Irlen Syndrome

Irlen Syndrome…[Page number]

Contents… [Page number]

Summary… …[Page Number]

Terminology… …[Page Number]

Aetiology… …[Page Number]

####### Symptoms… …[Page Number] ######## Prevalence… …[Page Number]

Diagnostic Procedure…

Irlen Syndrome… …[Page Number]

Visual Stress… …[Page Number]

Differential Diagnosis… …[Page Number]

Co-Ocurring Conditions…

ADHD… …[Page Number]

Specific Learning Disorder… …[Page Number]

Who Recognises Irlen Syndrome?

Treatments for Irlen Syndrome…

Types of lenses

Types of lenses ……………… 13

Evidence of Efficacy

A short line is present here. Evidence of efficacy ………….. 13

Prognosis

The prognosis section begins below: Prognosis …………… 18

References

References are listed on page nineteen: … References ………. 19

This document was released under the Freedom of Information Act 1982 by the National Disability Insurance Agency

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2. Summary

Irlen syndrome, also called Scotopic Sensitivity Syndrome, visual stress, Meares-Irlen syndrome, and Meares-Irlen syndrome/visual stress, refers to a collection of symptoms associated with visual processing problems and difficulty reading. The recommended treatment for Irlen’s syndrome is prescription tinted/coloured lenses and/or overlays.

Irlen syndrome does not appear to be recognised by major medical bodies or public health organisations such as the World Health Organisation. Some state school systems in Australia offer accommodations for children diagnosed with Irlen’s syndrome.

There is no consensus in the literature that the symptoms described are associated with a separate visual processing condition distinct from dyslexia, other recognized disorders of the isual processing system or other neurodevelopmental conditions. Some researchers present evidence suggestive of the existence of a distinct visual processing disorder like Irlen syndrome, but these studies are often low quality with findings open to interpretation. Theseindings are further complicated by the link to visual stress, a term that is sometimes used internchangeably with Irlen’s syndrome, sometimes used to refer to a more general condition ofwhich Irlen syndrome is a type, and sometimes used to refer to a separate condition altogether.

There is no consensus in the literature that tinted/colored lenses and/or overlays can treat or anage the symptoms associated with Irlen syndrome. Evidence suggesting efficacy of tinted lenses or colored overlays is complicated by low-quality studies, self-reported assessment procedures, prietary treatment procedures, commercial conflict of interest and lack of clarity about what symptoms or conditions are actually being addressed with use of the lensessoverlays.

3. Irlen Syndrome

irren syndrome is defined by the American Academy of Ophthalmology (AAO) as a visual- itprocessing disorder that is characterized by difficulty with reading (2025). According to the rilen Syndrome Foundation (n.d.c), Irlen syndrome is not an optical problem but a problem with the brain’s ability to process visual information. It is not remediable and can be a lifetime barrier to learning and performance.

colored filters (colored overlays/lenses) are often claimed to be a treatment for people who experience the symptoms described as rilen syndrome (Wilkins & Evans, 2024, p. 10).

3.1 Terminology

Irlen syndrome is known by several names including Scotopic Sensitivity Syndrome, visual stress, Meares-Irlen syndrome, and Meares-Irlen syndrome/visual stress (MISViS) (AAO, 2025; Miyasaka et al., 2019).

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Research paper OFFICIAL For Internal Use Only The Irlen Institute (2014b) explains that the set of symptoms known contemporarily as Irlen syndrome or visual stress was initially called Scotopic Sensitivity Syndrome (SSS), and referred to as such in the research, based on the belief that the primary difficulties associated with the disorder occurred when the brain tried to process light within the scotopic range of the visible light spectrum. However, this name was often misinterpreted to mean scoptic vision/night vision which lead to confusion and discreditation of the method. As a result, the name Irlen syndrome began to be used, named after the psychologist who first described the set of symptoms, Helen Irlen.

Irlen syndrome is sometimes referred to as Meares-Irlen syndrome, jointly named after Helen Irlen and Olive Meares, the latter being a teacher who identified symptoms similar to those noticed by Irlen during the same time period. The term visual stress has been used in recent years, primarily in the United Kingdom (UK), in an attempt to “simplify and generalise the name with the hopes to garner broader acceptance and understanding of the disorder” (Irlen Institute, 2014b).

Miyasaka et al. (2019) state:

It is remarkable that IS advocates changed their position slightly, shifting from the controversial lacking evidence denomination of IS to Meares-Irlen syndrome/visual stress and then to a vaguer term, visual stress, supposedly as the same condition (p. 204). Throughout this paper, the original terms used in the sources under discussion will be used. When referring in general to the set of symptoms described by the various names discussed above, the term Irlen syndrome will be used.

3.1.1 Visual Stress and Irlen Syndrome

As noted in the previous section, the term ‘visual stress’ is often used to refer to the symptoms which are also described a Irlen syndrome or SSS. However, there is some evidence that Irlen syndrome is a type of visual stress and using the two terms interchangeably may not always be appropriate. Purcell (n.d.) states that in the UK, visual stress and Irlen syndrome tend to be treated as the same thing. Originally, Irlen syndrome was used to describe specific pattern-related visual difficulties first described by Irlen and Meares. However, visual stress is now the preferred term as it encompasses a wider range of visual discomfort and difficulties, and not only those described by Irlen and Meares. Visual stress is now used as a descriptor for all types of visual perceptual difficulties associated with reading, making it a more inclusive term. The Village Optician (n.d.) and Dyslexia Scot West (n.d.) both state that Irlen syndrome is a specific type of visual stress, and The Village Optician provides an overview of the key differences between Irlen syndrome and visual stress:

Table 1 Key Differences (Source: The Village Optician, n.d.)

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Aspect	Irlen Syndrome	Visual Stress
Scope	Specific Condition	Broader term
Diagnosis	Specialised Irlen screening	Various visual assessments
Treatment	Irlen filters	Range of colour-based solutions

Additionally, Evans (2022) states that the term ‘visual stress’ is potentially problematic as it is also used to describe visually stressful conditions relating to binocular vision anomalies which are more motor in origin. The author suggests that the term ‘sensory visual stress’ maybe be more appropriate. However, this distinction does not seem to be widely used in the research on Irlen syndrome or visual stress. Wilkins and Evans (2024) also mention the term “pattern-related visual stress”(PRVS). While this term appears frequently within Wilkin’s work but isn’t commonly utilized regarding Irlen syndrome literature.

