Digital Eye Strain + Blue Light July 2019

DIGITAL EYE STRAIN + BLUE LIGHT

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Addressing Modern Challenges to the

APPROVAL: ABO APPROVED FOR 1 HOUR, TECHNICAL LEVEL II ONLINE COURSE: STWFVM004-2 ISSUE DATE: JUNE 19, 2022

APPROVAL: This course has been approved for one hour of Technical Level II continuing education credit by the American Board of Opticianry. NOTE: This course is only available with online testing. Please see instructions at the end.

COURSE DESCRIPTION: Challenges abound with regard to our eyes and vision in the modern world. Our eyes can be exposed to ocular dangers in various outdoor environments to indoor vision stresses caused by intense use of various digital devices. This article will survey various problems caused by blue light, digital eye strain and the outdoor environment and provide solutions the ECP can use to achieve the best outcome in correction and ocular protection for their patients.

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By Richard W. McCoy LDO, ABOC, NCLEC

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The modern world presents numerous challenges to the eyes and vision. These challenges include environmental concerns in the natural world in addition to factors that are manmade. The light spectrum (ultraviolet, visible and infrared) covers a wide range from 100/200 nanometers (in a vacuum) to over 800 nanometers in the infrared range. The spectrum that eyecare professionals (ECPs) concern themselves with consists of the wavelengths between 380nm and 760nm and is commonly called the visible spectrum of light.

A modern concern for ECPs is high energy blue light, which resides in the

wavelengths slightly higher than 380nm to 460nm. Blue light is scattered in the atmosphere (known as Rayleigh scattering) and is responsible for the sky appearing blue. Blue light is a component of normal daylight comprising 25%-30% of the total wavelengths. This scattering of blue light can affect vision a number of ways, including depth and color perception.

Furthermore, blue light exposure not only affects patients in an outdoor environment but up close and personal with modern conveniences, electronic devices and lifestyle. This and the accompanying problem of digital eye strain represent real challenges to modern vision.

Blue light affects us in three ways: • daily vision and performance • health and general well being

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• long-term vision loss (such as AMD) (source : www.ncbi.nlm.nih.gov/pubmed/16445433 www.ncbi.nlm.nih.gov/pubmed/18838601)

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DIGITAL EYE STRAIN According to Business Insider magazine (March 27, 2019), a number of factors affect the modern American worker’s visual well being. As early as the 1960s, the change began when designer Robert Propst introduced the cubicle as a functional workplace. This was the beginning of work being up close and personal, causing stress on the eyes by way of the ciliary body. With the invention of smartphones, tablets and computers, near vision issues are compounded not only by the length of time spent on devices but the devices themselves, which emit blue light. The American population looks at cell phones 12 billion times per day, and 60% of Americans spend more than five hours a day on various digital devices. Prolonged use of these devices overworks the eye’s refractive system, stressing the ciliary muscle and causing digital eye fatigue.

In addition, Americans are no longer separated from the workplace. Of the working population, 77% of Americans work more than 40 hours per week, with the average full-time worker putting in a 47hour week. According to the International Labor Organization, the average American worker puts in 260 hours more per year than their British counterpart and 499 more hours per year than a comparable French worker.

Digital devices are manmade challenges to modern vision exacerbated by long hours of continuous use that is either work related or personal. More than half of American adults suffer adverse effects from overexposure to the screens of various devices. These effects are collectively identified as digital eye strain according to The Vision Council.

Information revealed by a VisionWatch survey shows close to 49% of American adults don’t know what digital eye strain is, and furthermore, nearly 35% aren’t concerned about the effects on their eyes.

The VisionWatch survey further highlights that Americans spend more time looking at a montage of different devices and screens.

More than 80% of adults use digital devices for over two hours per day, and nearly 67% use two or more devices simultaneously. In addition, close to 55% report looking at a screen the first hour after waking, and 80% say they use digital devices in the hour just before sleep. When asked, approximately six out of 10 reported symptoms that can be attributed to digital eye strain. These symptoms include but are not limited to: • neck/shoulder pain (35%) • headaches (27.7%) • eye strain (32.4%) • blurred vision (27.9%) • dry eyes (27.2%)

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IMPORTANT NOTE • Neck/shoulder pain can further be aggravated by the workplace itself—improperly positioned monitors, chairs that have poor ergonomic design or cannot be adjusted to fit the operator, keyboards that cannot be positioned effectively contributing to carpal tunnel syndrome and other repetitive motion injuries. In addition, poorly positioned computer terminals coupled with poor light sources in an office can result in discomfort glare for the operator, requiring excessive movement to be able to see a computer screen or series VCPN | DIGITAL EYE STRAIN + BLUE LIGHT | JULY 2019

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BLUE LIGHT CONCERNS The key factor with digital devices and the internal environment is blue light.

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Although blue light has always existed in the natural world, it now touches every aspect of our internal environment and lifestyle. This is due primarily to the advent of LEDs (light emitting diodes). This component has been embraced by the electronics industry as a light source for a multitude of electronic devices due to the fact it emits light, is cool running and does not require excessive power to operate. Examples include laptops, desktop computers and cell phones. Cell phones in particular undergo intense use due to the multitude of tasks they can perform whether for business or pleasure.

