BLOG: Performance-tinted contact lenses can help control light sensitivity
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My practice is focused on patients recovering from brain injury, including concussion, stroke, brain tumors and other conditions.
Despite the diversity of their injuries, what unites many of these patients is a common symptom: severe light sensitivity. Photosensitivity can be a debilitating symptom and one that leaves patients feeling isolated, as they sit at home with blackout drapes drawn and the lights off. Not only does photosensitivity prevent patients from working, driving and going outside, but it can also hinder recovery efforts if they are unable to get to a provider’s office for therapy.
The exact neuro pathway that causes photosensitivity is rarely specified in my patients, but the symptoms can persist for months. Exposure to light can trigger other symptoms, such as nausea, fatigue and dizziness, which is why concussion patients end up sitting in the dark at home.
I find that performance-tinted contact lenses can be a great tool for patients who are struggling with photosensitivity as they recover from brain injuries. They are available in a dark grey-green tint that blocks significant portions of the light spectrum, allowing patients to function comfortably in normal lighting conditions so they can tolerate resuming activity.
One patient I treated recently had not been able to work or drive since suffering a concussion 4 months earlier. Light sensitivity was actually her main problem. Not only was she bothered by bright light, but she was also experiencing near-constant spots in her vision, similar to a migraine aura or floaters. When she tried the performance-tinted lenses, she reported that they reduced the aura by about 75%. This patient was extremely relieved to be able to socialize with family, drive and return to work.
Chronic migraine patients are another group of people who commonly experience photosensitivity. I have a patient who gets cyclical migraines that can be triggered by glare, among other things. Normally, he wears Acuvue Oasys with Transitions contact lenses (Johnson & Johnson Vision), which help with day-to-day glare outside, but they aren’t enough when he actually has a migraine. Once the migraine starts, it may last for several days or up to a week. And because most of his work is done at a computer, he finds it extremely hard to function during these migraine cycles.
I prescribed the Altius grey-green lenses (Altius Performance Vision Technologies) for him to wear, and he was able to go back to work the next day. He still had a migraine, but he was better able to tolerate room light and computer screens. These lenses block much more light than typical blue light-blocking spectacles or contact lenses and even more than sunglasses, because there is no light coming in around the frames. They are available as plano lenses or with correction, so they can be prescribed to patients who are suffering from brain injuries or migraines, whether they need vision correction or not.
Migraine patients may wear the lenses only a day or a few days per month, to prevent or get through a headache. Concussion patients, by contrast, may wear performance-tinted lenses every day for several weeks or months as they recover, and then may not need them at all.
This is a great opportunity for dual prescribing in a primary eye care practice. For a patient who struggles with chronic migraine — and I guarantee that every practice has patients like this — you can offer a regular lens and a performance-tinted lens, so the patient can start wearing the tinted ones as soon as he or she feels a migraine beginning.
I recommend adding questions about migraine and light sensitivity to your patient history questionnaire. When appropriate, you can prescribe the performance-tinted lenses. This becomes a nice niche for the practice that builds revenue and word-of-mouth referrals —and it also solves a major problem for your patients.
For more information:
Heather Webster, OD, is a neuro-optometrist and owner of Weber Neuro-Ocular Institute, with locations in both St. Louis and Columbia, Missouri. She is a past president of the Central Missouri Optometric Society. The lenses discussed here will be covered in a sponsored course, “Use of performance-tinted contact lenses in patients with photosensitivity,” taught by Amanda Nanasy, OD, and Eric Sugarman, ATC, at the 2023 NORA conference on Brain-Based Rehabilitation. For more information and to register, visit https://noravisionrehab.org/about-nora/annual-conferences/2023-annual-conference.
Disclaimer: The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of the Neuro-Optometric Rehabilitation Association unless otherwise noted. This blog is for informational purposes only and is not a substitute for the professional medical advice of a physician. NORA does not recommend or endorse any specific tests, physicians, products or procedures. For more of our online content, click here.
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