Aetiology

The American Academy Of Optometry(AAO)(2025)suggeststhereiscurrentlynostrongevidenceofclearaetiologymISViSandthatthepreciseunderlyingmechanismsremainill-defined.Thereisthegeneticcomponent.However,furtherstudyarerequiredtoconfirmthis.TheIrenInstitute(n.d.b.)statesmedicalresearchhasshownthatttIslenSyndromeappeartobe causedbyadefectinoneofthesevisualpathwaysthataretransmitmessagesfromeyeto brain.Thisdefectcausesatimingfaultprocessingvisualinformation.Filteringout specificwave lengths of light helps pathway function normally.

Symptoms

Symptoms described by peak bodiesanddiagnosticclinicsinclude:

distortions(letterswordbecomingblurryfadingshakingorbeingwashed;paragraphsonapageswirlingbeawyewrippeled,andappearancehalosaroundletters eystrain difficulty focusing\light sensitivity
haveachesmigraines\nausea\dizziness|

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• attention and concentration problems • strain and fatigue • poor depth perception • inefficient reading • poor spelling • a reluctance to write (Irlen Diagnostic Clinics, n.d.b; Irlen Syndrome Foundation, n.d.c).

3.4 Prevalence

The Irlen Syndrome Foundation (n.d.c.) reports the prevalence of Irlen syndrome as 14% among the general population. However, no citation for this figure is provided. Studies on the prevalence of Irlen syndrome in different cohorts show dissimilar results. Raj (2020) found that 50% of 103 college and school students exhibited symptoms of Irlen syndrome, while Bernal and Tosta (2015) found the prevalence of “severe” Irlen syndrome to be 25.84% in third graders of elementary schools in Cuenca but also state that the worldwide prevalence is 12–15% (p. 2). Prevalence has been reported as between 20% and 24% in two Australian secondary schools (Caskey & Freney, 2019, p. 146). Miyasaka et al. comment that studies on the prevalence of Irlen syndrome exhibit concerning heterogeneity (p. 196).

4. Diagnostic Procedure

4.1 Irlen Syndrome

Diagnosis of Irlen syndrome is based solely on the self-reporting of symptoms and individuals’ subjective response to treatment (Flaherty et al., 2024, p. 162). Irlen Diagnostic Clinics (n.d.a), refer to The Irlen Method. This method consists of two testing sessions: a screening appointment by Irlen Screeners and Irlen Diagnosticians, and a testing appointment for Irlen Spectral Filters by Irlen Diagnosticians. The Irlen Institute (n.d.b) describes the Screening session as including various perceptual tasks carried out with a certified Irlen Screener or Diagnostician. The colour of the overlay which will provide the greatest benefit is determined during this session and the customer can take the overlay home to use. If the customer experiences improvements in reading, they attend a second session called a Tint Assessment. During this session, the customer works with different coloured lenses to create their own unique color. The AAO (2025) states that a proposed diagnosis of MISViS occurs in two stages: • Stage 1 Diagnostic Phase: initial screening with the Irlen Reading Perception Scale (IRPS). The IRPS determines severity of reading difficulties, visual discomfort and

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The document was released under the Freedom of Information Act 1982 by the National Disability Insurance Agency.

Stage 2 Treatment Phase: full assessment and determination of Irlen lens filter colour combination for reduction of symptoms which demonstrates an immediate improvement, usually exceeding 5%, on the Wilkins Rate of Reading Test (WRRT).

The Irlen Institute also provides an Irlen Syndrome Self-Test to help people determine whether they should contact an Irlen Screener or Diagnostician for a formal assessment.

According to Griffiths et al. (2016), the Irlen testing procedure involves a series of questions to probe for perceptual difficulties during reading which can include distortions, light sensitivity and headaches, and a series of visual tasks (pp. 529-530). Importantly, Flaherty et al. (2025, p. 2) state that the assessment process is a commercial secret and all screeners are required to sign a non-disclosure agreement. However, it is claimed that the Irlen process is the only method that has been scientifically proven to effectively address visual processing problems associated with Irlen syndrome.

4.2 Visual Stress

A 2017 Delphi study, Evans et al., attempted to develop practical diagnostic guidelines for visual stress. The study involved 26 optometrists, orthoptists and opticians who were frequent prescribers of precision tinted lenses. The study identified putative diagnostic features to be:

At least three of the following six typical symptoms:

words move
words merge
patterns or shadows in text (e.g., rivers)
text seems to stand out in 3D above the page
words or letters fade or darken
discomfort with certain artificial lights and flicker.

And at least two of the following three signs from investigations:

voluntary unprompted use of an overlay for 3 months or more
overlay improves performance at the WRRT by >15%
Pattern Glare Test result is >3 with mid-spatial frequency grating.

Harkin et al. (2025) state that visual stress diagnosis is on an ad-hoc basis, with symptomology and diagnostic criteria poorly understood (p. 1). Khan et al. (2024) also state that the absence of standardised diagnostic criteria for SSS remains a challenge for research as many studies rely on subjective reports of symptom relief as a primary outcome (p. 2).

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4.3 Differential Diagnosis

The AAO (2025) state that there is no biomarker or imaging finding that can diagnose MISViS. They recommend that before establishing diagnosis of Irlen syndrome, conditions such as accommodative, binocular, and ocular motor dysfunctions, other ocular motor conditions, dyslexia, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, behaviour problems and psychological or psychiatric disorders should be considered. The AAO also recommends evaluation by an ophthalmologist with experience with paediatric care to exclude alternative aetiologies.

The Irlen Institute (n.d.b) states that visual problems should be corrected before Irlen testing occurs.

5. Co-Occurring Conditions

The Irlen Syndrome Foundation (n.d.a) reports that Irlen syndrome is commonly misdiagnosed as dyslexia, ADHD, behavior problems, or psychological/psychiatric disorders. According to the foundation (n.d.c), 33% of individuals with autism spectrum disorder and 33% of those withattention and concentration problems, including ADHD, have co-occurring Irlen syndrome. Additionally, 46% of people with reading or learning difficulties (including dyslexia) and 35% of people with traumatic brain injury or concussion are said to have Irlen syndrome. These statistics were provided without citations.

5.1 ADHD

The Irlen Institute (n.d.a) state that Irlen syndrome can cause symptoms that are very similar to ADHD such as attention and concentration difficulties, irritability, and agitation. However, the main difference is that for those who have Irlen syndrome, lighting causes these symptoms rather than ADHD.

In their 2013 paper, Watson and Loew found a lack of significant variations between participants with ADHD (n=12) and those diagnosed with SSS (n=18,) whereas variations between those with ADHD or SSS compared with the controls (n=46) were highly significant. The variations discussed were elicited via a self-report questionnaire surveying participants about the presence or absence of 9 symptoms.