In addition, due to their energy efficiency and cool operation, LEDs are fast replacing conventional incandescent light sources in homes and the workplace. A major concern for ECPs about an LED source is a strong blue light emitter. When looking at the visual spectrum, LEDs and digital electronic devices peak at 455nm wavelengths. Of concern is the fact that blue light at 440-500nm disrupts melatonin production, which directly affects an individual’s sleep cycle.

Disruption or poor quality sleep cascades into a wide range of negative consequences. According to a National Safety Council study, 30% of adults have a decrease in cognitive performance. Over 20% of fatal auto accidents are attributed to drowsy driving, and over 10% of workplace injuries are attributed to sleep loss.

Blue light is exacerbated by strong sunlight in an outdoor environment. Blue light intensity in the outdoors is 100 to 500 times that of everyday digital devices.

It is believed that macular cellular damage and cell death occur between 400nm and 435nm as a direct result of strong sunlight. Sunglass manufacturers have realized blue light filtration as an important protective filter and have been including it in many of their lens products.

In addition, blue filtration gives the wearer superior vision over conventional sunglasses. Depth perception is increased, and colors are much more vivid and true. Of importance to ECPs, the prescribing of a blue light lens/filter not only represents a choice for quality vision for the patient, it takes on an important medical aspect as well. These points are summarized as follows: BEST PATIENTS • children under 18 yrs., eyes are not fully developed • post cataract and LASIK patients • high risk and current macular degeneration patients. (ECPs also prescribe lenses that block UV in addition to blue light to help slow the progression of retinitis pigmentosa.)

• contact lens wearers • anyone who works in a strong sun environment or individuals who enjoy prolonged recreational activities outdoors ULTRAVIOLET LIGHT Another important factor of light that resides in the outdoor environment is ultraviolet radiation (UV). Wavelengths of light shorter than 400nm are designated as UV radiation. These wavelengths can be

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ABO TECHNICAL LEVEL II

of screens properly. When the operator has to look back and forth between different illuminations, visual comfort is lost even though object resolution is maintained.

• Dry eyes are shared by computer users and scuba divers alike. Individuals have a tendency to blink less when doing these two activities. For the computer operator, this condition can be further compounded if they wear contact lenses and/or their work area is located near office air conditioning vents.

Children in this modern era have aggressively embraced all forms of today’s electronic devices and have suffered from a variety of issues as a result.

The Vision Council reports that parents indicate that 23.1% of children play on a digital device as a favorite pastime with more than 70% of adults saying their children are exposed to two or more hours of screen time per day. An alarming 25% of parents report that they are not concerned about the impact of digital devices and user time on their child’s eyes. Children are of special concern as the juvenile crystalline lens absorbs less shorter wavelength light than an adult lens, thereby allowing more blue light to pass to the retina. With regard to quality sleep, limitation of electronic devices before bedtime has proven to be an effective method for increasing quality sleep in children. (source: American Optometric Association) Many of the issues adults face with digital devices also affect children and exacerbate other issues. These include but are not limited to: • headaches (8.8%) • neck/shoulder pain (5%) • eye strain, dry or irritated eyes (9.1%) • reduced attention span (15.2%) • poor behavior (13.3%) • irritability (13.5%) The last three bullet points show a direct correlation of behavior due to poor quality rest.

• Grass reflects up to 3% of UV intensity.

Just as blue light is dangerous for children’s eyes, UV exposure is even more so.

Unlike an adult cornea, a juvenile crystalline lens cannot effectively filter UV wavelengths. In addition, intense UV exposure is cumulative, which can result in ocular pathology for the child later in life. According to The Vision Council, only 5% of American adults report their children “always” wear sunglasses. Furthermore, 12.6% report using nothing to protect their children’s eyes. This should serve as a wake-up call for ECPs to educate adults and children about the importance of quality sunglasses that give proper filtration protection.

Although sunwear is fashionable, its main function is “ophthalmic body armor” with quality lenses. Without sunglass protection, even short-term eye problems can result. These include: • bloodshot eyes • swollen eyes • hypersensitivity to light • photokeratitis or sunburn of the eye that can cause vision loss for up to 48 hours (source: The Vision Council)

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further broken down and subdivided into categories. These categories represent the critical danger to the eye and surrounding tissues. Where blue light can pass through and cause tissue damage to the retina, UV light is absorbed by the components of the eye itself, the cornea, the humors, aqueous and vitreous, and the crystalline lens. The eye can suffer damage from UV light, with intense short-term exposure or lower exposure over a prolonged period of time resulting in cataracts and/or age-related macular degeneration. The categories of UV are as follows: • UVA 315nm-380nm • UVB 290nm-315nm • UVC 200nm-290nm • UV vacuum 100nm-200nm UVA is a long wavelength of ultraviolet, is the least harmful and causes tanning of the skin.

