title: Treatment of photosensitive epilepsy using coloured glasses.
abstract: A recently introduced optometric technique, colorimetry, enables the perceptual effects of ophthalmic tints to be evaluated subjectively, optimized, and then prescribed in tinted spectacles. The new technique is beneficial in reducing visual stress in patients with dyslexia and migraine. We describe an open trial designed to ascertain: (1) whether the colorimetry assessment, as it is now given, is safe for the investigation of photosensitive patients in optometry clinics where colorimetry equipment is most readily available, but where EEG control is not practical; (2) what proportion of patients with photosensitive epilepsy is likely to benefit to the extent already described in individual cases; (3) whether a tint selected by colorimetry could be shown to reduce the incidence of paroxysmal epileptiform EEG activity in response to flicker and patterns, thereby validating the subjective methods and corroborating the reported seizure reduction. Twenty-four females and nine males (aged 12-43 years) took part. All the patients had suffered visually-provoked seizures, had exhibited a photoparoxysmal response on at least one previous EEG recording, and had received a diagnosis of photosensitive epilepsy. Twenty-two were currently experiencing seizures. A further EEG was recorded in all except seven cases: a routine resting record, followed by hyperventilation. Colorimetry was performed after hyperventilation and before photic stimulation. Twenty-three (70%) reported beneficial effects during colorimetry and were prescribed glasses. There was a preponderance of lenses with a rose or purple colour, in contrast to patients with dyslexia. Seventeen of the 23 patients were available at follow-up, an average of 2.4 years later. Thirteen (57%) reported benefits, and said they were still using the lenses. In six of the 13 the benefits were pronounced, including a reduction of dizziness from fluorescent lighting, elimination of aura when using computer screens etc. Only in three cases was there a reduction in seizures that could reasonably be attributed to the use of lenses; in two of these cases no medications were prescribed, and in the third the medications remained unchanged for four years, two before and two after the introduction of the glasses. In an additional four cases a reduction in seizures was observed but medication had been changed. There was a modest reduction in EEG photosensitivity with the coloured lenses but also to an equivalent or lesser extent with grey in all of the eight patients examined in this way. One patient had seizures during colorimetry, but the seizures were not accompanied by scalp EEG changes.
authors.affiliation: Visual Perception Unit, University of Essex, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Wilkins
authors.forename: A
authors.initials: A
authors.lastname: Baker
authors.forename: D
authors.initials: D
authors.lastname: Amin
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Bradford
authors.forename: Z
authors.initials: Z
authors.lastname: Zaiwalla
authors.forename: F M
authors.initials: FM
authors.lastname: Besag
authors.forename: C D
authors.initials: CD
authors.lastname: Binnie
authors.forename: D
authors.initials: D
authors.lastname: Fish
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003124:Colorimetry / Q000379:methods; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006985:Hyperventilation / Q000209:etiology; D008027:Light / Q000009:adverse effects*; D008297:Male; D010775:Photic Stimulation / Q000009:adverse effects*; D016896:Treatment Outcome