Who Should We Talk to About Protection from Potential Hazards Blue Light Exposure?
Allan Barker, OD
Which patients should receive recommendations for products that specifically help protect from the potential damages of exposure to harmful blue light?1 Historically, eye care professionals were concerned about ultraviolet light exposure and then only about protecting patients’ eyes from outdoor sunlight when it posed an occupational or recreational hazard. Blue light protection was not even an afterthought.
Let's look at the argument for advising all of our patients about the potential harm from blue light exposure and their options for protecting their eyes. For this exercise we will concentrate only on our efforts to protect potential AMD patients from the oxidative damage from harmful blue light. AMD is a leading cause of vision loss in the United States for our patients over 60.2 The American Macular Degeneration Foundation lists the following as AMD risk factors on their official web site.3
2. Being overweight overall and around the abdomen
3. Unchecked cardiovascular disease
4. High blood pressure
5. Long term exposure to the sun without protection
Other lessor factors mentioned are light colored irises, hyperopia, high levels of C-reactive protein (CRP) and being female due to longer life expectancy.
Let’s examine the potential population with these main risk factors. According to the Centers for Disease Control (CDC), 36.5 million Americans still smoke.4 Studies such as that by Ogden et al estimates that more than one third of adults and 17% of youth in the United States are obese.5 That is conservatively 80 million people. The American Heart Association estimates that 77.9 million adults have high blood pressure.6
What about genetics? In an article I co-wrote with Dr.Greg Stockbridge for Optometric Management, we address the genetic question. By using the basis of 11 million people with some form of AMD in the United States, we mathematically predict up to 73.37 million people in the U.S. with a family history of AMD.7
Obviously, some people may have multiple risk factors including obesity, hypertension, cardiovascular disease, and be genetically predisposed to AMD. However the numbers 36.5M, 80M, 77.9M and 73.37M are quite compelling and could represent a significant portion of the population before we even consider other factors listed by the American Macular Degeneration Foundation such as sunlight exposure. Again, we are only looking at AMD in this exercise. Certainly a solid argument exists for providing all patients with ultraviolet and blue light protection guidance. This can be in the form of protective lenses, or being cognizant of our patient's total health regimen and initiating proper medical referrals when needed, and recommending nutritional therapy concentrating on lutein and zeaxanthin and omega-3 fatty acids.
In our previous article we asked the question regarding an eye care professional's responsibility to our patients in providing preventative care as opposed to reactive care. Do we wait till the patients shows signs of damage or do we provide preemptive health care? If we truly want to protect our patients, we should consider recommending blue light and ultraviolet protection for all of our patients.
Article sponsored by Essilor.
1. Harmful Blue Light is the blue-violet wavelengths (415-455 nm) on the light spectrum believed most toxic to retinal cells.
2. National Institutes of Health National Eye Institute. Leading Causes of Blindness. NIH Medline Plus. Summer 2008 Issue: Volume 3 Number 3 Pages 14 – 15.
3. The American Macular Degeneration Foundation (AMDF). About Macular Degeneration: Risk Factors. https://www.macular.org/risk-factors. Accessed April 17, 2017.
4. Centers for Disease Control. Smoking and Tobacco Use. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/. Accessed April 17, 2017.
5. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014 Feb 26;311(8):806-14.
6. American Heart Association. Statistical Fact Sheet 2013 Update: High Blood Pressure. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_319587.pdf. Accessed April 17. 2017.
7. Barker A, Stockbridge G. How Should You Prescribe Blue Light Protection? Optometric Management. Volume: 49, Issue: November 2014, page(s): 26-28.
Dr. Allan Barker practices optometry in Wilmington, North Carolina and serves on the Board of Directors for Eyecare Partners. He also currently serves as board president of the American Optometric Association's charity foundation, Optometry Cares, and is a former State Association president in North Carolina. Dr. Barker first learned about blue light danger while serving on the Essilor Advisory Panel from 2010 to 2015. He has published over 40 journal articles on various subjects, both research and practice management.