I've been of the opinion that Median XL's visual clarity is a hot mess through most of the content, but the worst part of it seems to consistently be the Punisher totems in High Heaven. It's one thing to have to dodge them because they erase you down to 1 HP if they hit you, strong enough to melt through all but the most severely high sustain builds, but it's difficult to spot them out if you have a large number of summons, use a raise skill gear, or just happen to be in the wrong spot, and they duck behind a solid wall to hit you.(which means you can't see them!)