LENSES FOR A DIGITAL WORLD

SCREEN TEENS (AND TOTS)

How lens technology is evolving to solve that which increased screen time has caused

BY SUSAN TARRANT

Photo courtesy of Essilor of America, for Crizal Prevencia

My 12-year-old spends a lot of time staring at an iPod, or a tablet, or a smartphone. He plays games on them, texts, and watches videos on them. Constantly. And while it may drive me crazy, he’s certainly not the only one with that kind of usage habit.

According to The Vision Council’s 2015 digital eye strain report, nearly one in four children in the U.S. use digital devices for more than three hours a day. The numbers for adults are even more alarming, but that’s another story.

The result of all that digital use among kids is an uptick in eye strain complaints, and an increased exposure to high-energy visible (blue) light, which risks early-onset AMD and other retinal issues.

EYE STRAIN

Digital eye strain is the physical discomfort felt after two or more hours in front of a digital screen and is associated with the close to mid-range distance of digital screens, according to The Vision Council. We are focusing our eyes longer and in a range that we previously hadn’t.

Symptoms include general fatigue, irritated or dry eyes, back and neck pain, headaches, and blurred vision.

Lens technology has responded with a multitude of single vision lens designs that provide a little relief in the near-focus region. These lenses give a little boost, usually anywhere from .50 to .65, in the near focus zone to provide more visual comfort when staring at screens.

Dennis Fong, O.D., FAAO, is on the clinical faculty at the School of Optometry at University of California Berkeley. He explains how beneficial these new lens designs can be.

“They are providing a little bit of assistance with the near focusing,” he says. “We’re working our eyes 125% more than normal. So let’s reduce that by 25%, so the eyes during the day are working more around the amount that we’ve been used to in the past,” he says. “It’s like saying, ‘Let’s stop walking 20 miles every day. Let’s cut that down to 10 miles a day.’”

These designs can provide a welcome solution to young, strained eyes.

“Discussing lens designs that alleviate this fatigue is an important step to providing the best visual solution,” says Pam Benson-Gibson, an optician for 30 years and now education director at Shamir Insight. “I personally believe that they are one of the most forgotten benefits in our arsenal. It is not just for young children, but the tweens and teens, continuing from high school through college. There are many studies that explain eye fatigue and the impact on vision and performance in young people.”

BLUE LIGHT

Prolonged exposure to the high-energy visible light (blue light) emanating from digital screens is another area of concern among ECPs. Studies show a connection between prolonged exposure and a higher risk of AMD and retinal issues.

Gary Morgan, O.D., of Eye Tech Associates in Peoria, AZ, is a blue light expert who has been working closely with VSP on the issue.

“Numerous peer-reviewed papers point to the fact that cumulative lifetime blue light exposure is what causes photo-oxidative retinal damage leading to drusen formation and photoreceptor loss, i.e., AMD,” he notes. “Look at how our world has changed in the last 10 years. Where blue light used to be mainly an outdoor phenomenon from sunlight exposure, our indoor world has turned blue from energy efficient lighting, all of our computers, televisions, and of course digital devices.” Additionally, children have pristine crystalline lenses in their eyes, without the natural yellowing of the lens that comes with age and affords some protection from blue light.

GAME ON!

Four out of five households own a device that plays video or computer games, with 155 million of us playing video games. About half (51%) of U.S. households own a dedicated video game console (Xbox, Wii, PS, etc.), and 42% of Americans play video games “regularly.” A quarter of those players are under 18 years old (Entertainment Software Association report, April 2015).

With this video game use comes a bigger source of eye fatigue, explains Joe Croft, chief technical officer and co-founder of Gunnar Optics, which makes eyewear specifically for gamers and computer users.

“Obviously, a bigger screen equals more blue light entering the eye, and with increased exposure comes more of all of the problems that go with that,” he says.

Gaming eyewear can be offered to all as a plano display in the dispensary. Many, Gunnar included, offer Rx programs as well.

Croft says his eyewear addresses the visual and eye health issues of gaming with high-wrap lenses that helps thwart the dry eyes that come with a reduced blink rate, an amber lens color to cut the blue light, and a slight add to magnify and move the focal distance to a more comfortable range.

