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Evidence lacking to support blue-blocking treatments
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To the Editor:
The September Primary Care Optometry News article, “Need increases to educate patients, offer protection against blue light,” nicely illustrates the growing interest in this area. While there are meritorious concerns regarding blue light, I feel clinicians also need to recognize that the supporting evidence needs to catch up in areas.
Presently, in vitro evidence implicates blue light toxicity to the retina. However, there is still no compelling in vivo evidence to show that blue light causes or exacerbates retinal disease such as macular degeneration. In fact, a 2011 review article by Yousseff in Eye stated, “Many investigators remain skeptical regarding the role of blue blocking lenses, as most patients with macular degeneration are phakic at the time of diagnosis and have developed disease despite the protective tissue optics of the aged natural crystalline lens.”
In a fervor to block out all blue light, in the worst case scenario, optometrists may even be harming their patients. Blue light appears to have a role in circadian rhythms (Chellappa et al.), preventing seasonal affective disorder in adults (Strong et al.) and also regulating myopic progression (Foulds et al.).
Would it be worthwhile to incrementally decrease the risk of macular degeneration if doing so turned out to disrupt sleep, induce depression and cause myopic progression? The aforementioned is not yet known, but forthcoming research should help guide practitioners in how to adopt blue-blocking treatments, if at all.
Brian Chou OD
San Diego