Blue-light filtering intraocular lenses (IOLs) for protecting macular health

Downie, Laura E; Busija, Ljoudmila; Keller, P.

doi:10.1002/14651858.cd011977

Cited by 44 publications

(50 citation statements)

References 45 publications

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“…The optical and clinical performance of blue light‐blocking spectacle lenses has been relatively understudied compared with blue light‐filtering intraocular lenses . Leung et al .…”

Section: Introductionmentioning

confidence: 99%

Insights into Australian optometrists’ knowledge and attitude towards prescribing blue light‐blocking ophthalmic devices

Singh

Anderson

Downie

2019

Ophthalmic Physiologic Optic

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Purpose The aim of this cross‐sectional study was to survey Australian optometrists regarding their attitudes towards, and knowledge of, blue light‐blocking lenses designed to attenuate blue light transmission to the eye. Methods A 29‐item survey was distributed at a major national optometry education conference and through professional networks. Respondents provided information regarding their demographics and practice modalities, knowledge about the potential effects of blue light, and attitudes towards prescribing blue light‐blocking ophthalmic devices. Ordinal logistic regression analysis was performed to assess the factors that predicted optometrists’ prescribing of blue light‐blocking lenses. Results Of 372 respondents, 75.3% indicated prescribing blue light‐blocking spectacle lenses in their clinical practice. Forty‐four per cent of optometrists considered daily environmental exposure to blue light as a potential cause of retinal damage, and approximately half of respondents thought blue light emitted from computer screens was an important factor in causing computer vision syndrome. About half of optometrists considered placebo effects to potentially play a role, at least sometimes, in patients’ experiences with blue light‐blocking lenses. Most optometrists estimated that they first prescribed a blue light‐blocking lens in 2016. The most common reason optometrists prescribed these devices was for patients who were computer or electronic device users (87.9%). The two main sources of information used to guide practitioners’ management approaches were conference presentations and manufacturer product information. Practitioners were significantly more likely to prescribe blue light‐blocking lenses if they considered blue light to cause either retinal damage (odds ratio, OR 2.28, 95%CI 1.34–3.88, p = 0.002) or computer vision syndrome (OR 2.52, 95%CI 1.41–4.50, p = 0.002) compared with practitioners who did not consider such factors to be relevant. Conclusion Prescribing trends by Australian optometrists in relation to blue light‐blocking lenses reflect the inconclusive nature of several aspects of the evidence in this field. Blue light‐blocking lens prescribing has increased since 2010, despite practitioners acknowledging the lack of high‐quality evidence to support their use and also commonly believing that placebo effects may have a role in patient responses to these lenses. Information from this study will help inform the development of resources to guide evidence‐based prescribing of blue light‐blocking lens products.

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“…The optical and clinical performance of blue light‐blocking spectacle lenses has been relatively understudied compared with blue light‐filtering intraocular lenses . Leung et al .…”

Section: Introductionmentioning

confidence: 99%

Insights into Australian optometrists’ knowledge and attitude towards prescribing blue light‐blocking ophthalmic devices

Singh

Anderson

Downie

2019

Ophthalmic Physiologic Optic

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“…These ophthalmic devices, which include spectacle lenses, contact lenses and intra‐ocular lenses (IOLs), contain or are coated with dyes that selectively absorb blue and violet light. The choice between a conventional ultraviolet (UV) light blocking IOL and a blue‐blocking IOL following cataract surgery has generated significant debate in the literature in terms of achieving a balance between photoreception and photoprotection . Possible disadvantages of blocking short‐wavelength visible light transmission include disturbances of colour perception, decreased scotopic sensitivity (leading to poorer performance in dim lighting conditions) and disruption of the timing of the circadian system .…”

Section: Introductionmentioning

confidence: 99%

The effect of blue‐light blocking spectacle lenses on visual performance, macular health and the sleep‐wake cycle: a systematic review of the literature

