There was a new referral to our clinic who was diagnosed with ALS in April 2017 (symptoms began Nov 2016; limb onset) and began using the Tobii i12+ in Dec 2017. Reportedly, her eye issues started about mid 2018 when she began using the SGD "full time" (she estimates being on the Tobii about 14 hours a day). Each day, after being on for a few hours, she starts to get a horizontal red line on her sclera in line with her pupil that gets darker red as the day progresses. Her family reports that some days the redness extends all the way down to the bottom of her eye. When she wakes up the next morning, the whites of her eyes are back to normal. The family also reports that her vision was evaluated recently and has been declining rapidly in the last year. She is a bright woman who is a proficient SGD user and no oral speech. While I am concerned about her decreased visual acuity, I know this can be from visual demands when using this access method or possibly ocular involvement. I am very concerned about her eyes with regard to the redness (family calls it "'eye burn" from the infa-red) and wonder if you have seen this before?