BarNir et al. (2023) tested 59 adults diagnosed with both ADHD and visual stress, redacted of which received spectral filters to address visual processing difficulties and redacted of which had no intervention. Before the intervention and one hour after the intervention short-term changes were assessed in participants’ attention profiles using a computer based continuous performance test called the MOXO d-CPT. Long-term effects were assessed using the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) before and 3–6 months after the intervention. The intervention group had significant short- and long-term improvements in overall attention compared to the control group. redacted% of participants after the short-term intervention and redacted% after the long-term

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intervention no longer met criteria for an ADHD diagnosis. The authors state that findings suggest that spectral filters may be an adjunctive treatment for many adults suffering from perceptually-based attention issues common to visual stress and ADHD.

It is important to note that these studies both have rather small participant cohorts. Additionally, BarNir et al. (2023) point out the limitations of their study as the inability to control for a Placebo effect and their decision to not include the control group at the 3–6 month follow- upp.

5.2 Specific Learning Disorder

Miyasaka et al. (2019) state there is a lack of clarity around whether the disease pathophysiology of Irlen syndrome is an independent entity or part of the dyslexia spectrum (p. 194). Some treat Irlen syndrome as a type of dyslexia (see Soares & Gontijo, 2016; Irlen Diagnostic Clinics, n.d.b), while others claim they are two distinct conditions (see Chouinard et al., 2012; Dyslexia UK, 2025; Irlen Institute, 2014a; SpecSavers UK, n.d.).

As mentioned in section 5, the Irlen Syndrome Foundation states that 46% of people with reading or learning difficulties (including dyslexia) also have Irlen syndrome. However, Wilkins and Evans (2024) claim that visual stress occurs only in a minority of individuals with dyslexia (p. 201). Singleton (2012) claims that individuals with dyslexia may have a reduced sensitivity threshold for visual stress, making them more sensitive to the physical characteristics of text (such as contrast, glare, striped-ness, and font size) and increasing their risk of experiencing the unpleasant symptoms of visual stress.

coloured filters were originally claimed to be a treatment for learning disabilities (Specific Learning Difficulties (SpLD) Assessment Standards Committee, 2025, p. 33). However, this claim appears to have changed to suggest that filters may assist individuals with reading difficulties, including dyslexia.

There is some contemporary evidence that the use of coloured filters may assist individuals with dyslexia. Many of the studies investigating the efficacy of colored filters have included participants with dyslexia and participants with Irlen syndrome. These studies are discussed in section 7.2 below.

The reaffirmed 2014 Policy Statement on Learning Disabilities, Dyslexia and Vision from the American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American Association of Certified Orthoptists and Academy Secretary for Quality of Care states that scientific evidence does not support the efficacy special tinted filters or lenses for improving the long-term educational performance in complex paediatric neurocognitive conditions (p. 1). Their recommendations include the following:

• children with learning disabilities should receive appropriate support and individualised evidence-based educational interventions combined with psychological and medical treatments as needed (p. 9)

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• diagnostic and treatment approaches for dyslexia that lack scientific evidence of efficacy such as behavioural vision therapy, eye muscle exercises, or colored filters and lenses are not endorsed or recommended (p. 9).

Dyslaxia UK (2025) states that screening for visual stress could previously be carried out during a dyslaxia assessment. However, since 2018 that is no longer the case. Those with visual difficulties should be referred to qualified optometrists. Dyslexia UK also reports instances where individuals were incorrectly diagnosed with visual stress or other visual difficulties during dyslaxia assessments as the assessors did not have the appropriate knowledge and training to diagnose visual stress/difficulties.

Specific Learning Difficulties (SpLD) Assessment Standards Committee (SASC) (2025) state that the inclusion of visual stress within SpLD assessment is unnecessary, inappropriate, and potentially misleading for the client, as visual stress is not recognised as a defining or identifying characteristic of dyslxia or other SpLD. If visual diffculties are reported during the screening process, SpLD practitioners should refer the individual to an optometrist (p. 18). They go on to say that the use of coloured flters should never be presented as a ‘treatment’for dyslxia, nor are they primarily intended to improve reading ability. Their purpose is specifically to alleviate symptoms of visual stress, i.e. hypersensitivity / hyper-responsivity to visual stimuli, especially patterns (p. 33). The SASC also states that the claim that dyslexia is not a visual problem has been contested in recent literature (p. 33).

6. Who Recognises Irlen Syndrome?

The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) released a position statement in 2018 stating that there is no evidence that Irlen syndrome exists; there is no proof that supposed treatments, such as Irlen lenses, help those with reading difficulties and Irlen syndrome is not recognized by the medical community or the World Health Organisation. It also states that RANZCO does not support the use of Irlen lenses (p. 2). The following further elucidates RANZCO’s position on the question of Irlen syndrome as a condition:

Despite Irlen Syndrome being first described in the early 1980’s there is still no sound theoretical basis or evidence that the condition actually exists. A diagnosis of Irlen Syndrome is based solely on symptoms with no quantitative physiological correlation.

There remains a lack of clearly established criteria. In fact, the only defining criterion is a self-reported benefit of coloured flters while reading.

While the premise is “scotopic” sensitivity, it is the photopic system that is used for reading. Importantly, those with Irlen Syndrome do not show any electrophysiological changes of retinal function compared to control groups. There is also a large disparity in prevalence rates which suggests a fundamental problem in definition.

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Consistently, systematic and critical reviews have shown no scientific basis for the benefit of tinted lenses in reading disorders. There are no objective quantitative measurements available to assess or monitor treatment. The studies that have purported to show some benefit have generally suffered from poor methodology, selection bias, small sample numbers and lack of control groups. Often these are individual reports or testimonials, interviews or anecdotal evidence (p. 3). The Irlen Institute (2025) criticised this position statement for not including neuroscience or biochemical studies in its literature review, and claims that research published post-2018 continues to support the existence of Irlen syndrome and the use of coloured filters. The SASC(2025) also criticized RANZCO for not recognizing the correspondence between Irlen syndrome and visual stress and not reviewing any studies on visual stress when formulating their position statement (p. 33). Several bodies, including the Irlen Institute (n.d.c), and the Irlen Syndrome Foundation (n.d.b), claim that several agencies in Australia have officially recognized Irlen syndrome and the Irlen Method including:

Department of Employment, Education & Training
Departments of Army, Navy, and Air Force
Board of Studies (NSW)
Board of Secondary Education (WA)
Department of Children’s Services (WA)
Commonwealth Employment Service (CES) (since closed)
Department of Rehabilitation
Geelong Medical Fund
Technical and Further Education (TAFE).

