Related condition


The Rose report is a detailed investigation into the identification and teaching of young people with dyslexia and literacy difficulties.  Presented in 2009, it defined dyslexia as a learning difficulty that primarily affects the skills involved in accurate and fluent word reading and spelling with characteristic difficulties with phonological awareness, verbal memory and verbal processing speed. The report noted that motor coordination and sensory difficulties such as visual stress can occur alongside dyslexia. [1] While visual stress may contribute to the overall difficulties that a dyslexic individual experiences it is unlikely to be a cause of dyslexia [2] however a higher prevalence of visual stress is found in individuals with dyslexia than in good readers.[3]


While research supports the existence of visual stress, there are inconsistencies in the diagnosis of the condition.  Twenty eyecare professionals including optometrists, orthoptists and opticians, joined three key vision and perception researchers to clarify presenting symptoms and improve the consistency of diagnosis for visual stress. They designed “practical diagnostic guidelines for visual stress” published here [2]. The guidelines list headaches, repetition, and the appearance of words moving when reading, and the appearance of patterns or shadows in the text as some of the key indicators.  The guidelines also list a personal history of dyslexia as an indicator that there is a greater likelihood that visual stress may be present. 


While visual stress is distinct from dyslexia, it sometimes co-occurs with dyslexia and the symptoms reported such as word or letter movement may get confused as being caused by dyslexia. These key indicators to visual stress listed above are also often listed as indicators of dyslexia.  If perceptual distortions are reported it should be investigated as visual stress. Individually prescribed coloured filters have been shown to reduce perceptual distortions such as word movement, to improve reading performance in people with visual stress. While filters may make reading easier because the perceptual distortions are removed, filters are unlikely to influence the phonological and memory deficits associated with dyslexia and therefore are not a treatment for dyslexia. [4] 


Because of these visual aspects of dyslexia, it is essential to visit an optometrist to rule out vision issues that may be contributing to difficulties, and to test for visual stress to identify and treat visual perceptual problems. 



[1] Rose J. DCSF; 2009. The Rose report - Identifying and Teaching Children and Young People with Dyslexia and Literacy Difficulties. 


[2] Evans BJ, Allen PM, Wilkins AJ. A Delphi study to develop practical diagnostic guidelines for visual stress (pattern-related visual stress). Journal of Optometry 2017 Jul-Sep; 10(3): 161-168 

[3] Kriss I., Evans B.J.W. The relationship between dyslexia and Meares-Irlen Syndrome. J Res Read. 2005; 28:350–364. 


[4] Evans, BJ, Allen PM. A systematic review of controlled trials on visual stress using Intuitive Overlays or the Intuitive Colorimeter. Journal of Optometry 2016 Oct-Dec; 9(4): 205–218.