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Please mouse click in the box if a yes answer to the question:

Are you light sensitive

Bothered by sunlight
Bothered by glare
Do you frequently wear sunglasses
Bothered by bright or fluorescent lights
Get a headache from bright or fluorescent lights
Feel fidgety under bright or fluorescent lights
Harder to listen under bright or fluorescent lights
Performance deteriorates under bright or fluorescent lights
Feel like there is not enough light when reading
Feel like there is too much light when reading
Read in dim light
Use fingers or other marker to block out part of the page
Shade the page with your hand or body

Types of reading difficulties:

Skip words or lines
Repeat or reread lines
Lose place
Read in a "stop and go" rhythm
Omit small words
Poor reading comprehension
Reading becomes harder as you continue
Avoid reading for pleasure
Rereads for comprehension
Reversals of letters and/or numbers

While reading or using a computer, do you:

Rub your eyes
Move closer to or further away
Open eyes wide
Incorporate breaks
Change position to reduce glare
Close or cover one eye
Read word by word
Unable to speed read

Do you feel strain, fatigue, tired, or have headaches when:

Doing paper and pencil tasks
Working on the computer
Watching TV, movies, or live stage production
Copying material
Playing video games
Doing visually-intensive activities like needlepoint, sewing,cross stitching, crossword puzzles, woodworking, soldering, etc.
Working under bright or fluorescent lights
Looking at stripes, patterns, bright colours and high contrast


Write up or down hill
Unequal or no spacing between letters or words
Unequal letter size
Unable to write on the line
Problems Proofreading
Leave out words, letters, or punctuation marks


Easily distracted when reading or writing
Easily distracted when listening
Easily distracted when taking tests
Problems staying on task
Problems starting tasks


Lose place (book, screen, whiteboard, overhead)
Leave out words (book, screen, whiteboard, overhead)
Slow (book, screen, whiteboard, overhead)
Incomplete (book, screen, whiteboard, overhead)
Difficulty re-focusing
Difficulty copying things onto or from the computer


Mis-align digits in number columns
Difficulty seeing numbers in the correct column
Sloppy or careless errors
Use finger, graph paper, or other when working with columns of numbers
Difficulty seeing signs, symbols, numbers, decimal points
Reversals of numbers


Problems sight reading notes
Prefer to memorise rather than read music
Prefer to play by ear
Use finger to track notes
Lose your place
Trouble reading the notes or notes and words together
Difficulty interpreting the music notations
Little progress in spite of regular practice

Depth Perception:

Difficulty getting on and off escalators and other moving objects
Bump into table edges or door jams
Difficulty walking up and/or down stairs
Difficulty judging distances
Drop or knock things over
When walking next to someone, do you drift into the person
When walking, do you feel dizzy or light headed


Difficulty parallel parking
Do you feel like you will hit the car in front when parking
When parking, do you hit the curb or leave too much space
Difficulty judging when to turn in front of oncoming traffic
Uncertain about making lane changes
Do passengers tell you that you tailgate
Are you overly cautious, leaving extra room between you and the car ahead

Sports Performance:

Problems tracking a flying ball in golf, tennis, etc.
Trouble following the ball when watching sports on
TV such as tennis, football or basketball
When watching sports on TV, can you follow the ball but not
see anything else
Trouble catching or passing a ball
Difficulty playing pool or snooker
Difficulty hitting the ball when playing cricket, hockey or tennis

Fatigue While in a Car:

As a passenger, do you become drowsy
When driving, do you become drowsy
Bothered by glare off the rear window of car in front of you
Bothered by headlights and street lights at night
Avoid driving at night
Have night blindness
Bothered by red rear lights on cars
Bothered by red traffic lights
Stressful to drive in the rain (glare)

If you answered yes to Three or more of these questions in any One of the above sections, then you might be experiencing the effects of a perception problem called Irlen Syndrome/ Scotopic Sensitivity.

Please highlight the complete form, copy and then paste to an email with additional information to

Irlen East

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