Americans stare at digital screens. A lot. And we live and work under an increasing number of CFL lightbulbs. And we spend time outside in sunlight. All of these things are sources of high-energy visible (HEV) light—or blue light—and all of them are reasons why blue light remains a hot topic in eye care.

NEED-TO-KNOW FACTS

What is blue light? Part of the visible light spectrum (between 400nm and 500nm), blue light has a very short wavelength so it produces a higher amount of energy. According to most experts, blue light’s most damaging wavelengths are between 415-480nm.

Overexposure to blue light has been linked to retinal damage in animal studies, and experts suggest there exists a potential link to eye damage in humans after years of exposure to blue light. With the population’s recent uptick in digital device use, our exposure to blue light is higher than ever. But at what cost? Consider this:

Sleep Disruption: Myriad studies have shown the correlation between blue light exposure and circadian rhythm (sleep/wake cycle) disruption. This is due to HEV’s proven effect on suppressing the natural release of melatonin.

Eye Strain: There is no doubt that blue light contributes mightily to digital eye strain. Blue light is the most “scattered” of the visible spectrum rays and the hardest wavelength in which to focus. Combining the blue light with the accommodative stress of staring at a screen for prolonged times is a recipe for DES.

Retinal Damage: Studies—most notably on mice and pigs—have revealed the occurrence of retinal damage due to long-term exposure to HEV rays. Though no study has inked a direct line between HEV exposure and retinal damage/macular degeneration in humans, many researchers believe the possibility is strong.

An American Optometric Association paper on “Light and Eye Damage” sources one of those animal studies when it states, “Shorter wavelengths of the visible spectrum (i.e., blue light, 400nm to 480nm)…show the greatest effects possibly due to photochemical or photooxidative damage in the retinal pigment epithelium.”

The paper goes on to state: “As the damaging processes are thought to be at least partially photochemical in nature, the damaging effects can be cumulative in nature, which may compound across one’s lifetime.”

ECP Involvement: It’s that latter sentiment, repeated in many research papers and roundtables, that gives the eyecare community cause to talk to patients about their own blue light exposure—and the lens solutions that may reduce the risk of exposure.

Gary Morgan, O.D., of Eye Tech Eye Associates in Peoria, AZ, has written several papers on the subject, on his own and on behalf of VSP Optics Group. He states: “The blue light story is not going away. Researchers continue to study the impact of long-term, cumulative blue light exposure on our eyes. As technology like virtual reality headsets become more mainstream, screens will be at even closer proximity to our eyes than ever before. In a sense, we’re in the early days of the blue light story. The opportunity for our profession is right in front of us.”

Read on to see how two eyecare practitioners are making the most of that opportunity.

BECOMING A BLUE LIGHT SPECIALIST

Drs. Aaron Werner and Bradley Schwartz have both made blue light education (and lens solutions) an important part of their practices. They each had a goal of establishing their practices as the blue light/digital eye strain experts in their communities, and it has paid off in terms of patient service and satisfaction—and revenue.

Though each may have approached the goal differently, they followed the same basic blueprint, based on these tenets:

01
EDUCATION

Start with yourself and the staff. Then, make patient education a focus.

“People can talk about it, but until you do the research to find out for yourself how this protection can help your patients, you can’t speak about it with confidence,” notes Dr. Schwartz. But then, get your staff on board.

Each year, the staff at Oneota Family Eye Care decides on a specific topic on which to focus patient education. In 2015, they decided to put the onus on the macula.

Together, they created a packet of information for patients, including blue light (and the need for sunglasses to protect eyes), as well as macular nutrition topics. This packet gets distributed to patients as soon as they check in at the front desk, and the information within is reinforced throughout their office visit.

At his practice, Dr. Werner has dedicated several of his weekly staff meetings to blue light, and has invited lens company sales reps in to discuss their products and the solutions they provide.

02
STAY ON MESSAGE

Incorporate blue light messaging into the exam and optical area.

“We decided as an office that the effects of looking at a digital device all day was a problem we wanted to address throughout the practice,” explains Dr. Werner. “We then discussed which education would be best provided by the doctors, and which messaging would be better coming from our expert optical team. And we followed through.”

Dr. Schwartz’s team begins at patient check-in, when they distribute that education packet. The message is then reinforced during pretest.

Then the doctors talk about blue light and eye health during the exam. After the exam, the optician continues the conversation in the optical. That’s right: Each patient hears the blue light message verbally three times in a visit.

03
DEMO. DEMO. DEMO.

Visual aids are powerful. Use them.

Lens companies and labs have plenty of high-tech demo devices to help your staff “show” what lens products can do to block, filter, or reflect blue light.

The practices use a variety of demo methods, including iPad-based demo apps and spectrometers, using an HEV light laser pen to show how much blue light gets through different lens products, and using the blue or purple reflections to show the lens product is working.

Oneota Valley Family Eye Care even uses its large aquarium (illuminated with blue light) to bring the message home. “You look at that light for 15 seconds and tell me that your eyes aren’t affected,” Dr. Schwartz says. “It just shows you how much energy is being put on your macula.”

04
MARKET YOURSELF.

Brand yourself as the specialist you are.

Both practices feature their blue light and digital eye strain expertise in their internal marketing and patient-education pieces. But Dr. Schwartz has taken his message to the airwaves, in the form of radio ads in which he’s interviewed on the topics.

“Patients come in mentioning that they’ve heard [the interviews] and want to know more about blue light,” he notes.

And the bottom-line result? An increase in sales and patient acceptance of the product.

“Our anti-glare rate on lenses is almost 95%. Of these, the vast majority are products aimed directly at limiting blue light,” says Dr. Werner.

During the year that he focused on macula and blue light education, Dr. Schwartz saw his optical sales jump by 7%. The following year it stayed flat, something he attributes to patient acceptance of the products.

“We firmly believe that it’s because of that initial introduction to blue light. A lot of our patients are already living it, and coming back in the next year simply replacing that technology.”

Regardless of how it may benefit their revenues, both doctors strongly believe that a discussion about blue light exposure and digital eye strain is necessary.

“We don’t sell our patients anything. We advocate for them,” says Dr. Schwartz. “At the end of the day, it’s up to the patient to decide what they want to do. But it’s our responsibility to present them with information. And that’s what we do.”

And both believe that this is an area that will continue to be a focus for optometry.

“Digital eye strain, of which blue light plays a large role, is incredibly underdiagnosed and overlooked,” Dr. Werner says. “Patients don’t complain and most clinics are not focused on finding and treating it. This is an exciting and emerging area that requires continued research and focus.”

PRODUCTS TO KNOW

Delivering a range of solutions, scores of blue light lens products are available today.
DISPENSING TIP: Lenses that block the most HEV will have a distinguishable light brown tint. Those that offer clearer lenses will likely block less of the HEV.

NOTE: This list represents a sampling of the lens solutions available. Please see your lens supplier or lab for other products and for info on the range of HEV wavelengths blocked/filtered.