- You should explore visual problems by means of a thorough eye examination.
- You should use tests that are appropriate to the patient’s needs.
- You should tell the patient that there is currently no strong evidence that tinted lenses are effective in improving visual function in patients with specific learning difficulties. However, optometrists who practise in this area report that some patients find them helpful.
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This guidance does not change what you must do under the law.
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Specific learning difficulties affect how people learn and process information. They can include dyslexia, dyspraxia, dyscalculia and attention deficit disorder.60
References
60 British Dyslexia Association. What are Specific Learning Difficulties? [Accessed 25 Nov 2020]A164
You should ensure you have the necessary training in the techniques required to examine patients with these difficulties.
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Patients with specific learning difficulties may have co-occurring visual or orthoptic problems that require treatment. You should explore visual problems by means of a thorough eye examination.
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Treating conventional optometric or orthoptic problems may alleviate the patient’s visual symptoms, but you should not claim that this treats the specific learning difficulty.
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You should carry out all tests necessary to satisfy yourself of the appropriateness of any intervention prescribed.
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It has been claimed that tinted lenses can treat a condition called visual stress, which affects some people with specific learning difficulties, but this remains controversial. 61, 62, 63, 64 65, 66, 67 Optometrists who practise in this area report that some patients find these interventions help to alleviate visual symptoms, but you should not claim that these interventions treat specific learning difficulties.
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You should explain this to the patient because interventions carry a cost in terms of expense, time, and raised expectations, and parents and patients might be vulnerable to the suggestion that any intervention may help.
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A Delphi study of optometrists with experience in this field has led to proposed diagnostic criteria for visual stress.68 These may help to reduce the risk of over-prescribing coloured filters.
References
61 Griffiths PG, Taylor RH, Henderson LM et al (2016) The effect of coloured overlays and lenses on reading: a systematic review of the literature. Ophthalmic and Physiological Optics 36(5), 519-544 [Accessed 18 Nov 2020]62 Evans BJW (2017) Coloured filters and reading: reasons for an open mind. Ophthalmic and Physiological Optics 37(1),105-107 [Accessed 18 Nov 2020]
63 Wilkins AJ (2017) Risk of bias in assessing risk of bias. Ophthalmic and Physiological Optics 37(1),107-109 [Accessed 18 Nov 2020]
64 Griffiths PG, Taylor RH, Henderson LM et al (2017) Authors’ response. Ophthalmic and Physiological Optics 37(1),109-112 [Accessed 18 Nov 2020]
65 Evans BJW and Allen PM (2016) A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter. Journal of Optometry 9(4), 205-218 [Accessed 18 Nov 2020]
66 Griffiths PG, Taylor RH, Henderson LM et al (2017) Letter to the Editor concerning “A systematic review of controlled trials on visual stress using intuitive overlays or colorimeter”. Journal of Optometry 10(3) 199-200 [Accessed 18 Nov 2020]
67 Evans BJW and Allen PM (2017) Reply to Letter to the Editor by Griffiths et al. commenting on Evans & Allen. Journal of Optometry 10(3), 200-202: [Accessed 25 Nov 2020]
68 Evans,B.J.W., Allen, P.M. and Wilkins, A.J.(2017). A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress) Journal of Optometry 10(3), 161-168 [Accessed 18 Nov 2020]
