Irlen Syndrome

What is Irlen syndrome?

Irlen syndrome (also known as Meares-Irlen syndrome, Scotopic Sensitivity syndrome or Visual Stress) is a perception disorder that affects the brains ability to process visual information. Irlen syndrome is not an ocular problem [1].

Causes of Irlen syndrome

It has been observed, that Irlen syndrome runs in families, but currently definite genes causing this problem have not be found [2]. This condition can affect people suffering from epilepsy, migraine, multiple sclerosis and others. 3]. This syndrome can also occur after traumatic brain injury, in Post concussion syndrome.

Irlen syndrome also has similar features with attention deficit/hyperactivity disorder, chronic fatigue syndrome and dyslexia. In these three disorders, disruption in normal lipid metabolism have been found, like low serum cholesterol and fatty acids. These disturbances are correlated with apolipoprotein B-100 – a transport molecule. Gene APOB coding for this molecule is located in chromosome 2. The APOB gene is now associated with Irlen syndrome[4].

Irlen syndrome symptoms

The symptoms vary greatly for each patient, also depending on the primary condition.

Irlen syndrome can affect the ability to concentrate, academic performance, ability to work and even behavior.

  • Sensitivity to light
    • Difficult to find comfortable lightning
    • Stain under bright light, fluorescent lights or sunlight
    • Physical symptoms caused by light sensitivity: tiredness, anxiety, irritation, headaches, trouble focusing. These symptoms might be present when watching TV or working on a computer.

irlen syndrome

  • Reading difficulties
    • Hard to understand the text
    • Skipping words or lines of text
    • Trouble following the lines of text
    • Patient might start to avoid reading, or read in dim light
  • Trouble holding attention when reading or studying

Example of how normal text can look to a patient ith Irlen Syndrome

  • Writing difficulties
    • Unequal space between the lines and/or unequal letters
    • Hard to copy text
    • Written text either goes up or down the page
  • Problems connected with depth perception
    • Often has accidents
    • Difficulty catching objects
    • Clumsiness
  • When reading, patient might experience that the words are blurry, spinning or disappear [1].

Irlen syndrome differential diagnosis

The symptoms of Irlen syndrome might also be a sign of another possible disease. These include Autism spectrum diseases, like Autism and Asperger´s syndrome, Irritable bowel syndrome, Short bowel syndrome. When screening for Irlen, doctor should also pay attention to other symptoms associated with these conditions.

Irlen syndrome and dyslexia

Dyslexia is sometimes referred to as reading disability, but it can also affect spelling and even speaking. Dyslexia runs in families and some anatomical and functional disturbances in brain have been linked to this condition[5]. Dyslexia can also occur with various syndromes, like Triple X syndrome, West syndrome. Symptoms of dyslexia include: trouble recognizing words, letters and sounds, trouble learning new words and word sequences, difficulty understanding jokes, sequences, directions or idioms. Irlen syndrome can also be found in children suffering from dyslexia.

Irlen syndrome screening

Colored overlays have been used to screen for Irlen syndrome. This test can show an immediate improvement on the Wilkins Rate of Reading Tests. This test consists of random words, that look like a normal text. Results are measure based on the speed and accuracy of reading [6]. Irlen syndrome is diagnosed if the improvement on this test is more than 5% if using color filters [7].

wilkins rate of reading test

Example of text for Wilkins Rate of Reading test
Image source:

Irlen syndrome treatment

Irlen syndrome is not a curable condition, but it can be managed with various therapies. In patients who have an underlying condition like migraine or epilepsy, this condition has to be managed first. Treatment can improve the ability to read.

The treatment involves using color overlays and eye exercises to improve eye coordination. It is believed, that color overlay can help to reduce the visual stress. The color overlay sheet is simply put on a page of text.

The Irlen method refers to use of color glasses. Color filter combinations are used to determine which tone best helps to improve the symptoms.

There are still ongoing discussions about the advantages of using color filters. Some studies have found that color filters can increase the accuracy and comprehension of reading, but not speed [8].

irlen lenses

Irlen glasses
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Irlen syndrome controversy

Research is continuing to find the causes and remedies for Irlen syndrome. Still, Irlen syndrome has not been recognized as an existing disease. It is not listed as a disease on International classificatory of diseases and related health problems (ICD) or on Diagnostic and Statistical manual of mental diseases. These manuals also do not recognize visual perception disorder as a symptom of dyslexia. It can be argued, that this syndrome is not recognized because of lack of research or perhaps it simply does not exist. The diagnosis and treatment was promoted before any legitimate scientific proof was found [9].

It has also been speculated that the use of colored lens glasses is a marketing idea. Testing of this syndrome and special glasses are very expensive, but the results of their use are controversial.

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