Abstract：
OBJECTIVE: Visual stress (VS) is characterised by symptoms of visual perceptual distortions and eyestrain when viewing text, symptoms that are alleviated by individually prescribed coloured filters. A recent review supports the existence of VS and its treatment, but noted that controversy remains, in part due to inconsistencies in the diagnosis of the condition. The present paper reviews the diagnostic criteria for VS in the literature and reports a Delphi analysis of the criteria currently used in clinical practice.
METHODS: Twenty-six eyecare practitioners were invited to participate in a Delphi study. They were selected because they were frequent prescribers of precision tinted lenses. In the first round they were sent a list of the indicators for which there is literature to suggest a relevance in the diagnosis of VS. The practitioners were invited to rank the indicators and add any additional criteria they use in diagnosis. In the second round a revised list was circulated, including items added from the responses in the first round.
RESULTS: The respondents included optometrists, orthoptists and opticians. In the first round the response rate was 85%. Ninety-one percent of those who participated in the first round also responded in the second round. Strong indicators in the second round included the symptom of words moving when reading, voluntary use of an overlay for a prolonged period, improved performance of ≥15% with an overlay on the Wilkins Rate of Reading test, and an abnormally high score on the Pattern Glare Test.
CONCLUSIONS: The strongest diagnostic criteria are combined in a diagnostic tool. This is proposed as a guide for clinical practice and further research.
METHODS: Twenty-six eyecare practitioners were invited to participate in a Delphi study. They were selected because they were frequent prescribers of precision tinted lenses. In the first round they were sent a list of the indicators for which there is literature to suggest a relevance in the diagnosis of VS. The practitioners were invited to rank the indicators and add any additional criteria they use in diagnosis. In the second round a revised list was circulated, including items added from the responses in the first round.
RESULTS: The respondents included optometrists, orthoptists and opticians. In the first round the response rate was 85%. Ninety-one percent of those who participated in the first round also responded in the second round. Strong indicators in the second round included the symptom of words moving when reading, voluntary use of an overlay for a prolonged period, improved performance of ≥15% with an overlay on the Wilkins Rate of Reading test, and an abnormally high score on the Pattern Glare Test.
CONCLUSIONS: The strongest diagnostic criteria are combined in a diagnostic tool. This is proposed as a guide for clinical practice and further research.
摘要：
目的：视觉应激（VS）的特征是观看文本时视觉感知扭曲和眼睛疲劳的症状，通过单独规定的彩色滤光片缓解的症状。最近的一篇评论支持VS的存在及其治疗，但指出争议仍然存在，部分原因是对疾病的诊断不一致。本文回顾了文献中VS的诊断标准，并报告了目前临床实践中使用的标准的Delphi分析。
方法：邀请26名眼科医师参加Delphi研究。之所以选择它们，是因为它们经常是精密有色镜片的处方者。在第一轮中，他们收到了一份指标清单，有文献表明这些指标与VS的诊断有关。邀请从业者对指标进行排名，并添加他们在诊断中使用的任何其他标准。在第二轮中，分发了一份经修订的名单，包括从第一轮响应中添加的项目。
结果：受访者包括验光师，矫形师和眼镜师。第一轮反应率为85%。参加第一轮的人中有91％也在第二轮中做出了回应。第二轮强有力的指标包括阅读时单词移动的症状，长时间自愿使用覆盖层，在威尔金斯阅读率测试上叠加了≥15%的性能，和异常高的分数在模式眩光测试。
结论：最强的诊断标准结合在一个诊断工具中。这是建议作为临床实践和进一步研究的指导。
方法：邀请26名眼科医师参加Delphi研究。之所以选择它们，是因为它们经常是精密有色镜片的处方者。在第一轮中，他们收到了一份指标清单，有文献表明这些指标与VS的诊断有关。邀请从业者对指标进行排名，并添加他们在诊断中使用的任何其他标准。在第二轮中，分发了一份经修订的名单，包括从第一轮响应中添加的项目。
结果：受访者包括验光师，矫形师和眼镜师。第一轮反应率为85%。参加第一轮的人中有91％也在第二轮中做出了回应。第二轮强有力的指标包括阅读时单词移动的症状，长时间自愿使用覆盖层，在威尔金斯阅读率测试上叠加了≥15%的性能，和异常高的分数在模式眩光测试。
结论：最强的诊断标准结合在一个诊断工具中。这是建议作为临床实践和进一步研究的指导。
