Clinical Protocol

This chapter starts with an introduction outlining the evidence-based approach, and a flow-chart summarising the typical procedure for investigating visual factors that may be relevant to reading difficulties. The limitations of a diagnosis of exclusion, as applied to visual stress, are discussed. Symptoms are considered in detail, noting that many symptoms can be caused by a variety of conditions. The main components of the eye examination are summarised, together with the diagnosis of binocular and accommodative anomalies and of visual stress. The key diagnostic tests and criteria for visual stress are described. This chapter is largely aimed at eye care practitioners but may also be of interest to education professionals and parents who are involved in the investigations that eye care practitioners are likely to undertake. The last two sections of the chapter, which relate to funding and finding an appropriate practitioner, are also likely to be of interest to non-eye care practitioners.