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BLOG: Changes in the blue light conversation – supplements, lenses, lighting
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In the last 5 years, we have seen the blue light conversation move from nonexistent to fringe to mainstream. Opening any of our industry journals now reveals multiple articles and product ads centered on protecting patients from the dangers of blue light.
The conversation currently centers around three main threats: age-related macular degeneration, sleep disruption and digital eye strain. Product ads include nutritional supplements, lens materials, lens coatings and screen covers for devices.
Yet when I gave my first continuing education lecture on these topics in 2011, I got the feeling most in attendance were more than a little skeptical. But this conversation has continued to evolve. As we head into another Vision Expo, I wanted to recap where we have been, where we are now and what the future might hold.
Supplements
My entry into the blue light conversation began with my interest in measuring and rebuilding macular pigment in 2004. Practicing in an area that draws retirees from across the country, I watched many of my patients lose vision to AMD. The ability to measure a risk factor for AMD (low macular pigment levels) and positively alter it with nutritional supplementation was a turning point in my practice. Since then, many peer-reviewed studies on macular pigment have been published.
A statement that has shaped my view on blue light comes from one of these papers: “The protection that macular pigment may offer patients afflicted with, or at risk of, AMD is putatively attributable to its antioxidant properties and/or its pre-receptoral filtration of damaging (short-wavelength) blue light.”
“Putatively” is an important word here, as it means “generally accepted” due to the sheer number of studies both in vitro (animal and human models) and in vivo (animal models) linking blue light exposure to retinal damage. As clinicians, I feel we can now state that the foundation of the putative standard of care for those at risk of AMD or with AMD is a triple carotenoid supplement.
Lenses
Lenses that absorb or deflect blue light have also come to the forefront. The first blue light-absorbing lenses were introduced at Vision Expo West in 2012. Since then we have seen at least a dozen other entries into the marketplace, mostly in the form of antireflective coatings.
I see this technology as continuing to evolve, as more research is completed regarding wavelengths that affect visual performance, digital device usage, retinal damage and sleep function. We are just getting started in our understanding of neuroendocrine function, with new research emerging on effects of altering spectral transmission of various wavelengths (not just blue) and their effect on intrinsically photosensitive retinal ganglion cell/neural function. Understanding spectral transmittance graphs of the lens products we prescribe will become increasingly important.
Lighting
Our indoor world has changed significantly in the last 5 years with the advent of energy-efficient lighting. An unintended consequence of reducing our carbon footprint is the increased amount of blue light we are exposed to, especially after dark. We are just starting to scratch the surface of effects of night-time blue light exposure, but experts state that the sleep disruption that comes with lower melatonin levels are linked to increased incidence of depression, obesity, diabetes, attention deficit hyperactivity disorder-like symptoms in children and cancer.
It will be interesting to see how the lighting industry deals with this growing body of research to introduce lighting solutions with less potential for harm.
Next week
Digital screens have become interwoven into our visual environment. Recently, there have been opinions put forth regarding the safety of their usage and criticism of operating system upgrades that seek to make their use safer. We need to prepare for this controversy to present itself in our exam chair. Stay tuned.
Reference :
Nolan J, et al. Eye. 2013;27:899–905. doi: 10.1038/eye.2013.98.