Lawrenson

Hull

Downie

2017

Ophthalmic Physiologic Optic

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124

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Purpose: Blue-blocking (BB) spectacle lenses, which attenuate short-wavelength light, are being marketed to alleviate eyestrain and discomfort when using digital devices, improve sleep quality and potentially confer protection from retinal phototoxicity. The aim of this review was to investigate the relative benefits and potential harms of these lenses. Methods: We included randomised controlled trials (RCTs), recruiting adults from the general population, which investigated the effect of BB spectacle lenses on visual performance, symptoms of eyestrain or eye fatigue, changes to macular integrity and subjective sleep quality. We searched MEDLINE, EMBASE, the Cochrane Library and clinical trial registers, until 30 April 2017. Risk of bias was assessed using the Cochrane tool. Results: Three studies (with 136 participants) met our inclusion criteria; these had limitations in study design and/or implementation. One study compared the effect of BB lenses with clear lenses on contrast sensitivity (CS) and colour vision (CV) using a pseudo-RCT crossover design; there was no observed difference between lens types (log CS; Mean Difference (MD) = À0.01 [À0.03, 0.01], CV total error score on 100-hue; MD = 1. 30 [À7.84, 10.44]). Another study measured critical fusion frequency (CFF), as a proxy for eye fatigue, on wearers of low and high BB lenses, pre-and post-a two-hour computer task. There was no observed difference between low BB and standard lens groups, but there was a less negative change in CFF between the high and low BB groups (MD = 1. 81 [0.57, 3.05]). Both studies compared eyestrain symptoms with Likert scales. There was no evidence of inter-group differences for either low BB (MD = 0.00 [À0.22, 0.22]) or high BB lenses (MD = À0.05 [À0.31, 0.21]), nor evidence of a difference in the proportion of participants showing an improvement in symptoms of eyestrain or eye fatigue. One study reported a small improvement in sleep quality in people with self-reported insomnia after wearing high compared to low-BB lenses (MD = 0.80 [0.17, 1.43]) using a 10-point Likert scale. A study involving normal participants found no observed difference in sleep quality. We found no studies investigating effects on macular structure or function. Conclusions: We find a lack of high quality evidence to support using BB spectacle lenses for the general population to improve visual performance or sleep quality, alleviate eye fatigue or conserve macular health.

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“…However, one key challenge when using these products is finding the balance between effectively reducing blue-light hazards without compromising the essential visual functions in daily life, i.e., there is a pressing need to determine the potential benefits of these blue-light filtering ophthalmic devices. [19]…”

Section: Introductionmentioning

confidence: 99%

Blue-Light Filtering Spectacle Lenses: Optical and Clinical Performances

2017

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PurposesTo evaluate the optical performance of blue-light filtering spectacle lenses and investigate whether a reduction in blue light transmission affects visual performance and sleep quality.MethodsExperiment 1: The relative changes in phototoxicity, scotopic sensitivity, and melatonin suppression of five blue-light filtering plano spectacle lenses were calculated based on their spectral transmittances measured by a spectrophotometer. Experiment 2: A pseudo-randomized controlled study was conducted to evaluate the clinical performance of two blue-light filtering spectacle lenses (BF: blue-filtering anti-reflection coating; BT: brown-tinted) with a regular clear lens (AR) serving as a control. A total of eighty computer users were recruited from two age cohorts (young adults: 18–30 yrs, middle-aged adults: 40–55 yrs). Contrast sensitivity under standard and glare conditions, and colour discrimination were measured using standard clinical tests. After one month of lens wear, subjective ratings of lens performance were collected by questionnaire.ResultsAll tested blue-light filtering spectacle lenses theoretically reduced the calculated phototoxicity by 10.6% to 23.6%. Although use of the blue-light filters also decreased scotopic sensitivity by 2.4% to 9.6%, and melatonin suppression by 5.8% to 15.0%, over 70% of the participants could not detect these optical changes. Our clinical tests revealed no significant decrease in contrast sensitivity either with (95% confidence intervals [CI]: AR–BT [–0.05, 0.05]; AR–BF [–0.05, 0.06]; BT–BF [–0.06, 0.06]) or without glare (95% CI: AR–BT [–0.01, 0.03]; AR–BF [–0.01, 0.03]; BT–BF [–0.02, 0.02]) and colour discrimination (95% CI: AR–BT [–9.07, 1.02]; AR–BF [–7.06, 4.46]; BT–BF [–3.12, 8.57]).ConclusionBlue-light filtering spectacle lenses can partially filter high-energy short-wavelength light without substantially degrading visual performance and sleep quality. These lenses may serve as a supplementary option for protecting the retina from potential blue-light hazard.Trial RegistrationClinicalTrials.gov NCT02821403

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Blue-light filtering intraocular lenses (IOLs) for protecting macular health

Abstract: To assess the effects of blue-light filtering intra-ocular lenses (IOLs) for providing protection to macular health and function. 1 Blue-light filtering intraocular lenses (IOLs) for protecting macular health (Protocol)

Cited by 44 publications

References 45 publications

Insights into Australian optometrists’ knowledge and attitude towards prescribing blue light‐blocking ophthalmic devices

Insights into Australian optometrists’ knowledge and attitude towards prescribing blue light‐blocking ophthalmic devices

The effect of blue‐light blocking spectacle lenses on visual performance, macular health and the sleep‐wake cycle: a systematic review of the literature

Blue-Light Filtering Spectacle Lenses: Optical and Clinical Performances

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