Stronger UVB radiation with significant exposure can cause cataract formation, photokeratitis and retinal issues. Potentially lethal, UVC is fortunately filtered by the ozone in the earth’s atmosphere. With changes in the environment, the ozone layer does not give uniform filtration across the globe. Residents of Australia, for example, have serious concerns regarding UV exposure as a result of a thinner ozone layer in the atmosphere. The environment and time of day affects UV strength in sunlight. UV radiation is most intense during the hours of 2:00pm to 4:00pm with 60% of the day’s UV emissions occurring at that time. During this time, Americans spend 39.8% of their time outdoors. Furthermore, UV radiation increases as an individual moves closer to the equator and/or moves to higher elevations. The elements of the earth can equally contribute to ocular damage as direct UV exposure by reflection. It is important to note that reflected UV light off various surfaces in no way diminishes its strength. A short list comprises the reflective value of UV interacting with various terrains: • Water reflects up to 100% of UV intensity.

• Dry sand and concrete reflect up to 25% of UV intensity.

• Snow reflects up to 85% of UV intensity.

PROTECTIVE PRODUCTS A multitude of lens options are available to the ECP to protect their patients’ eyes from blue light dangers. Lenses include single vision in a variety of lens materials and optioned with blue light filters and complemented with anti-reflective coatings. In addition, for outdoor environments, blue light filters can accompany polarized lenses for maximum protection and clarity of vision. Depending on the manufacturer, the blue light filter is fabricated in-mass with respect to the lens. The advantage of that process is the protection factor will not degrade due to lens thickness or age. In addition to the obvious feature of darkening, various photochromic products protect against blue light whether the patient is using various electronic devices or is outside either at work or play.

Lens manufacturers have responded to digital eye strain issues with a montage of lenses designed to relieve accommodative stress. In single vision, these lenses provide an accommodative “boost” in the near area of the lens to give patients comfort in using their eyes at near for hours on end. Depending on the lens company, power boosts can range from +0.57D to +1.32D. The advantage of this type of lens over a conventional reader is a plano can be prescribed for distance in the case of an emmetrope.

These lenses are a viable choice for myopes from 18 to 40 years old who are experiencing the symptoms of digital eye fatigue. Furthermore, they act as a “bridge” for emerging presbyopes who have problems at near but are not ready to move into a progressive lens choice. Manufacturers provide the ECP with a choice of base curves to accommodate a range of Rx’s. In addition, lens materials include polycarbonate, CR-39 and high index 1.67. Add-ons are available including anti-reflective coatings.

Various photochromic products provide an excellent lens option for children as well as adults. Photochromic options are available in different formulations and will activate to a darkened state when 35

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ABO TECHNICAL LEVEL II exposed to UV. An additional advantage of the variable tint lens is it’s filtration of harmful blue light indoors and outdoors.

The ECP can select an option for a patient that has a filtration property of a minimum of 20% indoors to a maximum of 34%. In addition, the filtration option in an outdoor environment will block a minimum 85% to a maximum of 88%.

For low vision patients and those who suffer from severe glare issues, a series of lenses are available for the ECP to prescribe. These lenses are wavelength specific and have photochromic capabilities.

Depending on the wavelength selected, the patient can enjoy reading, television viewing and blocking glare from harsh fluorescent lighting. As an example, a lens that is selected with a filtration value of 511nm will give relief to patients with the following: • developing cataracts • aphakes and pseudophakes • macular degeneration • corneal dystrophy • optic atrophy (source: Corning) Another example is a glare control lens with a filtration value of 550nm. This variable tint lens aids patients with intense sensitivity to light, poor dark adaptation or retinitis pigmentosa. (source: Corning) Anti-reflective (AR) coatings are a strong lens option that will help a patient in a number of ways. In an office environment, a workstation or cubicle may not be positioned to take advantage of environmental or natural lighting. A front and backside AR coating can eliminate annoying reflections and allow higher light 36

transmission in low light environments.

In addition, the patient can receive visual benefits while driving at night as light transmission is increased and the star-like glare from illuminated objects such as streetlights and headlights are gone.

Instrumentation on today’s automobiles is much easier to see at night with the addition of an AR coating. Patients who enjoy numerous outdoor activities benefit from adding an AR coating option to their new sunglasses.

For maximum benefit in sunwear, a backside AR coating should be included to prevent harsh reflections when strong sunlight is emanating from behind the wearer. Antireflective coatings are an important viable complement to UV, blue light filters and sunglass lenses that are polarized.

Contact lenses continue to be a popular choice of correction with today’s fastpaced lifestyles. Recognizing the dangers of blue light and UV exposure, breakthrough technology has been introduced into contact lens design. The breakthrough comes in the form of light-adaptive photochromic technology. This feature in a contact lens helps a wearer’s eyes throughout the day in a variety of lighting conditions.

This variable photochromic option in a contact lens allows the lens to become dark in 45 seconds and fade to clear in 90 seconds. When the contact lens is exposed to UV and HEV the lens activates and 70% of visible light is blocked from the patient’s eyes.

