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you have the necessary training in the techniques required to examine
patients with these difficulties”.10 Not all eye care practitioners will have
the expertise and equipment to carry out these detailed investigations
of children with reading difficulties. But within the professions of
optometry, orthoptics, and ophthalmology, there are practitioners who
have specialised in assessing and treating visual factors that can affect
reading and learning. Parents, teachers, and educational psychologists
often ask how they can find such a specialist practitioner in their area
and in response to this question an organisation was established in
2007 called the Society for Coloured Lens Prescribers.
Society for Coloured Lens Prescribers
The Society for Coloured Lens Prescribers is an internet-based
organisation, found at www.s4clp.org. It is a not-for-profit voluntary
body that is independent: it is not funded by any commercial
organisation and does not charge for membership. The society is
multidisciplinary and aims to encourage a high level of care from
practitioners specialising in this field. Members have consented to
abide by a code of conduct that ensures that they have appropriate
training, expertise, and equipment.
A list of members of the Society is published at www.s4clp.org for
the public and education professionals so that they can find
practitioners who can provide expert advice on coloured filters and
prescribe these when appropriate.
The code of conduct states that members will adopt an evidence-
based approach and will only prescribe coloured lenses after a full eye
examination to detect other relevant conditions. Society membership
is open to optometrists, orthoptists, opticians, ophthalmologists,
psychologists, and teachers. Practitioners can join through individual
Chapter 10 Clinical protocol
301
membership, where the practitioner (typically an optometrist) provides
for all the visual needs of people who might need coloured filters.
Practitioners can also join the society as part of a team who together
provide for the visual needs of people who might need coloured filters.
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Chapter 10 Clinical protocol
307
Chapter 11
Other potential clinical uses of precision
tinted lenses
Chapter abstract
In this chapter we review studies in which precision tints have been
used in a variety of neurological disorders, including photosensitive
epilepsy, autism, migraine, cluster headache, visual snow, stroke,
multiple sclerosis and concussion (mild brain trauma). Whilst the
evidence regarding these topics is preliminary and indicative, the
effects of coloured filters in these conditions may help to further
elucidate the mechanisms underlying the benefit from colour. In
particular, the extent to which these findings provide convergent
support for the cortical hyperexcitability hypothesis is discussed.
Photosensitive epilepsy
Photosensitive epilepsy is a condition in which seizures are
provoked by flickering light. It is usually diagnosed with the help of the
electroencephalogram (EEG), which shows a particular configuration of
waveforms, known as a photoparoxysmal response, when the patient
is exposed to flickering light. Over the years there have been many
studies of the effect of the colour of the light that provokes this
response. In their review, Harding and Jeavons1 (pp 57-61) cite 17
studies, some showing greater effects of red light and some showing
little difference between light of various colours when brightness is
controlled. Many patients with photosensitive epilepsy are sensitive
© 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_11
309
not only to flickering light but also to patterns.2 To see whether
precision tints might offer symptomatic relief, Wilkins and colleagues3
examined 33 patients with photosensitive epilepsy. Twenty-three
(70%) reported beneficial perceptual effects of coloured light in the
Intuitive Colorimeter and were given precision tints to wear. The
chromaticities of the tints are shown in Figure 11.1. They transmitted
29.9% of the light on average. Seventeen of the 23 patients were
contacted after an average of 2.4 years. Thirteen of the 17 (76%) were
still wearing the tinted glasses and reporting reduced symptoms. There
were reduced seizures in three patients, some of whom received
changes in antiepileptic medication during this period. One patient,
however, had no change in medication over the course of five years
and the reduction in her seizures was unequivocal, see Figure 11.2.
Figure 11.1 Chromaticities of lenses selected by patients with photosensitive
epilepsy, redrawn from Wilkins et al.3 The large points represent lenses that
were of particular benefit. Compare the distribution of chromaticities to
that in Figure 8.1.
Vision, Reading Difficulties and Visual Stress
310
Chapter 11 Other potential clinical uses of precision tinted lenses
311
Figure 11.2 For one patient who appeared to receive a marked benefit from
precision tinted lenses, the number of seizures every 3-month period before
and after blue glasses became available. Reproduced under
Permissions Guidelines from Wilkins et al.3
STM
Autism
Many children with autism spectrum disorder (ASD) have a sensory
sensitivity. A series of studies has revealed how coloured filters can
reduce this sensitivity and thereby improve the perception of emotion.
The first study, conducted by Ludlow et al.4 used the Intuitive Overlays
(described in Chapter 9). Nineteen school children with a diagnosis of
autism (aged 8-15 years) and a control group of 19 typically developing
children (matched for age and intelligence) selected an overlay of a
colour that improved the clarity of text. Eleven of the children with
autism increased their reading speed on the Wilkins Rate of Reading
Test by more than 15%. An increase of this magnitude was seen in only
two children in the control group. Subsequent work by Fong and
colleagues5 has failed to find any effect of coloured overlays in children
with autism, but their task involved reading digits arranged in a widely
spaced matrix.
In a subsequent study Ludlow et al.6 placed overlays over a page of
text and asked children to select those that improved the clarity of text.