One of my patients, a 10-year-old boy has been advised by his teacher to have an eye examination. He is an intelligent pupil when it comes to verbal school work but when it comes to reading he struggles. The teacher has estimated that the boy reads at the level of a 7-year-old? He complains of words moving around the page and the page being too bright. He hunts down old books in the local library which have pages that have yellowed with age. He says he prefers to read from books with yellow pages as his eyes don’t hurt. He has no uncorrected refractive error and no binocular vision disorders. What should I do?

It sounds like your patient has pattern glare.

Sadly, there are many children and young adults who struggle with reading. This of course prevents them from reaching their full educational potential. There are many adults who struggle to read because they had problems when at school and this is likely to prevent them from reaching their full work and life potential.

Words moving on the page and the page being too bright in the absence of uncorrected refractive error and binocular vision disorders are signs of pattern glare. There is a very good test for pattern glare available from http://www.ioosales.co.uk/html/practice/eye06D.html

The cause of pattern glare is not well understood but it has been proposed to be an overreaction of some brain neurons when striped patterns are viewed. I get a pattern glare reaction when I iron strippy shirts. I see diamond shapes radiating outwards from the part of the shirt I am looking at. Fortunately, for me to experience perceptual distortions from pattern glare the stripes have to be high contrast and closely spaced. This is a very common phenomenon. Like most people with pattern glare, I do not experience pattern glare when I read print. But for those people who do experience pattern glare when they read print, the perceptual distortions can have a marked effect on reading development and education.

Some people with dyslexia have pattern glare to print as well. Some people with dyslexia do not have pattern glare to print.

It is possible to reduce the perceptual distortions caused by pattern glare from print using colour.