Furthermore, 100% of dangerous UVB is blocked for the patient’s benefit. The ECP must caution the patient that a variable tint contact lens does not preclude the use of UV-absorbing eyewear. The

contact lens does not give any benefit of protection to delicate ocular structures surrounding the eye. In addition, the patient’s lifestyle with regard to outdoor activities, duration, geography and altitude have a bearing on the degree of ocular protection that is prescribed.

A further innovation in contact lens technology addresses the concern of digital eye fatigue, which manifests itself as dry tired eyes. A contact lens is available utilizing a new digital optical zone concept and fabrication technology. These two components of the contact lens design help reduce the stress on the ciliary muscle and help minimize the discomfort of dry eyes. This is another opportunity for ECPs to utilize technology as a practice builder and cater to their contact lens clientele who experience digital eye fatigue.

In addition to utilizing breakthrough technology with contact lenses to defeat digital eye fatigue, ECPs can use state-ofthe-art spectacle products to accomplish the same goals. Digital eye strain can be detected and addressed during the routine refraction by using duochrome or binocular balance testing to ensure the patient is not over corrected with too much minus power, then fogged to relax accommodation, then add low plus power to help the patient with near tasks. A one diopter flipper lens can also show and provide the needed relief the patient needs from performing countless hours of work using digital devices.

Taking care of this type of a patient is rewarding for the practice. In order to effectively capture this patient, good consultation in the beginning is essential to ensure a positive patient outcome. For

JULY 2019 | DIGITAL EYE STRAIN + BLUE LIGHT | VCPN

advanced products and achieve an effective patient outcome? A simple fact emerges, a patient doesn’t know what they don’t know. When shopping for eyewear the patient gravitates to the frame displays to pick out a fashionable choice.

Lenses are the second choice when they should be the first choice. The frame is the fashionable platform within which the prescribed correction is housed. A fresh approach is called for in regards to eyewear.

Patients many times have snippets of information with regards to UV or blue light protection. This is an opportunity for the ECP to have a meaningful discussion and provide education regarding various corrective options. Many doctors resist the notion of selling from the chair, relegating that to the support staff.

Another approach is to discuss the patient’s particular visual needs, disregarding brand names/products and what they can do for the patient. When the conversation is at a more medical/visual correction level, the patient views the eyewear and options as something that can improve their visual health and overall well being as opposed to a commodity item in which critical lens options are not taken seriously.

A sale will take place when the patient fully understands how important their visual well being will become as opposed to economizing away critical lens components and not achieving the best outcome for long-term eye health. Eye examinations that are performed and result in no change in the prescription should not be excluded from the education process. The existing glasses should be inspected for scratched lenses, and the frame should be examined

ABO TECHNICAL LEVEL II

new patients filling out the patient record form to give a baseline on information, additional questions should be asked with regard to estimated time on: • smartphones • computers, one or two screens • printed materials and text • special vision tasks (Give patients the opportunity to elaborate on their job functions, which may give clues to the ECP of other issues that need to be addressed.)

Further questions are more pointed toward digital eye fatigue symptoms such as tired eyes, headaches, dry eyes, neck and shoulder pain, and reduced concentration.

These questions should be asked to established patients as well due to the fact that these issues were not explored in the past or the patient has undergone lifestyle/occupational changes that require a review of their vision care options. The importance of the additional questionnaire or bank of questions on the patient record form is to draw out information that is overlooked or not discussed. According to The Vision Council, 90% of patients do not talk about digital device usage to their eyecare provider.

Computer eyewear is another important option in the ECP’s arsenal of eyewear options to satisfy patient needs. This eyewear is the occupational “task specific” choice of the 21st century and helps with many of the issues previously stated. In addition they are an effective second pair option for the veteran presbyope. They are complementary as they are designed with a much wider intermediate and near portion with a smaller concern for distance vision. They help the patient function well with vision tasks at a large desk in a workstation or multiple desks, monitors and other electronics.

Lens manufacturers give the ECP a wide choice of lens options in the form of focal distance of the lens and upgrades.

The lens can be designed where the wearer can see anything they can reach or up to 12 feet further. They are true occupational eyewear. Computer lenses are available in today’s popular materials and lens options such as filters for blue light and AR coatings (front and backside).

We live in a complex, fast-paced society in which our patients are faced with visual demands unheard of 15 years ago.

The ophthalmic retail market operates many times in a price-driven market. How can the ECP promote technologically

to see if it will be sufficient until the next examination. Finally, depending on the age of the present eyewear, the patient may be informed to change eyewear with the existing Rx so they can reap the benefits of upgrades in lens technology.

Staff should support the education the doctor provides the patient while in the exam room and reiterate the importance of the visual corrections, beginning with product and what it can do for the patient’s lifestyle both occupationally and recreationally. Once eyewear and contact lens options have been decided they should be reviewed and the price given.

The patient can then make an informed choice, or alternatives can be presented by the staff member.

