Open University Disabled Student’s Allowance Office
Visual Stress policy update
Background
Visual Stress is the scientifically accepted term for the condition often referred to as Meares-Irlen Syndrome/Visual Stress (MISVIS), Irlen Syndrome or Scotopic Sensitivity Syndrome/SSS. To avoid confusion and the implicit preference for a particular treatment method the Open University DSA office will refer to the condition only as Visual Stress.
The condition was discovered in the 1980’s by Olive Meares and Helen Irlen. It describes the problems of word movement, visual perceptual problems and eye ache/strain experienced whilst reading black words on a white background that are relieved by individually prescribed colours.
Prof Arnold Wilkins, who at the time was a scientist with the Medical Research Council at the Applied Psychology Unit in Cambridge, undertook independent research in the early 1990’s and developed the Intuitive Colorimeter and precision tinted lenses system . The license to manufacture and distribute the system was awarded by the MRC to Cerium Visual Technologies of Tenterden, Kent. Prof Arnold’s research suggests that the symptoms may be caused by hyperexcitabilty of the visual cortex.
Visual Stress symptoms often include a combination of the following:
- Light sensitivity
- Contrast problems
- Restricted fields of clear vision
- Poor depth perception
- Binocular stability and near focussing problems
- Words and letters running in to each other
- Headaches and migraines
Visual Stress is often found in, but is not limited to, individuals with a Specific Learning Difficulty (SpLD). Some people are more likely to be assisted by the use of colour than others. However, if an equal sample was taken of people with and without a SpLD more people would find the use of colour beneficial in the SpLD affected group. Ms Irlen states in her book Reading by the Colours [Perigree, 2005]
‘Scotopic Sensitivity Syndrome is not, of itself, a learning difficulty in the accepted sense. Rather it is a complex and variable condition often found to exist as a component of [SpLDs]’
Ms Irlen’s early claims of discovering a syndrome that could be treated with her patented Irlen Filters were met with scepticism. Irlen Filters were being widely publicised in the media as a successful treatment for reading disorders but eye care professionals had no evidence, in the form of published research data in peer reviewed scientific journals, upon which to make their judgments.
There is now significant scientific evidence available following Prof Wilkins extensive research, including a double-blind placebo controlled trial, which confirms the beneficial effects of the use of coloured overlays and tinted lenses on reading speed and visual perception. This research has resulted in optometry’s acceptance of clinical methods (use of the intuitive colorimeter) of assessing visual stress.
The Irlen Method for diagnosis is carried out by an Irlen trained diagnostician. There remains considerable scepticism from qualified vision practitioners that such diagnoses can be carried out in the absence of professional eye care knowledge.
Ms Irlen states in her book Reading by the Colours [Perigree, 2005]
‘For SSS treatment to be successful, existing visual problems need to be treated first...It is essential for individuals to eliminate all visual problems prior to getting treatment for perception or other learning difficulties’
It is therefore essential for any individual undertaking a Visual Stress diagnosis to first have had their vision tested by a qualified vision practitioner. It has been argued that a standard sight test is not likely to be sufficient to eliminate Binocular Instability, the diagnosis of which requires robust and detailed investigation of the reflexes involved in maintaining binocular single vision. It could therefore be argued that ‘all visual problems’ are not being sufficiently ruled out under the Irlen Method in all instances.
If a diagnostic assessment is carried out by an Optometrist then a formal and thorough eye examination will take place prior to use of the Colorimeter. This examination affords a professional eye care practitioner the opportunity to formally rule out visual acuity issues that could contribute to an individual’s visual perception difficulties and in most instances will take place in a clinical or hospital setting.
Once the presence of Visual Stress has been confirmed, normally including the process of identifying a beneficial coloured overlay, the next step is to undertake testing to select the optimum coloured lens.The process takes around 2 hours in the case of the Irlen Method and around 30-40 minutes with the Intuitive Colorimeter. There remains significant conflict about the relative merits of the differing evaluation methods. Irlen diagnosticians feel that the Colorimeter does not provide a sufficiently thorough evaluation. Optometrists feel that the Irlen method could be construed as subjective and the extra length of assessment may leave students with concentration difficulties (often associated with SpLDs) at a disadvantage.
It is worth noting that there are currently in the region of 500 Colorimeters in high street communityvision practices as opposed to a total of 10 Regional Irlen centres. A full list of all available providers can be located at the following web addresses:
Ultimately, there does not appear to be a significant difference in the final treatment for Visual Stress regardless of the diagnostic/evaluation method. There are anecdotal examples of both methods being successful and in some cases unsuccessful. The Open University DSA Office will therefore express no direct preference for either method but has based its policy on the Student Finance Regulations 2009, 2011/12 Student Finance Disabled Students Allowance Guidance Notes and its own independent research to establish a reasonable funding contribution.
DSA Policy
Paragraph 37 of the Disabled Students Allowance Guidance Document states:
‘Under regulation 141 an eligible part-time student qualifies for DSAs to assist with the additional expenditure that SLC is satisfied the student is obliged to incur to undertake (i.e. to attend or study by distance learning) a designated part-time course because of a disability. DSAs for students undertaking a part-time course with the Open University are administered by the Open University and not by SLC’
We also note that from paragraph 68 there is no ‘requirement or provision within the Regulations to apply the definition of disability contained in the Equality Act.’
Despite the lack of obligation to adhere to the Equality Act definition of disability, The Open University DSA Office is satisfied that the additional costs associated with treating Visual Stress are an ‘additional expenditure that a student is obliged to incur ‘and is prepared to fund a contribution.
The guidance specifically precludes the use of DSA funds to cover the costs of obtaining Medical Evidence. Paragraph 71 (DSA Guidance) clarifies this position:
‘Any cost a student incurs obtaining the necessary expert evidence or opinion cannot be met from the DSAs. This is because such costs are not incurred by the student to attend or undertake their course; they are incurred to substantiate their claim for DSAs.’
DSA funds cannot therefore be used to fund the cost of an eye examination or formal diagnosis of visual stress.
Paragraph 85 (DSA Guidance) states that the ‘SLC [in this instance SLC refers to the OU DSA Office] must also be satisfied that all such expenditure is reasonably incurred and appropriate to the individual needs of the student’
DSA funds can therefore only be used to make a reasonable contribution towards the cost of:
- Evaluation of the appropriate coloured lens/overlays
- Coloured Overlays
- Lens Tinting of prescription Lens
- The full cost of non-prescription lens and tinting
- A contribution towards the cost of frames
The details of the specific contribution will be included in a student’s DSA award letter.
Summary
- The OU DSA Office will not support the costs of obtaining a formal diagnosis of visual stress
- Students must have their vision formally tested by a professional eye care practitioner either prior to or as part of a visual stress diagnosis. The OU DSA Office reserves the right to request evidence of this prior to approving an award for support for Visual Stress.
- Once a formal Diagnosis has been obtained, The OU DSA Office will support a contribution towards;
- Evalution/Colorimetery
- Coloured Overlays
- Lens Tinting (inc cost of non-prescription lens)
- Contribution towards frames
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