66% of the world’s 7.47 billion people have a mobile phone, and 34% (2.55 billion people) are active on social media on their mobile devices1. It is therefore no surprise to optometrists that our patients are experiencing Digital Eye Strain symptoms2, which have become a rising global eye health concern.
The effect of blue light exposure from LED digital devices is generating much interest. What we know and can prescribe today will be reviewed in the final Blue Light Bulletin of 2017.
• Macular Pigment (MP) is composed of three dietary carotenoids: lutein, zeaxanthin, mesozeaxanthin;4 MP protects macula from blue light induced oxidative stress and enhances vision5
• MP is a modifiable risk factor for age-related macular degeneration6,7
• Dietary supplements of all three macular carotenoids are more superior and together they increase MPOD, enhance visual function and lower risk of AMD in healthy and diseased retinas8-14
• Ophthalmic lens with anti-glare & blue blocking treatments reduce glare, visual discomfort, and blue light exposure from the sun, environment, and digital devices3
• Staring into LED digital devices before bedtime disrupts the biological clock, affects melatonin production, and leads to sleep issues15, 16, 17,18
What We Will Learn with Time and More Research3
• The depth and amount of damage on human retina from the long term accumulative effect of blue light exposure from LED digital devices3
• Long term benefit of blue blocking ophthalmic lenses on development and progression of AMD
• Use of MP as a biomarker for neurodegenerative diseases such as Alzheimer’s19, and its protective role in the neurosensory system
Figure 2 – A Balancing Act: Minimizing Exposure & Increasing Protection
“Ocular Light Toxicity and the Requirement for Protection”. Points de Vue, International Review of Ophthalmic Optics. April 2017, page 135
Be TheOcular Health Protectors
• Identify patients with risks and symptoms20,21
• Prescribe internal macular pigment protections through proven ocular nutrition20
• Prescribe external blue blocking lenses and Digital Eye Health solutions21
In today’s digital world, optometrists can serve important roles in educating patients, assessing blue light risks, and prescribing protections to ensure the best long-term ocular health.
1. 2017 Digital Snapshot https://wearesocial.com/special-reports/digital-in-2017-global-overview
2. “The Digital Eye Strain Report”. The Vision Council. 2016. https://www.thevisioncouncil.org/content/digital-eye-strain
3. “Ocular Light Toxicity and the Requirement for Protection”. Points de Vue, International Review of Ophthalmic Optics. April 2017.
4. Shen Lee, Bridgitte. “The Three Musketeers of Macular Pigment”. Optometric Management. August (2017): https://www.optometricmanagement.com/newsletters/blue-light-bulletin/august-2017
5. Shen Lee, Bridgitte. “More about MP and MPOD”. Optometric Management. September (2017): https://www.optometricmanagement.com/newsletters/blue-light-bulletin/september-2017
6. Sabour-Pickett, S., Nolan, J.M., Loughman, J., Beatty, S., “A review of the evidence germane to the putative protective role of the macular carotenoids for age-related macular degeneration”. Mol Nutr Food Res. 2012 Feb;56(2):270-86. doi: 10.1002/mnfr.201100219.
7. Bernstein, P et al "Lutein, Zeaxanthin and Mesozeaxanthin; The basic & clinical science underlying carotenoid-based nutritional interventions against ocular disease."
8. Akuffo, K. O.; Nolan, J. M.; Howard, A. N.; Moran, R.; Stack, J.; Klein, R.; Klein, B. E.; Meuer, S. M.; Sabour-Pickett, S. (2015-07-01). "Sustained supplementation and monitored response with differing carotenoid formulations in early age-related macular degeneration". Eye (London, England). 29 (7): 902–912. ISSN 1476-5454. PMC 4506345. PMID 25976647. doi:10.1038/eye.2015.64.
9. Loughman, James; Nolan, John M.; Howard, Alan N.; Connolly, Eithne; Meagher, Katie; Beatty, Stephen (2012-11-01). "The impact of macular pigment augmentation on visual performance using different carotenoid formulations". Investigative Ophthalmology & Visual Science. 53 (12): 7871–7880. ISSN 1552-5783. PMID 23132800. doi:10.1167/iovs.12-10690.