Literature should be available for the patient to take home, read and discuss with family members. The literature should be stamped with the ECP’s information and contact phone number. For a personal touch, a staff member should include their name in case the patient has follow-up questions. Finally, a staff member should reach out within three days to further reiterate the importance of the discussion and corrective choices selected. n Richard W. McCoy LDO, ABOC, NCLEC, has been a licensed optician for 39 years and is licensed in Florida and Virginia. He has been an instructor for the Hillsborough Community College Opticianry program based in Tampa, FL, for 18 years. Furthermore, as an educator, he has lectured to various associations and meetings across the U.S. on a variety of ophthalmic topics.

This course is ONLY available for online testing.

TO TAKE THE TEST ONLINE: Go to VisionCareProducts.com/Education 1. Under the black log-in bar, log in (Note: Use the “register” link to register for online education, and record your user name and password for future access.)

2. Click on the course you would like to complete.

3. Review the course materials.

4. Take the test, and at the end of the course, after you submit your answers, your results will automatically appear on your screen!

5. All passing tests will automatically be submitted to ABO at the beginning of each month. You may print a copy of your certificate for your records.

VCPN | DIGITAL EYE STRAIN + BLUE LIGHT | JULY 2019

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DETAILS Americans spend nearly 22 years of their life looking at screens.1 It’s no wonder digital eye fatigue has become so prevalent.

BACK STORY More than 50% of those aged 18 to 29 years admit to spending more than nine hours per day on digital devices, and more than 90% of adults admit to using digital devices for more than two hours per day2—and that’s all it takes for digital eye fatigue symptoms to kick in.

Spherical contact lens wearers can benefit from CooperVision Biofinity Energys, from new wearers to those who transition from other monthly or two-week replacement brands. More than 40% of prescriptions for CooperVision Biofinity Energys contact lenses are for new contact lens wearers, indicating that this innovative technology has quickly become a new fit lens of choice for U.S. eyecare professionals.3 In a national survey, only 6% of U.S. consumers reported speaking with an eyecare professional about digital device usage.

However, 64% of contact lens wearers reported they would be interested in exploring ways to help reduce eye strain.2

Patients want to have options, and now is your chance to educate your patients about digital eye fatigue as well as the benefits of Biofinity Energys.

WOW FACTOR Biofinity Energys are the first and only contact lenses designed to help with eye tiredness and dryness associated with digital eye fatigue.4 Digital Zone Optics lens design can help reduce ciliary muscle stress during digital device use and helps eye tiredness, while Aquaform Technology helps with eye dryness.5 Not only are eyecare professionals seeing

outstanding results; patients are also noticing the difference.

• 95% of wearers who switched from another contact lens said Biofinity Energys met or exceeded their expectations6 • 83% of wearers said that Biofinity Energys help their eyes feel less tired at the end of the day compared to their previous contact lenses6 • 85% of wearers agreed their eyes feel relaxed while using digital devices when wearing Biofinity Energys6 Prescribe Biofinity Energys to meet your patients’ digital lives. n

1. OnePoll study for CooperVision, June 2018 2. CVI data on file 2019. Online YouGov plc survey (conducted 2017). n=9343 adults in Australia, France, the U.S., Germany, the U.K., Japan and Spain. Data weighted representative of countries. 3. U.S. industry data on file, 2018 4. U.S. monthly single vision lens 5. Based on a statistically significant difference of the mean change of accommodative micro-fluctuations and when compared to Biofinity sphere after reading on an iPhone for 20 minutes. Orsborn G, Kajita M, Muraoka T, Vega J. Changes in accommodative micro-fluctuations after wearing contact lenses of different optical designs. Cont Lens Anterior Eye. 2018 Jun;41(1):S83. doi: https://doi. org/10.1016/j.clae.2018.04.009. 6. CVI data on file, 2018. Online survey Biofinity Energys CL wearers, USA. n=200

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DIGITAL EYE STRAIN + BLUE LIGHT: LENS SOLUTIONS FOR MODERN VISION CHALLENGES

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Lens Solutions for MODERN VISION CHALLENGES Fortunately for today’s ECPs and their patients, there are many lenses available to filter blue light.

By Wendi Atchison, LDO, ABOC, NCLEC

T

he world we live in presents challenges to our eyes and vision every day. The visible spectrum of light between 380 and 760 nanometers contains wavelength components that can at a minimum create difficult vision situations but which can also eventually develop into long-term ocular health concerns. One of these components is blue light, which represents 25% to 30% of wavelengths that comprise normal daylight. The scattering of blue light in the outdoor environment poses critical issues with vision including but not limited to depth perception and color recognition.

Furthermore, blue light concerns are carried over into the indoor environment by way of LED lighting, which is replacing antiquated incandescent lighting and is emitted by multiple electronic devices used by adults and children of all ages. LED lighting and electronic devices such as laptops, desktop computers, smartphones and tablets are all constant sources of blue light. Fortunately, the eyecare professional has a number of lens products that can be chosen to combat these modern vision challenges.

DUAL PROTECTION A Transitions lens represents multiple benefits for the patient.

Financially, it is a good value by protecting the eye in multiple environments, indoors and outdoors with blue light filtration and the photochromic feature for harsh sunlight.