We were unable to verify whether this claim is accurate for the majority of these bodies. Of the listed agencies, we could not confirm the existence of the Departments of Army, Navy andAirforce, the Department of Rehabilitation, the Department of Children’s Services (WA) or the Geelong Medical Fund. Furthermore, the Department of Employment, Education and Training existed until 1996, the Board of Secondary Education (WA) until 1984, while the Commonwealth Employment Service ceased operations in 1998. It is also unclear which state or territory instantiation of TAFE is referred to in the list.

in their 2025 paper, Flaherty et al. state: Currently, however, there remains a lack of solid peer-reviewed published evidence supporting reading improvement with tinted lenses. In view of this, treatment with coloured filters/lenses for symptoms of reading discomfort or reading disability is not recommended. Instead, eye care practitioners should advocate for evidence-based interventions such as phonics, so that struggling readers are not left behind. The Irlen Syndrome Page 11 of 24 Page 87 of 100

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authors encourage Optometry Australia, the New Zealand Association of Optometrists, and other professional bodies to endorse this view (pp. 5-6). The term ‘Irlen syndrome’ does appear in several state government documents. A 2009 Review of Special Provisions for the Office of the NSW Board of Studies states that the OBOS receives applications in relation to Irlen syndrome (p. 4). The NSW Government HSC disability provisions guide for teachers and parents (n.d.) lists coloured lenses and overlay as principal- determined provisions. It also lists Irlen syndrome/scotopic sensitivity as a disability/condition/symptom for which colored paper or a reader or electronic reader/C-pen may be provided to the student. On the Western Australian Department of Education’s Supportfor children with a disability, chronic illness or impairment page (n.d.), Irlen syndrome (scoptic sensitivity) is listed as a condition and possible adjustments include specified seating, nonworking rest breaks, and colored overlay. The Department’s 2025 Applicant Guidelines for Gifted and Talented Secondary Selective Entrance programs for Years 7, 9, 10 and 11 entry in 2027 also lists Irlen Syndrome as a condition with the same possible adjustments mentioned above (p. 18).

Irlen syndrome has received media attention. This includes a 2019 ABC News article describing the condition and the controversy surrounding it, as well as a former member, Mr Christensen, moving that the House of Representatives recognise Irlen Syndrome as a specific type of visual perceptual dyslexia in 2013.

6.1.1 Evidence Base

There is some evidence of differences between individuals diagnosed with Irlen syndrome and individuals without this diagnosis. Tacuri-Reino et al. (2024) tested 55 children with Irlen syndrome and 55 children without this diagnosis using the Irlen Reading Perceptual Scale to assess reading processes. The results showed significant group differences in Word Reading, Pseudoword Reading, Punctuation Marks, Sentence, and Text Comprehension. A 2016 integrative literature review by Soares and Gontijo included 16 articles which looked at possible biochemical, genetic, and immunological bases for Meares–Irlen syndrome. They concluded that there is growing evidence that there is a biochemical base for Meares–Irlen syndrome but more research is required.

Chouinard et al. (2012) claim that neuroimaging conducted using a 1.5T Siemens Sonata MRI showed differences between 1 participant with MISViS and 10 participants without this diagnosis. Another 2012 pilot study (Loew & Watson), including 10 participants with Meares–Irlen Syndrome and 8 controls found evidence of certain allelic variants of the APOB gene were more common in participants diagnosed with Meares–Irlen syndrome than in individuals without the condition.

A 2003 preliminary study (Sparkes et al.) including 13 participants with Irlen syndrome and an age-matched control group found evidence that total plasma cholesterol level was significantly

Treatments for Irlen Syndrome

A significant increase was observed in the relative abundance of odd-chain fatty acid heptadecanoic acid. Miyasaka et al. (2019) state that despite the quality of the evidence regarding Irlen syndrome, it does not allow us to completely refute the disease in terms of symptomatology (p. 205). On the other hand, Handler and Granet (2022) state that many of the visual stress symptoms seem very similar to symptoms of accommodative and/convergence abnormalities found to co- occur in individuals who have appeared in Irlen studies (p. 6857).

There is also evidence of an effect of tinted lenses/overlays on the brain, discussed in section redacted: s47F - Personal privacy which may serve as evidence for the existence of Irlen syndrome.

Types of Lenses

The research has repeatedly documented the efficacy of both colored overlays and spectral filters, as measured by improvements in a variety of reading skills, reduction in physical symptoms that include headaches, migraines, eye strain, fatigue, and light sensitivity, and improved functioning and success in both academia and the workplace. Historically, studies reporting improvements in reading with the use of coloured lenses or overlays have been criticised for methodological flaws such as small sample sizes, significant bias due to study design or outcome measures, and/or lack of an adequate control group to rule out Placebo or Hawthorne effects (Flaherty et al., 2025). Additionally, reports of benefits are often anecdotal and/or reported by those with a vested interest in promoting the intervention (Flaherty et al., 2024, p. 162). Additionally, many other studies, including systematic reviews, have found that coloured filters do not improve reading ability. One exception by Evans and Allen (2016) found that, despite limitations of the existing research, the evidence suggests that coloured filters are beneficial in visual stress. Importantly, one of the authors declared a conflict of interest (Flaherty et al., 2025, p. 3). Customers also provide anecdotal evidence of the benefits of coloured filters for reading difficulties (Flaherty et al.,redacted: s47F - Personal privacy; Irlen Institute, n.d.d; Irlen Services Northwest, n.d.).

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in their 2014 joint position statement, the American Academy of Pediatrics (AAP), the AAO, the american Association for Pediatric Ophthalmology and Strabismus (Aapos) and the this document was released under the Freedom of Information Act 1982 by the National Disability Insurance Agency. american association of Certified Orthoptists concluded the following:

many of the Studies that have been cited as proof of IrLen-lens efficiency have actually have Been inconclusive after deeper analysis. The evidence does not support the effectiveness of tinted lenses and tinted filters in these patients because of the weaknesses in methodology and statistics, variability in techniques in the trials, and the largely negative results (p. 8).