10. Meagher, Katherine A.; Thurnham, David I.; Beatty, Stephen; Howard, Alan N.; Connolly, Eithne; Cummins, Wayne; Nolan, John M. (2013-07-28). "Serum response to supplemental macular carotenoids in subjects with and without age-related macular degeneration". The British Journal of Nutrition. 110 (2): 289–300. ISSN 1475-2662.PMID 23211762. doi:10.1017/S0007114512004837.
11. Nolan, John M.; Akkali, Mukunda C.; Loughman, James; Howard, Alan N.; Beatty, Stephen (2012-08-01). "Macular carotenoid supplementation in subjects with atypical spatial profiles of macular pigment". Experimental Eye Research. 101: 9–15. ISSN 1096-0007. PMID 22652506. doi:10.1016/j.exer.2012.05.006.
12. Sabour-Pickett, Sarah; Beatty, Stephen; Connolly, Eithne; Loughman, James; Stack, Jim; Howard, Alan; Klein, Ronald; Klein, Barbara E.; Meuer, Stacy M. (2014-09-01). "Supplementation with three different macular carotenoid formulations in patients with early age-related macular degeneration". Retina (Philadelphia, PA). 34 (9): 1757–1766. ISSN 1539-2864. PMID 24887490.do:10.1097/IAE.0000000000000174.
13. Thurnham, David I.; Nolan, John M.; Howard, Alan N.; Beatty, Stephen (2015-08-01). "Macular response to supplementation with differing xanthophyll formulations in subjects with and without age-related macular degeneration". Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie. 253 (8): 1231–1243. ISSN 1435-702X. PMID 25311651. doi:10.1007/s00417-014-2811-3.
14. Nolan et al., “Enrichment of Macular Pigment increases Contrast Sensitivity in subjects free of retinal disease: Central Retinal Enrichment Supplementation Trials – Report 1”. Inv. Ophth. & Vis Sci. June 2016, Vol.57, 3429-3439. doi:10.1167/iovs.16-19520
15. Stringham JM, Stringham NT, O’Brien KJ.Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure. Foods 2017, 6, 47. doi: 10.3390/foods6070047 http://www.mdpi.com/2304-8158/6/7/47
16. Tosini G, Ferguson I, Tsubota K. Effects of blue light on the circadian system and eye physiology. Molecular Vision. 2016;22:61-72.
17. Anne-Marie Chang, Daniel Aeschbach, Jeanne F. Duffy, and Charles A. Czeisler Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness PNAS 2015 112 (4) 1232-1237; published ahead of print December 22, 2014, doi:10.1073/pnas.1418490112
18. Shen Lee, Bridgitte. “Better Sleep & Less Digital Eye Strain”. Optometric Management. July (2017): https://www.optometricmanagement.com/newsletters/blue-light-bulletin/july-2017
19. Nolan et al.“Macular Pigment, visual function, and macular disease among subjects with Alzheimer’s disease: an expolratory study”. J Alzheimers Dis. 2014;42(4):1191-202. doi: 10.3233/JAD-140507
20. Shen Lee, Bridgitte. “Prescribe Proven Ocular Nutrition”. Optometric Management. October (2017): https://www.optometricmanagement.com/newsletters/blue-light-bulletin/october-2017
21. Shen Lee, Bridgitte. “Digital Eye Health Discussions with Patients”. Optometric Management. November (2017): https://www.optometricmanagement.com/newsletters/blue-light-bulletin/november-2017
Dr. Bridgitte Shen Lee earned an optometry degree from University of Houston College of Optometry in 1998. She is the CEO of Vision Optique and iTravelCE. She writes and lectures on the topics of Digital Eye Health, Dry Eye Disease, Anti-Aging Eye Care, Health Care Social Media, and Aesthetic Optometry.
Financial Disclosures: Johnson & Johnson Vision, Shire, Essilor, OCuSOFT, Guardion Health Sciences, Bausch & Lomb, Luxottica