Examples of dual protective lenses are the Transitions Signature lens, which helps filter 20% of blue light indoors and 85% of harmful blue light outdoors. Transitions XTRActive provides an increased level of protection by helping filter 34% of blue light indoors in conjunction with a robust 88% to 95% in an outdoor environment. Finally, Transitions Vantage lenses help filter 34% indoors and over 85% outdoors.

ACUVUE OASYS with Transitions was named one of Time magazine’s Best Inventions of 2018 and gives the ECP/contact lens fitter another powerful tool to protect patients against hazardous 40

LED lighting and electronic devices such as laptops, desktop computers, smartphones and tablets are all constant sources of blue light. blue light. This light-adaptive technology helps the patients’ eyes throughout the day in changing light conditions. The lens will quickly become dark in 45 seconds and fade to clear in 90 seconds. When the contact lens is exposed to UV and HEV the lens activates and 70% of visible light is filtered from the patient’s eyes.

HYBRID PROTECTION In response to the dangers of blue light, Signet Armorlite has developed Color Guard Lens Technology to combat this ocular danger. This technology combines a unique pigmented lens material with a specially formulated anti-reflective lens coating that filters and deflects blue light and maintains color perception. This hybrid lens is marketed as the KODAK Total Blue Lens and is available in clear and polarized, four lens indices and all profiles such as single vision, progressives and a task-specific computer design.

Another lens material available to ECPs is Shamir Blue Zero. The clarity of this lens provides comfortable vision in various light conditions and still maintains crisp visual acuity. In addition, the lens provides excellent ocular protection by blocking UVA and UVB radiation.

The lens is a viable option for adults and children whether in Rx or plano. Due to their proprietary formula, Shamir Blue Zero High Index 1.67 and Shamir Blue Zero Trivex block up to 98% HEV in the 415nm to 435nm wavelengths. Shamir Blue Zero Polycarbonate blocks up to 50% of HEV blue light in the 415nm to 435nm wavelengths.

MEDICAL BENEFIT The first near clear ophthalmic lens with a proven medical benefit comes from BluTech. Due to the HEV filtration of the lens, it’s a JULY 2019 | DIGITAL EYE STRAIN + BLUE LIGHT | VCPN

BENEFICIAL WAVELENGTHS Blue light, while hazardous in certain scenarios, is essential in regulating certain body systems such as circadian rhythm. The dual nature of blue light has prompted ZEISS to create the DuraVision BlueProtect lens. In essence, the coating is “tuned” to deflect harmful wavelengths of blue light without interfering with the beneficial wavelengths that are critical for proper homeostasis.

DuraVision BlueProtect passes the majority of visible light above the 460nm wavelength while reducing the hazardous blue violet light under 440nm. By reducing blue light using selective reflection natural true color vision is maintained.

Longevity of the lens surface is critical in all lens designs. ZEISS’s DuraVision BlueProtect lens has a super slick top coating that is matched to a patented anti-static layer and AR stack. These stacks have been engineered for maximum integration and compatibility. The end result is a lens with maximum filtration properties coupled with a lens surface of robust hardness that is easy to clean and maintain.

EXTRA PROTECTION Other damage caused by high energy blue light in the 290nm to 460nm wavelength is skin cancer. Endorsed by the Skin Cancer Foundation as an effective UV filter for the eyes and surrounding skin, VISION EASE Clear Blue Filter Lenses help protect your eyes from the most damaging ultraviolet and high-energy blue light rays, while offering superior clarity and vision. A high-quality everyday lens, VISION EASE Clear Blue Filter Lenses block 100% of UV rays and filter three times more blue light than standard polycarbonate lenses. Filtering properties are not a coating but are built into the lens.

HOYA, a company with a long history in blue light filtration lenses, markets the Recharge EX3 AR lens. The lens blocks 30% of harmful blue light and has a stronger coating to resist scratches with a Bayer abrasion rating higher than glass. HOYA supports the independent practitioner and believes this lens product will help

DIGITAL EYE STRAIN + BLUE LIGHT: LENS SOLUTIONS FOR MODERN VISION CHALLENGES

natural choice for children under the age of 18 who spend countless hours using digital devices. Furthermore, it is an effective medical option for post cataract and LASIK patients who experience glare from bright lights. Finally, high risk and current macular degeneration patients will benefit from the most near clear protection available without color distortion. BluTech lenses are available in plano for contact lens patients. An important advantage of the BluTech lens is in its fabrication. The HEV filtration property is not a coating as the lenses are infused with Blue Light Plus, a proprietary combination of pigments and dyes that protect eyes the way nature does.

BluTech lenses are available in a wide range of lens choices including plano, single vision, FT 28s, progressive and polarized.

the ECP deliver technology and innovation to educate patients so they can differentiate their practices.

For ECPs who do their own in-house surfacing with Super Optical’s FastGrind system, the company offers BlueShield, a blue filter lens with an overall 90% light transparency.

Luzerne Optical markets the TheraBlue filter lens with a variety of indices of materials, including 1.67, 1.60, 1.56 and polycarbonate.

Lens profiles include single vision, progressives, and computer lenses in addition to outdoor sun lenses. It is also available in ST28 bifocal for indoors and outdoors.

