The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and the Australasian College of Behavioural Optometrists (ACBO) are largely in agreement over the lack of evidence to support tinted lenses as treatment options for Irlen Syndrome.
In a position statement, RANZCO has explained that there is no evidence that Irlen Syndrome exists and there is no proof that supposed treatments, such as Irlen lenses, help those with reading difficulties.
“The real concern with diagnoses of Irlen Syndrome is that it can distract from genuine diagnosis and treatment, such as a comprehensive evaluation by an educational psychologist followed by the appropriate remedial educational input,” said RANZCO spokesperson Professor Frank Martin. “Any interventions that distract from and delay this evaluation could be detrimental to the effective treatment of any learning disabilities.”
Irlen Syndrome is commonly defined as a perceptual processing disorder, suggesting that the brain is unable to properly process visual information from the eyes because of sensitivity to certain wavelengths of light. Symptoms are said to include poor concentration; difficulties with reading, writing and comprehension; glare sensitivity; headaches and poor depth perception.
Despite Irlen Syndrome being first described in the early 1980s, there is still no sound theoretical basis or evidence that the condition actually exists
RANZCO’s Irlen Syndrome position statement says, “Despite Irlen Syndrome being first described in the early 1980s, 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.”
According to RANZCO, treatments associated with Irlen Syndrome, such as coloured lenses, have not been proven to be any more effective in improving reading difficulties in children than in children assessed in a control group (without coloured lenses and associated ‘treatments’).
RANZCO’s Irlen Syndrome position statement explains that there is no documented evidence to say that Irlen lenses are harmful, but the use of unproven methods may waste time and financial resources, preventing a child from receiving the appropriate evidence based educational remedies that could actually help with their learning development.
“Overwhelmingly, the research shows no benefit from this treatment in children with reading difficulties and vulnerable parents are being exploited and having their children subjected to unnecessary screening practices,” said Prof. Martin.
RANZCO has also warned parents about other “ineffective and unproven vision therapies” being offered as supposed treatments for learning disabilities such as dyslexia.
“As a medical education body supporting only evidence based treatments, RANZCO has an obligation to safe guard the interests of patients by speaking out against treatments that lack clinical or scientific merit,” explained RANZCO spokesperson A/Prof James Elder. “Ophthalmologists, like mainstream optometrists, are very passionate about saving sight and don’t like to see resources intended for health and wellbeing being misdirected. Reviews of the literature have consistently shown a lack of good evidence to support vision therapies, such as those offered by behavioural optometrists, for the treatment of learning disabilities such as dyslexia.
“Using these expensive, ineffective and controversial treatments may delay a child from receiving the appropriate evidence based educational remedies. Evidence shows that the earlier the intervention with the appropriate remedial programs, the more effective they are in improving reading outcomes. The use of ineffective interventions may also waste the limited financial resources of the family as well as giving them a false sense of security that the child’s reading difficulties are being addressed.
“It is important, therefore, that parents understand that dyslexia and other learning disabilities are not disorders of vision and so, visual therapy is misdirected. Scientific evidence shows that behavioural optometry treatments such as eye tracking exercises, vision therapy, weak glasses to relax the focus, and coloured lenses/overlays do not help children read any better.
“Eye care professionals such as ophthalmologists and optometrists are not qualified to diagnose or treat learning disabilities. However, children with learning difficulties will usually have both their hearing and vision assessed because listening and seeing are the first steps in information processing for the purpose of learning. The role of optometrists and ophthalmologists is therefore to diagnose and treat any treatable vision problems that may be contributing to any difficulties at school.”
ACBO WELCOMES RESPONSE
The Australasian College of Behavioural Optometrists (ACBO) has also stated that there is no valid evidence to support indiscriminate use of tinted lenses for people diagnosed with dyslexia.1
However, ACBO highlighted that behavioural optometrists do not treat dyslexia or other learning difficulties. In a statement it said, “ACBO is disappointed that RANZCO has again taken the opportunity to perpetuate their mistaken and unjustified assertions about behavioural optometrists treating dyslexia, and the validity of treatments such as vision therapy.
“ACBO members do not treat dyslexia or other learning difficulties.2 ACBO policy explicitly states that optometrists treat learning related vision problems that occur concurrently with problems like dyslexia and can have a significant effect on visual performance and learning.
“Ophthalmology research has shown that children with dyslexia have a significantly higher incidence of visual problems than their unaffected peers.3
“Behavioural optometrists are registered health professionals, providing eye care based on an extensive body of global research. We have a proud history as an extension of optometry practice that takes a broader approach to a person’s eye health and vision in the context of their environment and individual needs. Clinical evidence for behavioural optometry and vision therapy is substantial and rigorous,4 and continues to expand with new generations of clinicians, academics and researchers. Treatments such as vision therapy are also recommended and offered by ophthalmologists and orthoptists.”
References:
1. acbo.org.au/professionals/menu/news/238-acbo-positionstatement- irlen-lenses
2. acbo.org.au/images/News_Views_FAQs/Evidence_landing_ page/Learning_and_Vision.pdf
3. Creavin AL, Lingam R, Steer C, Williams C. Ophthalmic abnormalities and reading impairment. Pediatrics. 2015 Jun;135(6):1057-65. doi: 10.1542/peds.2014-3622.
4. acbo.org.au/for-patients/evidence