7.2.1 Systematic Reviews

systematic reviews of articles published between 1988 and 2015 did not find strong evidence of the efficacy of coloured filters in assisting individuals with reading difficulties. Additionally, each review notes methodological issues in the included studies.

in 2008, albon et al., in collaboration with the Department of Public Health and Epidemiology and the university of Birmingham, published a systematic review on the effectiveness of coloured filters (Irlen filters and lenses, Intuitive overlays, ChromaGen lenses and others) forreading ‘disability’ which included SSS and dyslexia. They reviewed 8 random controlled Trials (rcts) and found that study quality was generally poor, there were significant threats to validity including small sample sizes, inadequate controls, high levels of attrition and lack of reporting of randomization methods. Selection bias was also present (p. 6). The meta-analysis component of their paper focused on only 3 papers and found the colored filters showed no clear benefit for reading accuracy, speed or comprehension when compared with Controls. however, the authors state that the results of the meta-analysis should be treated With caution as the trial design, participant characteristics and outcome tests varied considerably Between Studies (p. 6). additionally, they Were unable to comment on whether Colored Filters can improve symptoms of visual stress That may Be associated with Reading disability due To a Lack Of available Evidence (p. 7). The Authors Also Reviewed 15 non-randomised comparative studies Which Showed A variety of Results ranging from some improvement In reading rate And Comprehension to No Improvement In reading performance (p. 72). The authors Caution against interpreting these results As evidence For the efficacy of the filters Due to Poor methodological Quality And Threats to Study Validity (pp. 7/72).

a 2014 Meta-Analysis of 22 rCTS investigated the effect of interventions such AS reading fluency And Comprehension trainings, phonemic awareness instructions, AND coloured overlays Or lenses On ‘reading disabilities’ including dyslexia (galuschka et al., p. 5). four Interventions With Coloured Overlays OR Lenses (including Irlen lenses) were included But the authors report the mean Effect size for These interventions did not reach statistical significance. The authors State their findings confirm earlier systematic reviews that could Not prove Any positive effect of colored lenses on literacy achievement, and suggest that Positive results in previous studies are mainly due to placebo effects (p. 10).

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in 2016, Griffiths et al. came to similar conclusions based on their systematic review of 51 papers on the effect of colored overlays and lenses on reading ability in individuals with reading difficulties including Irlen syndrome and dyslexia. They investigated systems including Intuitive, Irlen, Harris/ChromaGen and others, and found that the majority of studies were subject to ‘high’ or ‘uncertain’ risk of bias, including those which showed improvements with coloured lenses (p. 519). Moreover, studies showing improvements often had small effect sizes and/or effect sizes similar to that of the group with the placebo condition (p. 519). The reviewed studies with lower risk of bias provided less support for the effect of overlays and lenses on reading ability (p. 519). A further systematic review was carried out by Miyasaka et al. (2018) on Irlen Syndrome aetiology, diagnosis, and intervention (filters including Irlen and intuitive filters) efficacy. The review found high heterogeneity among the 45 included studies and a lack of evidence of treatment effectiveness. Serious methodological and validity issues similar to those mentioned in previous reviews were noted by the authors. The results of the reviewed studies were diverse including unequivocal positive effects, inconclusive findings, and findings of no evidence of positive effects.

We did not find more recent systematic reviews on this topic.

7.2.2 Contemporary Research

in their 2025 response to the 2018 RANZCO position statement discussed in section 6, the Irlen Institute refers to research published since the release of the position statement.Research from this time period is discussed in this section.

an In 2025 randomised, double-masked crossover trial, Suttle and Conway tested 29 participants who had been diagnosed with visual stress. Using the Intuitive colourimetry, participants were given a color overlay and tinted lenses with two color settings – optimal tint and sub-optimal/placebo tint. The tints were worn for one month each in a randomized order. Participants’ reading speed before and after was tested using the WWRT, their symptoms were gauged using a subjective scale and they were asked which tint better alleviated their symptoms. Results showed that participants’ reading speed increased with the use of colored overlays. Interestingly, only half of the participants reported a preference for the optimal tint while slightly less than half preferred the sub-optimal tint.

gode et al. (2025) present evidence that coloured overlays (Cerium) improved reading speed and experience in individuals with visual stress related to post-COVID-19 syndrome. Participants were concluded to have visual stress based on results of Visual Discomfort Scale (VDS), and their reading speed was determined using the WRRT. However, the differences in reading speeds with and without the coloured overlays were not statistically significant. The effect on reading experience was captured by recording participants’ comments.

alkhudairy and Al Shamlan (2022) investigated the effect of ChromaGen lenses on individuals with various diagnoses including 19 participants with Irlen Syndrome. They found that 78.9% of participants with Irlen syndrome showed improved reading speed and accuracy. They also

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A 2021 study by Jakovljević et al., reports some coloured background/overlays were beneficial for both the 18 participants with dyslexia and the 18 participants in the control group. An integrative literature review of 12 studies focusing on the effect of spectral overlays (including Irlen overlays) on visual parameters and reading ability found that effectiveness of overlays in improving reading quality is consistently demonstrated in the literature, including for individuals with dyslexia (Vilhena et al., 2020). However, the type of overlays each study discussed is not always mentioned and Vilhena et al. did not comment on potential bias or methodological issues in the studies. Importantly, all but one of the studies described had relatively small participant numbers (<100). The only large-scale study included in this review was conducted by Guimarães et al. (2020), It included 323 eye-hospital patients who had been diagnosed with visual stress. They tested patients’ ocular motor efficiency while reading both with and without Irlen spectral overlays. Results showed that using one or some combination of the spectral overlays immediately and significantly reduced the number of fixations and regressions per 100 words and resulted in significant gains in positive factors such as Span of Recognition, Reading Rate, Relative Efficiency, and Comprehension.

A critique of behavioural vision therapy techniques for children with reading difficulties including dyslexia, Flaherty et al. (2024, p. 151) state that the theoretical basis for behavioral optometry, including tinted/coloured lenses, is not well established and the literature in this area suffers from serious methodological and interpretive flaws. The abovementioned studies show some methodological weaknesses such as small participant cohorts and lack of control groups.

The Australasian College of Behavioural Optometrists produced a 2017 position statement on the use of tinted lenses. They state that while their use for reading problems is controversial, their use for pattern glare symptoms is supported. Symptoms of pattern glare include sensitivity to repetitive striped patterns, eyestrain and headaches, words moving when reading and light sensitivity (see also Flaherty et al., 2025, p. 4).

7.2.3 Brain Imaging

In the document A Toolkit for Allied Health Professions (2018), the Irlen Syndrome Foundation states:

The most current research on Irlen Syndrome utilizes advanced brain-mapping technology to show actual changes and normalization of brain functioning with the proper use of precision-tinted colored filters. Researchers have utilized functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), visual evoked responses (VER), and single photon emission computed tomography (SPECT) scans to objectively document the profound effects of visual sensory overload on the brain and the normalization of brain activity when individually-prescribed, precision-tinted coloured filters are worn. This research has shown increased activity in the brain’s emotional and

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Research paper OFFICIAL For Internal Use Only virtual processing centers, early hyper-reactivity to visual stimuli, abnormal V5 function (visual cortex), and visual cortical hyper-activation. Brain imaging has also been used as an objective correlate of headache reduction and reading improvements (p. 13).