TechShield Blue is a premium anti-reflective coating from VSP Optics that delivers targeted defense against blue light linked to digital eye strain (400-435nm). In addition to absorbing and reflecting blue light, this near-clear coating reduces glare, blocks UV and is resistant to everyday wear and tear from water, oils, scratches and smudges.

SunSync Light-Reactive lenses, a comprehensive photochromic portfolio from VSP Optics, filters blue light indoors and outdoors in both clear and dark states. SunSync lenses also deliver fast activation and fade-back times, 100% UV protection and a one-year satisfaction guarantee for VSP members in traditional, extra-active and ultra-fast lens options.

Gunnar Optiks markets the Clear lens, which blocks 35% of indoor blue light. The lens does not have an amber tint, making it a good choice for patients who prefer a clear lens.

A product born from joint research with the Vision Institute of Paris is the Crizal Prevencia from Essilor. It is a clear lens that selectively filters harmful blue violet light while allowing beneficial blue turquoise wavelengths to come through. Finally, the lens blocks harmful UV rays and has an AR coating coupled with substrate layers for superior scratch resistance and to repel everyday dust and smudges during eyewear usage.

Conant Lens Inc. offers Retinashield Blue and UV++. These lenses not only block harmful blue light but allow beneficial blue turquoise light to pass through that is essential for daily well being. These lenses use an in-monomer technology that allows filtering in a virtually clear product.

Also, 100% of dangerous UV radiation is blocked. Finished lenses have an AR coating to eliminate annoying reflections and provide high light transmittance. Availability includes: finished single vision and semi-finished single vision in 1.50, Hi-Vex, 1.60, 1.67, 1.74 as well as 1.60 D-28 bifocal.

Many blue light concerns are well documented with additional research continuing. Fortunately, ECPs can rely on the wealth of products and information lens manufacturers provide for the benefit of their patients. n Wendi Atchison LDO, ABOC, NCLEC, is a licensed optician and works in Fort Myers, FL.

BluTech Lenses 800.258.5902 BluTechLenses.com Info@BluTechLenses.com | Carl Zeiss Vision, Inc. 866-596-5467 ZEISS.com/Lenses Conant Lens, Inc. 904.599.2090 ConantRxLens.com Chris.Landers@Conant-Optical.com | Essilor of America, Inc. 800.542.5668 EssilorUSA.com | Gunnar Optiks 888.486.6270 Gunnars.com Sales@Gunnars.com | HOYA Vision Care, North America 800.423.2361 HoyaVision.com SalesSupport@HoyaVision.com | Johnson & Johnson Vision Care, Inc. 800.843.2020 ACUVUEProfessional.com Luzerne Optical Laboratories, Ltd. 800.233.9637 LuzerneOptical.com | Shamir Insight, Inc. 877.514.8330 ShamirLens.com Info@ShamirLens.com | Signet Armorlite, Inc. 800.759.0075 SignetArmorlite.com MarketingLiterature@SignetArmorlite.com Super Optical International/FastGrind 800.543.7376 SuperOptical.com Bert@SuperOptical.com | Transitions Optical, Inc. 800.848.1506 TransitionsPro.com CustomerService@Transitions.com | VISION EASE 800.328.3449 VISIONEASE.com Info@VisionEase.com VSP Optics TechShieldBlue.com BlueLightInfo@VSP.com SunSyncLenses.com VCPN | DIGITAL EYE STRAIN + BLUE LIGHT | JULY 2019

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DIGITAL EYE STRAIN + BLUE LIGHT: A MARKETER’S GUIDE TO PROTECTIVE LENSES

A Marketer’s Guide to PROTECTIVE LENSES

By Zvi Pardes

T

he data on the long-term dangers of blue light from prolonged exposure to electronic devices is now well established. It’s more than discomfort and eye strain; it’s a major factor in the drastic rise of childhood myopia rates worldwide and contributes to catastrophic vision-stealing conditions such as AMD. Yet, engaging patients and selling more blue light protection can often be a struggle.

It’s no secret that it’s getting harder for practices to make the revenue that they used to rely on from their optical departments.

The competition from online vendors and big box stores is fierce, and many patients walk in for their exam fully intending to make their final eyewear purchases elsewhere. Advanced lens options are a great way to maximize revenue but only if your capture rate is stable and you know how to present it to patients.

One thing we encounter when regularly speaking with eyecare professionals is that optometrists are hesitant to bring up optical choices to their patients from within the lane unless they are asked. Of course, every practice wants better capture rates and better revenue per patient, but the exam chair is thought of as distinct from the dispensary. The eye doctor doesn’t want to come off as “sales-y” but rather wants to “focus on patient care.” This is a mistake that is probably harming your practice. Maximal patient care means making the best eye health recommendations possible, including a strong recommendation for blue light protection for every relevant patient—which is just about all of them.

SOMETHING TO CONSIDER: You might want to take a stand and add blue light protection to all lenses as standard. This will increase the cost of the lenses, but that’s an opportunity for you and your staff to explain the importance of proper protection.