“The need to see an ECP should not be discounted when people are worried about their eyes,” Croft says. “However, for many children, an ‘OTC’ solution that they can either discover on their own, or walk out of an ECP office with, is just the right thing.”

Photo courtesy of Gunnar Optics

“Short arms coupled with clear crystalline lenses along with extended viewing of digital devices, in my opinion, is cause for concern as we just don’t know what the consequences are going to be,” Dr. Morgan continues.

Again, lens technology has responded with blue light filtering elements built into AR treatments, and even a lens material that uses ocular lens pigments. The object of these solutions is to filter the harmful blue light while still allowing the range of blue light rays that is beneficial to our mood and circadian rhythms.

“The fact that we have blue filtering spectacle lens products available makes my answer: yes, all kids, regardless of refractive status, should wear them when viewing digital devices,” Dr. Morgan says. “If you had a child in a wood shop, wouldn’t you require they wear safety lenses? Blue light filtering lenses are the 21st century safety glasses.”

Photo courtesy of Hoya Vision Care, for Sync with Recharge

PATIENT ID

In general, any young patient who uses digital devices is a potential—but not automatic—patient for these lens solutions.

“In the exam room, we discuss each patient’s lifestyle and medical history. I start by asking patients to describe their typical day at school and at home,” says Howard Purcell, O.D., FAAO, formerly in a group practice for 11 years, and now senior vice president for customer development at Essilor of America. “If they reveal heavy digital device usage and/or a family history of AMD, I recommend (blue light filtering) lenses.”

Dr. Fong says that the lenses designed for digital use (those with a slight add in the near zone) should be considered one of the many tools to deal with visual strain.

LENS SOLUTIONS

LENS DESIGNS

(Single-vision designs with a slight “boost” in the near focus zone.)

Essilor Anti-Fatigue lens — essilor.com

HOYA Sync — thehoyafreeformcompany.com

Shamir Relax — shamirlens.com

ZEISS Digital Lens — zeiss.com/vision

LENS TREATMENTS

(Coatings that filter a range of harmful blue light rays.)

Essilor Crizal Prevencia — crizalprevencia.com

HOYA Recharge — thehoyafreeformcompany.com

SeeCoat Blue — nikon-lenswear.com

Sharper Image Tech Shield — vspopticsgroup.com

ZEISS DuraVision BlueProtect — zeiss.com/vision

LENS MATERIALS

(Blue light filters built into the lens substrate.)

BluTech — available in lens designs from a number of lens companies; blutechlenses.com

“For some people, you could interrupt their eye coordination system by providing a reduced focusing effort,” Dr. Fong says. “That becomes the negative side of just recommending these types of lenses to anyone and everyone who complains of fatigue.”

While he agrees lenses that address digital use are highly effective in reducing fatigue, he stresses the importance of making them a consideration in the larger prescriptive process.

“It should be part of a typical battery of tests that will review whether these types of lenses are the appropriate device for the patient.”

PACKAGE DEAL

To bundle lens options or not is an eternal debate among ECPs. When dispensing to kids, however, with the myriad options discussed here plus other considerations like impact resistance, scratch resistance, and UV protection, it makes sense. And it can eliminate the often confusing menu and associated explanations that parents have to navigate.

“Parents end up purchasing the least expensive option because they know how hard their kids are on lenses,” Dr. Purcell says.

“Just like adults, children have a unique set of needs,” he notes. “That’s why it is important to make sure the visual solutions we recommend to children provide the benefits they need, such as clarity and vision, impact and scratch resistance, comprehensive UV protection, and glare and smudge resistance.”

“I always did a complete pricing for kids that included the lenses and frame. Having a moderately priced package, a mid-range package, and a top-of-the line package worked well,” Benson-Gibson says. “With my kids’ and youth packages, I had a warranty replacement co-pay. It is not to break the bank, nor is it to make a huge profit, but it does place a value on the eyewear.”

Some lens vendors do it all for us, with a “kids solution” lens that an includes impact-resistant material, AR, scratch resistance, and a treatment that attenuates blue light exposure. Those features can further be bundled with a lens design that provides an additional focusing boost.

Our reliance on digital devices has created a new era for our eyes. Keeping up with lens technology that addresses this new era is essential for serving the “new now.”