There are no references provided on the webpage to support these claims. However, in the following paragraph, the authors refer to an unspecified study which claimed SPECT scans showed increased activity in the brain’s emotional and visual processing centres and decreased activity in the cerebellum (an area that helps to integrate coordination and new information). They state that this over-activity normalised when individuals with Irlen syndrome put on their individually prescribed Irlen Spectral Filters (p. 13).

Khan et al. (2024) conducted a study on 40 individuals with SSS and without neurological or psychiatric disorders whose reading performance was tested with and without colour-tinted lenses. Results showed statistically significant improvement in reading speed with the use of color-tinted lenses. The fMRI results demonstrated that during the reading sessions with tinted lenses, brain regions which are critical for sentence comprehension, especially for integrating semantic and syntactic information during reading, were activated. Authors report no significant activation during reading without tinted lenses at the same statistical threshold (p. 3).

in 2015, Kim et al. published results showing activation in the left middle and superior temporal gyri during sentence reading after application of MISViS colour-tinted lenses compared with sentence reading with no colour-tinted lenses in 15 patients with Meares-Irlen syndrome. Riddell et al. (2006) tested 10 children who wore Intuitive Colorimeter lenses, and claimed they found the lenses beneficial, and two asymptomatic children. Steady-state potentials were measured in response to low contrast patterns modulating at a frequency of 12 Hz. Participants were tested in a variety of conditions: with no lens, with Colorimeter lens, with a lens of complementary colour and with spectrally neutral lens with similar photopic transmission. The symptomatic and asymptomatic children showed little or no difference between the lens and no lens conditions. However, when the symptomatic children were divided into two groups depending on their symptoms, children with visual stress but no headaches showed the largest amplitude visual evoked potential response in the no lens condition, whereas those children whose symptoms included severe headaches or migraine showed the largest amplitude visual evoked potential response when wearing their prescribed lens.

in 1997, Lewine et al. recorded steady-state visual evoked magnetic fields from 8 participants with SSS and 8 control subjects both with and without Irlen lenses. They claimed that data suggested that the coloured Irlen lenses provide for normalisation and crystallisation of visual information processing in most members of the SSS population. It is important to note that these studies typically have small participant cohorts which affects generalisability and they often do not include randomisation or control groups. As such, there is no way of determining the influence of effects such as the Placebo or Hawthorne effect.

7.2.4 Improvements in Other Symptoms

There is some evidence that spectral filters/optical tints may assist in improving symptoms of traumatic brain injury, headaches, migraines, social cognition, emotions, facial recognition, and attention (see Huang et al., 2011; Guimarães et al., 2010; Ludlow et al., 2020; Tosta et al., 2024; Whitaker et al., 2015).

8. Prognosis

The Irlen Institute (n.d.b) states that after the customer begins to use the coloured overlay supplied during the first Irlen testing session, the customer will experience immediate changes and improvement in reading in the following areas:

reading rate
comfort
comprehension
sustained attention
error rate
flow and fluency
tracking
sight vocabulary
ability to skim or speed read.

The Irlen Institute (n.d.b) reports that long term studies show positive feedback from people who have been wearing Irlen Filters for over 6 years. No citation is provided for this claim.

References

Albon, E., Adi, Y., & Hyde, C. (2008). The effectiveness and cost-effectiveness of coloured filters for reading disability: A systematic review. Department of Public Health and Epidemiology, West Midlands Health Technology Assessment Collaboration, The University of Birmingham. https://www.researchgate.net/publication/255651943_The_Effectiveness_and_Cost- Effectiveness_of_Coloured_Filters_for_Readin…

Alkhudairy, Z., Al Shamlan F..(2022) .The Use of Chromagen Lenses in Different Ocular and Non-ocular Conditions:A Prospective Cohort Study.* Curēus*(Palo Alto, CA), 14(9) e28963.http(s)://doi.org/ 107759/cureus.28963 American Academy o fOphthalmolog y.( October , October 27 ). Meares-Irlen Syndrome /Visual Stress(MISViS). https: eyewiki.org/Meare s- IrenSyndrome/V isualStressMisV iS)cite note -l AmericanAcademyofPediatrics,AmericanAssociationforPaediatricOpthalmolo gyStrabism us American Association Certified Orthoptists Academy Secretary for Quality Care (July). POLICY STATEMENT Learning Disabilities Dyslexia and Vision https: // www.aao org education clinical statement joint-statement-learning-disabilities-dysle xia-vis BarNir A Shaked H Elad S Tosta S. 2023 Evidence Overlapping Visual Processing Difficulties Adult ADHD Visu al Stres Perceptual Motor Skills, 130( 5) .https://d oiorg/1o.o1177/oo3i5125231192809 Bernal M &Tost a S (2015 IRLEN SYNDROME INCIDENCE IN CUENCA-ECUADOR ResearchGate DOI :.1 o1340/RG_2 _1.1 oo1.9682 Caskey J Freney P 2019 WHAT IS EFFECT OF DYSLEXIA AND MEARES-Irlen Syndrome ADULT VOCATIONAL STUDENTS European Journal of Education Studies, 6( ) ,doi: 1 o5281 zenodo 3246532 Chouinard B D Zhou C I Hrybouski S Kim E S Cummine J (July). Functional Neuroimaging Case Study MearesIrenSyndromeVisual Stress MISViS Brain Topography https: // doi org / t0548 -011- 0212-z Dyslexia Scot West n d Mea resIr len Syndrom e https www dys lexiasw com advice all about-dysle x ia/meare s irlen syndrome Dyslexia UK October VisualStress updatedOctober |DyslexiaUK. https://www.dyslexi au k.co.uk/visual-stres-syndrome/ evans b j w 2022 EvaluationHeterophoria InBjwevens Ed Pickwell’s Binocular Vision Anomalies pp.https:/ doi.org/1o.o16/B978-0_323 73317