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COURTESY OF HOYA

It’s your job to prescribe from the chair, recommending the best comfort, clarity and long-term protection for your patients.

Advanced lens options are a great way to maximize revenue but only if your capture rate is stable and you know how to present them to patients.

As the OD, your top priority is to ensure the best patient outcomes.

As a business owner, you also need to make sure that you’re profitable.

The surprise here is that the two things aren’t exclusive, in fact, they’re mutually complementary. When it comes to lenses and lens treatments, the optical end of your practice isn’t a side business selling fashion accessories. It might be that too, but, at its core, your dispensary should operate as an extension of the optometric care that defines you.

In fact, I’ll go so far as to say that being deeply involved in optical right from the lane is your duty to your patients. You aren’t just selling frames; you are recommending the best comfort, clarity and long-term protection for your patients.

The secret to maximizing your optical retail is that sales should come directly with a medical recommendation that rests on your authority as the eye doctor.

Of course, you want to focus on the comprehensive exam: checking the patient’s refraction prescription, looking at retinal health, asking about any symptoms, etc. But it’s also important to be proactive and educate your patients about the impact of blue light and UV, which happens to also boost the chances of that patient buying eyewear from you instead of online, not to mention maximizing the revenue from that sale.

In our experience, a great strategy is to make those lens recommendations right from the lane and follow it through to optical.

This is ultimately what will differentiate you from the box retailers and online vendors—you treat glasses as a medical device and strive for the best patient outcomes possible. This is why patients will choose to purchase their eyeglasses from you.

JULY 2019 | DIGITAL EYE STRAIN + BLUE LIGHT | VCPN

DIGITAL EYE STRAIN + BLUE LIGHT: A MARKETER’S GUIDE TO PROTECTIVE LENSES

COURTESY OF CARL ZEISS VISION

Before the Lane: Don’t let patients just sit or browse aimlessly.

Make sure that your staff is actively engaging patients by taking them through the dispensary and proactively suggesting frames that would suit each individual. People are anxious about making fashion decisions to begin with, and being guided through the process creates a bespoke fashion experience that is hard to beat online. This approach also gets patients into the frame of mind (no pun intended!) of making a purchase too, which is going to help prime them as you drive home your lens recommendations—such as blue light protection—from the lane, expanding the patient’s frame of mind from a fashion purchase to a medical decision.

In the Lane: If you are relying on patient forms to be in the know about your patient’s lifestyle or symptoms, be warned that things change all the time, and people are less likely to be as forthcoming on a sterile form as they might be in a real conversation.

Instead, make sure that you are proactively asking your patients about changes in their lifestyle, work habits, daily discomfort or soreness, etc. during each appointment. Could your patient benefit from advanced digital progressives? Is this person spending many hours in front of a digital device screen? Is your patient even aware of the risks to health and the importance of proper lens protections for blue light?

The point here is that it’s important to break people out of their assumption that when it comes to glasses it’s the frames that matter. Don’t mince words. Frames are merely fashionable housing for what matters: vision, quality of life and eye health. If you have an impressive lineup of frames, that’s great. Trust (or train) your optical staff to sell that.

As the OD, you should be discussing what’s at stake, so make direct recommendations for the lens technologies and products that will deliver the best comfort and long-term protection possible. At the same time, maximize your chances of making an optical sale while also maximizing the revenue of that sale. The beauty here is that you’re maximizing profits precisely by making sure your patients are as comfortable and protected as possible.

VCPN | DIGITAL EYE STRAIN + BLUE LIGHT | JULY 2019

PRO TIP: We know of a few ODs who even use a blue light LED pen to demonstrate the difference between regular lenses and ones that protect against blue light.

A pack goes for about $18 on eBay. THE HANDOFF IS ESSENTIAL Walking the patient back out to optical is a crucial step to maximize your chances that the patient won’t just bail and head to an online vendor or wholesaler—likely resulting in cheap frames with subpar or even flawed lenses, no blue light protection and no revenue earned for your practice. Make sure to verbally repeat to the optician the lens recommendations you made to the patient. Some practices we work with even go so far as to print out a customized “prescription,” where the doctor checks off recommendations along with any notes for the optician. This is an effective way to further underscore that their optical purchase is a medical one and not only a retail decision.

By the same token, your staff should be well informed about the lens side of things too. They should understand the benefits of polarized sunglasses vs. tinted and digital progressives vs. older bifocals. Of course, they should also understand the importance of blue light protection, even for those patients who don’t require corrective lenses.

An effective approach to selling more blue light protection is a microcosm of how an optometric practice should approach optical in general. Make sure you are engaging patients on what matters most— their eyes and that not all lenses are created equal. When framed that way, you have the best chance of maximizing capture and revenue while delivering the best patient care and experience possible. n Zvi Pardes is an optometry marketing expert and head of content marketing at EyeCarePro. Focused exclusively on optometry and ophthalmology, EyeCarePro helps practices to achieve real, measurable growth with an increased online presence, content and advanced SEO tools fine-tuned to eyecare. EyeCarePro.net 43

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