I like this little twine game. Nice indulgence into a few niche fetishes and really good scene writing. If you enjoy loser protagonist humiliation and censorship as a kink I wholeheartedly recommend Altered Vision. It isn't a big game, nor is it innovative, but it's a nice little ride as far as twine projects go.
Pleasantly each character has their own main theme and fetishes, and are distinct from one another even in their behavior and choice of words.
The core plot thread comes from the therapist who you are forced to meet with every week. Everything else appears to be optional and you can avoid much of the content which isn't to your tastes. There are usually warnings, both subtle and direct, when a scene could take a turn down to more controversial kinks like coerced-bi or netorare. Those warnings are accompanied by an alternative choice. Femdom is the cornerstone and is present across the whole game.
Don't assume this is some dime-a-dozen half-baked glorified clip viewer like most twine games end up being. Quality smut is the real draw here, with images chosen to serve the scene rather than scenes existing purely as a vehicle to dump random porn. The images themselves are a mix of (I think?) regular old hentai art and AI generated images, which is excusable given the small scope of the project. Pictures are lightly or moderately edited in order to fit the setting and scene.
Gameplay is typical of twine games. Click a choice, move to the next page. You can pick from X option during Y time slot. There's no complicated management system, the UI is simple, and what few variables there are can be undersood easily. Nothing impressive, but nothing overwhelming either.
The monthly updates are consistent if not meaty. One or two new scenes, various bug fixes, and occasional rewrites to account for new or expanded features like the chastity cage. Slow and steady, the amount of new content is to be expected of smaller projects like this. The developer is active in the discord and listens to feedback.