OFFICIAL

For Internal Use Only Evans, B. J. W., Allen, P. M., Wilkins A.J.(2017) . Delphi study for practical diagnostic guidelines on pattern-related visual stress Journal Optometry(10)(3):p.p. Flaherty,M.Bhate,A.K.Gole,G.A,(2025). Coloured filters and lenses for discomfort and difficulty: an Australian New Zealand perspective Clinical Experimental Optometry(1-8) Flaherty.M.Crippa,J.Sim,I,Bhate,C.Chow,Taranath,D.Gole,G.(2024). Critique Behavioural vision therapy techniques children with reading difficulties including dyslexia Aust Learn Difficulties (2), p.p. pGaluschka,K.Ise,E.Krick,Schulte-Körne,G.(2014). Effectiveness Treatment Approaches Children Adolescents Reading Disabilities Meta Analysis Randomized Controlled Trials PloS One (9/2)e.e Gode K.Weström S Johansson J (2025).Colored overlays improve speed experience patients post COVID syndrome Vision Research Oxford 228 Article https://doi.org/10.1016/j.visres.2025.108550 Griffiths,P G Taylor,R H Henderson,L M Barrett B T,2016.The effect of colored overlays lens on reading systematic review literature Ophthalmic Physiological Optics 36(5) pp Guimarães,M R GuimarãesJ GuimarãesR Q NogueiraM BotelhoM GuimarãesM E A,(2010).Selective spectral filters treatment visually induced headaches migraines clinical study Headache Medicine:72https://www.researchgate.net/publication/333093027_Selective_spectral_filters_in_the_treatment_of_visually_induced_headaches_and_migraines_A_clinical_study_of_93_patients Guimarães MR Vilhena D deA Loew SJ Guimarães RJQ.(2020).Spectral Overlays Reading Difficulties Oculomotor Function and Efficiency Among Children Adolescents Visual Stress Perceptual Motor Skills p.p. Handler S.M Granet,D.B (2022).Reading Dyslexia Vision Therapy Albert Jakobiec’s Principles Practice Ophthalmology Springer DOI https://doi.org/10.1007/978-3-030-42634-7_285 Harkin DL Little J-A McCullough,S.J,2025.What are most salient visuoperceptual reading symptoms to identify visual stress adults Using exploratory factor analysis develop Ulster visual questionnaire Vision Research Oxford 235 Article doi org /10 . to.res.2025 ,p.p. Irlen Syndrome Page of 24 Pageof100

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Huang, J., Zong, X., Wilkins, A., Jenkins, B., Bozoki, A., &® Cao, Y. (2011). fMRI evidence that precision ophthalmic tints reduce cortical hyperactivation in migraine. Cephalalgia, 31(8), 925–936. https://doi.org/10.1177/0333102411409076

The document was released under the Information Freedom Act 1982 by the National Disability Insurance Agency.

Irlen Diagnostic Clinics. (n.d.a).

DIAGNOSIS & SOLUTION. https://irlenclinics.com.au/diagnosis-solutions/ Irlen Diagnostic Clinics. (n.d.b). ir len SYNDROME. https://irlenclinics.com.au/irlen-syndrome/.

Irlen Institute.

(2025, March 5). Response to RANZCO Position Statement on Irlen. https://irlen.com/response-to-ranzco-position-statement-on-irlen/. Irlen Institute.(2014a, August 12) Do I Have Dyslexia or Irlen Syndrome? https://irlen.com/the-difference-between-irlen-syndrome-and-visual-dyslexia/. Irlen Institute. (2014b) ir len Syndrome vs. Visual Stress: Simple Semantics or Something More.https://irlen.com/irlen-syndrome-vs-visual-stress-simple-semantics-or-something-more/ Irlen institute. (n.d.a). c an You have Both ADHD and ir len syndrome? https://irlen.com/can-you-have-both-adhd-and-irlen-syndrome/.

The Information Freedom Act 1982.

i rlen inst itute.( n . d . b ). FAQs. https :// i rl en . com / f aqs /

i r l e ni ns t i tu te .( n . dc). Published Research. h ttps :/ /i rl en .c om /p ubl ish ed -r es ea rc h/

i r le nin s ti tue .( nd) Success Stories. ht tp s:/ /irle n. co m /su cc ess –st or ie s/.

Irlen Services Northwest. (n.d.).

our TESTIMONIALS.https://irlenservicesnorthwest.com/testimonials/

ir len synd rome foundation. (2018 ) A Toolkit for Allied Health Professions[h tt ps: //w w w. ir lens ynd rom e.o rg /wp -co nt ent /u pl oa ds /2023/11/pow erpo int–PROFESSIONAL_Toolkit-02.pdf](https://www.irlensyndrome.org/wp-content/uploads/2023/11/powerpoint-- PROFESSIONAL_Toolkit-02.pdf). Irlen Syndrome Foundation.(n. d.a ). irlen SYNDROME INFOGRAPHIC. [ht t p ://ww w. i rl ens yd ro me o rg /i rl en –sy ndro me inf og ra ph ic/] (http://www.\href{irlensyndrome.org}{rlensydrom\text}e.org/irlen-syndrome-infographic/). ir lEn syndr ome f ou ndat ion . ( n . db). Research. h ttps :/ / ww w. i rle ns yn dr om eo rg /re se ar ch / i r le n sYndrome Foun datioN .( N . dc) What is Ir len Synd rome? htt Ps:/ /W W W. I Rl En S YNd Ro Me O Rg /w Ha T Is ir Len Sy Nd Rom E/ j akovljević,t., janković , m.m ., savić, M A,. soldato vic,I c olić g jakulin tj papa G kovíc v(2021 ) The Relation between Physiological Parameters and Colour Modifications in Text Background and Overlay during Reading in Children with and without Dyslexia Brain Sciences 11539 htt ps: //d oi org /10 20944 pre prints202103 0442v1 kh an ws malik i naz eer a adman razaM waleed m ghazanfarS.(2024 Assessment of Visual Processing in Scotopic Sensitivity Syndrome Using Functional. irlen syndrome page 21of 24 p age 97 o f 100

