Wikipaedia. See
Stockman and Sharpe.10
The rods are sensitive at low light levels and their sensitivity peaks
at 490nm. There are also retinal ganglion cells that are sensitive to light
– the intrinsically photosensitive retinal ganglion cells (ipRGCs). These
provide information about light intensity and are responsible for the
pupillary response.