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Clinical protocol

Clinical Protocol for the identification and management of visual stress
Form on Clipboard
Eye examination
Identification of diagnostic indicators
Assessment with coloured overlays
Assessment with Intuitive Colorimeter
Testing for sensitivities and effectiveness of filters

For children with reading difficulties, and individuals with migraine, concussion/ABI, sensory processing disorder and other neurological and neurodevelopmental difficulties where the visual system is hypersensitive or compromised.


This clinical protocol was originally outlined by the College of Optometrists in the United Kingdom; supported by the International Institute of Colorimetry; and published in 1995 in the Journal of Ophthalmic & Physiological Optics. A further study, published in 2016, identified practical diagnostic guidelines for the identification of visual stress.  The Opticalm Visual Stress Assessment follows this Protocol and the Diagnostic Guidelines. 


The steps in the process include :


1) Eye examination 

The first step to take when there are reports of problems with vision, including reading difficulties is to see an optometrist. Opticalm works with clients and their optometrist to ensure this step is completed and any recommendations are completed prior to booking an assessment. 


2) Identification of diagnostic indicators  

Key symptoms and difficulties are identified and rated to determine if visual stress is contributing to symptoms and if an assessment is justified. 


3) Assessment with coloured overlays  

If testing a child for reading difficulties, this is the first assessment identified in the testing protocol. It is, however, understood that if symptoms include light sensitivity and sensory processing difficulties from environmental stimuli, a tinted lens will provide an optimal and effective solution and Intuitive Colorimeter testing is recommended in the place of the overlay assessment. 


4) Assessment with the Intuitive Colorimeter 

The Intuitive Colorimeter is an instrument that systematically and independently samples hue (360 degrees of colour), saturation (50 degrees of saturation) and luminance (4 levels of brightness) to arrive at a precise colour that reduces physical discomfort and visual perceptual distortions. This testing process has been shown to be effective in reducing visual stress. 


5) Testing for sensitivities and effectiveness of filters 

Independent tests for pattern sensitivity, perceptual distortions, and rate of reading improvement are performed to further confirm the diagnosis of visual stress, identify visual triggers, and capture experiences. 

In addition to the Protocol and Diagnostic Guidelines, Opticalm provides consultation on additional Assistive Tools and Technologies that may help individuals manage their visual stress symptoms.

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