Research paper

OFFICIAL For Internal Use Only Magnetic Resonance Imaging. Journal of Health and Rehabilitation Research. 4(3,), 1-6. https://doi.org/10.61919/jhrr.v4i3.1516 Kim, J., hSeo, H.-J,, Ha S-G,,, kim S-H..(2015). Functional Magnetic Resonance Imaging Findings in Meares-Irlen Syndrome: a Pilot Study.Korean Journalof Ophthalmology,29(2,),€ⴛ-ⴞ.https://doi.org/10.3341/kjo.2015.29.2.121 Leslie,S.( 2017 ,July).Pattern Glare Photosensitivityand Tinted lenses.The Australasian Collegebehavioural Optometrists.[https://www.acbo.org.au/images/News_Views_FAQs/Evidence_landing_page/Leslie_- Pattern_Glare_Photosensitivity_and_Tinted_lens.pdf](https://www.acbo.org.au/images/News_VisewsFAQs/Evidence_landingleading_page/Leslie_PatternGlarePhotosensitivity andTintedlenses.pdf) Lewine,J.D. davis, j., provencal, s,, edgar,j,,, orrison,w.. (1997). amagnetoencephalographic investigation of visual information processing in Irlen’s Scotopic Sensitivity Syndrome.Conducted at The Center for Advanced Medical Technologies,the Universityof Utah SchoolMedicine SaltLakeCityUtah,and DepartmentOf PsychologyTheUniversityNewMexicoAlbuquerque New Mexicohttps://dyslexiaservices.com.au/downloads/lewine_new.pdf Loew S.J.& Watson,K.. (2012.).A PROSPECTIVE GENETIC MARKER OF THE VISUALPERCEPTION DISORDER MEARES-IRLEN SYNDROME.Perceptualand MotorSkills,** 1** 4(3,),8€.* https://doi.org/10.2466/24.10.11.27.PMS.114.3.870€882 Ludlow, a. k., gianadou, a,, franklin,a,,, allen,p.m,,,, simmons,d.r,,,,,,,, wilkins,A.j.(2020).the possible use of precision tinted lenses to improve social cognition in children with autism spectrum disorders.Vision Research(Oxford), * €,53-€9. https://doi.org/10.1016/j.visres.2020.03.007 Miyasaka,J.D.S,Vieira,R.v.G,Novalo-Goto,E.s,Montagna,e,&Wajnsztejn,r..( 2019 ).Irlen syndrome:systematic review and levelof evidence analysis.Arquivos de Neuro-Psiquiatria,* 7 (3,),**ⴛ-207.[https://doi.org/10.1590/0004 -282X20190014 ] ( https :// doi .org /10 ,1590/000🇸2x20,19,🧾 ) Purcell R.( n.d.).What Is Visual Stressand How Does It Relate to Dyslexia? CareScribe.[https://carescribe.io/blog/what-isvisual-stress-and-how-does-it-relateto dyslexia/] Raj.R. (n d).Prevalence of symptoms scotopic sensitivitysyndrome/Irle nsy ndrom e.International Journal Applied Research,6(,1*), * €,. [https://www.allresearchjournal.com/archives/2020/vol6issue11/PartF/6-€11-€ 31-296.pdf](https://www.allresearchjournal.com/archives/2020/vol6issue11/ Part F/ 6 ⴛ€11-296. pdf) Riddell,P.M.,Wilkins,A.&Hainline,L..(2006). heffectof Colored Lenses on theVisual EvokedResponse in ChildrenWith VisualStress.Optometry and Vision Science,7(5,),299€,.[ https :// doi .org /10 ,�,�p.x. ooox ooxx16125 x83236 af ] Singleton,C.( n.d.).visual stressand its relationship to dyslexia.In J.Stein&Z.Kapoula (Eds.), visual aspects of Dyslexi a(pp.€91 -unlO). Oxford University Press.[https://doi.org/10.1093/acprof:oso/ * €,. [https://doi.org/10.1093/acpro f.oso/ 978-0-€199589814.003.0006](https://doi.org/10.1093/acprof:oson 978ⴛ*-019,9589814 0*. 000****) Irlen Syndrome Page 22of24 OFFICIAL Page 98 Of 100

Research paper

OFFICIAL For Internal Use Only Soares, F.A.& Gontijo,L.S.(2016) Productionofknowledgethegeneticbasisbiochemicalandimmunologicalof Meares-IrIenSyndrome.RevistaBrasileiradeOftalmologia, 5(5), 412−415. https://doi.org/ https://doi.org/10·5935-0034-·7280.20160084 Sparkes,D.L.,Robinson,G.L.Dunstan,H,& Roberts,T.K,(2003).PlasmaCholesterolLevels and IrLen SyndromepreliminaryStudyOfTo-toT7YROldStudents.Perceptual MotorSkills, 97( 3) 743–752.http://doiorg//pms.2003.97 3 .743SpecSaversUK.n.dDyslexiaAndVisionhttpswww.specsavers.co.ukeyehealth/dyslexi a-and-vision?srsltid=AfmBOooq6akKq0jClAcfZxDdQvNuRMVCN_0Hewa673 nUR71lt5zG25BSuttle,C.M.& Conway,M.L.(2025)Efficacyofcolouredlensesforpatientsdiagnosedwithvisualstress.ClinicalandExperimentalOptometry, , 108(1), 72−78. https://doi.org/10·1080-08164622-·2024 -2302822Tacuri-Reino,D., ElosúaM.R,& Bernal M (2024).Readingskillsinchildren with IrLenSyndrome.Ocnos,, https://doi org/ ocnos , _2024.23.1 .387The Royal Australian and New Zealand College of Ophthalmologists(RAN ZCO)(2018,April) Irlen Syndromehttpsran zcoeduwpcontentuploads /2018//Ir Len-Sy ndrom ePositionStatementMay2018.pdf The SpLD Assessment Standards Committee(SASC). JuneSpecific Learning DifficultiesSpLDSAndVisualDiffic ultie s.httpswww.sascorgukmedia/l2hfsbmhs asc-splds-and-v isual-difficulti es-june- Act by the National Disability Insurance AgencyTosta,S.Ferreira,M.Lewine,J.& Anderson A( 2024) Individualizedspectralfiltersalleviatepersistentphotophobia,headachesandmigraines in activeduty militaryVeteransfollowingbraintrauma.BrainInjury , .38( ), 177−185. https:// doi.org/10·1080-·02699052 -2024.-2309253V ilhen a,D.deA.,GuimarãesM.R.Gui marãe sRQ,& PinheiroAM.V.(2020).Effectof spectraloverlaysonvisualparameters andreadingabilityanintegrativereview.RevistaCEFAC, 2_2( ). https//doi org/ 1982 Watson,KLoewS.J (2013) Theprevalenceofs y mptomsofscotopic sensitivityMeares-IrLen syndromeinsubjectsdiagnosedwithADHDDoesmis diagnosisplayasignificantroleHrvatskaRevijaZarehabilitacijskai strazivanja,,httpswww.researchgate.net/publication /261988287 The prevalence of scotopicsensitivity Meares- Irlen syndrom e in subjects diagnosed with ADHD does misdiagnosis play roleIren SyndromePage Page 23Of24

Research Paper

The following research papers are referenced in this document:

Writaker, L., Jones, C. R. G., Wilkins, A. J., & Roberson, D. (2016). Judging the Intensity of Emotional Expression in Faces: The Effects of Colored Tints on Individuals With Autism Spectrum Disorder. Autism Research, 9(4), 450–459. [https://doi.org/10.1002/aur.1506]

Wilkins, A. J., & Evans, B. J. W. (2024). Vision, Reading Difficulties and Visual Stress. Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-65568-5

A redacted notice follows regarding release under Freedom of Information Act 1982 from National Disability Insurance Agency.