Red-Tinted Contact Lenses May Improve Quality of Life in Retinal Diseases

Abstract

To determine the benefits provided by centrally red-tinted contact lenses on visual acuity, contrast sensitivity (CS), photophobia, and quality of life in patients with degenerative retinal diseases.We evaluated the impact of centrally red-tinted hydrogel contact lenses on nine patients (aged 15 to 22 years) with severe photophobia and poor visual acuity. Each patient underwent a full eye examination with and without contact lenses, including visual acuity at distance and near, CS, eye movement recording for nystagmus, refraction, and a fundus examination. All patients completed a low vision-adapted VFQ 25-Version 2000 quality-of-life questionnaire.Seven of nine patients demonstrated improvement in binocular visual acuity as well as improvement in CS with the tinted contact lenses. Subjectively, all patients described a major improvement in their photophobia both outdoors and indoors, as well as a marked improvement in quality of life.Red-tinted contact lenses may dramatically improve visual functions, outdoor performance, and quality of life of patients suffering from retinal diseases. These lenses should be a part of the regular assessment in specialty clinics treating patients with low vision, glare, and photophobia.

The use of contact lenses in low vision rehabilitation: optical and therapeutic applications

“…A tinted contact lens is often an excellent solution for patients with achromatopsia, as the lens can usually provide sufficient relief of symptoms to eliminate the need for dark‐tinted sunglasses with side shields and/or protective headwear, while indoors . In addition to the reported benefits of increased peer acceptance and social interactions in children with achromatopsia fitted with tinted contact lenses, modest improvements in visual acuity (0.10 to 0.20 logMAR), contrast sensitivity (0.9 to 1.2 log units) and colour discrimination have also been reported. While it is possible to produce very dark tinted contact lenses, these may significantly reduce visual acuity in low illumination.…”

“…The contact lens used may be soft or rigid and the final preferred tint may be red, brown, amber, grey or a combination of these, with a transmittance value typically between 14 to 30 per cent . Some authors recommend extending the tint only to 2.0 mm beyond the pupil diameter measured in dim illumination; however, light entering the eye through the peripheral cornea may still cause glare using this approach. Therefore, it may be prudent to use a conservatively large tint, at least to within one to two millimetres of the total lens diameter or include an opaque tint in the lens periphery.…”

BCLA CLEAR – Medical use of contact lenses

“…Centrally tinted soft contact lenses are available in a range of colours, tint densities and pupil options (Ultravision, Cantor and Nissel) and can be used to reduce photophobia in patients with various retinal conditions such as in retinitis pigmentosa, cone dystrophies, and albinism. Case reports and case series show a marked reduction in photophobia and improved daily QOL in adults and in children [716][717][718][719][720][721][722].…”

Wavelength of light and photophobia in inherited retinal dystrophy

“…Nevertheless, it is generally believed that short-wavelength light plays a major role in photophobia, because it induces intraocular scattering 8 and because of its potential energy 9 . Several previous reports have proposed the hypothesis that photophobia is primarily caused by cells that respond to short-middle wavelength light including S-cones 10 , intrinsically photosensitive retinal ganglion cells (ipRGCs) 5 , and rods 11 . The fact that patients with S-cone related diseases such as enhanced S-cone syndrome 12 , and blue cone monochromacy 8 often complain of photophobia also supports the S-cone theory.…”