READING

When reading

1. Do you unintentionally skip lines, repeat lines or lose your place?

2. Do you have to re-read in order to understand?

3. Are you easily distracted?

4. Do you avoid reading whenever possible?

5. Do you experience headaches or fatigue?

EYESTRAIN

When reading:

6. Do your eyes hurt, burn, itch, water, become tired, ache?

7. Does it take energy and effort to see the words clearly?

8. On the computer do your eyes hurt, burn, itch, water, become tired, ache?

9. Does it become progressively worse as reading continues?

PRINT RESOLUTION

When reading do words ever:

10. Blur, seem fuzzy or appear less sharp?

11. Move or merge?

12. Double or distort?

13. Get darker or lighter in colour?

14. Have halos or shadows?

LIGHT SENSITIVITY

Do you find:

15. Sunlight too bright and/or sunglasses a necessity?

16. Fluorescent lighting too bright?

17. It uncomfortable to read or work under fluorescent light?

18. It easier to read in dull or dim light?

19. White pages too white, bright or glary?

20. You squint when outside because the light bothers you?

21. You have difficulty adjusting from bright lights to darkness and/or darkness to bright lights?

22. Computer screens / white boards / Smart Boards / electronic device seem bright?

23. Magazine or text book pages seem shiny or glossy, so you adjust the book in order to eliminate glare?

24. Headlights or streetlights bother you, or have halos?

FATIGUE

Do you:

25. Experience headaches or migraines?

26. Experience discomfort, strain, fatigue, headaches when using computers?

27. Fatigue after work?

DEPTH PERCEPTION

Do you:

28. Hold onto the railing while walking up or down stairs?

29. Have difficulty getting on or off escalators?

30. Bump into objects when walking e.g. table edges or door jams?

31. Veer into people when walking beside them?

32. Ever feel dizzy when walking?

33. See yourself as clumsy?

34. Experience motion sickness?

35. Have trouble catching, hitting or following a ball while watching sport on TV?

When driving do you:

36. Have difficulty judging the distance of oncoming traffic?

37. Leave lots of room between your car and the car ahead?

38. Have difficulty making lane changes or are extra cautious?

39. Feel nervous about passing cars on a two lane road?

40. Tailgate or do your passengers tense when you change lanes?

41. Have difficulty parking the car?

Your response contain errors which are highlighted in red. Please correct them and try again.
Cancel

You can also download PDF versions of the following Irlen Syndrome questionnaires:

Children's Questionnaire

Teenager's Questionnaire

Adult Questionnaire

Understanding Irlen Syndrome Booklet - dyslexia centre sydney

more info irlen com - Sydney Irlen Dyslexia Centre

AAIC - Sydney Irlen Dyslexia Centre