Without State Licensing of Opticians are Indiana Consumers Left in the Dark

Indiana State Licensing Board building

After a recent visit to America’s Best for discount eyewear, and with summer’s sunshining bright – giving off  UVA/UVB rays and Blue Light, HE, Indiana’s Best Media Company, reports on protecting our readers eyes – even if the Hoosier state doesn’t care enough to license Opticians.

States often receive criticism from over regulation. Gov. Mike Braun is not one to support overregulation, but equally often and equally true when left to the market, health care in particular is always honestly marketed.  Profits outweigh the best practice or access to the best information.

Our eyes are all failing after age 40 or so.  It is a scientific fact that they lose the accommodation powers of the crystalline lens.  HE has taken on researching allowing literally anyone to advise consumers of eyewear and contact lenses.  HE was drawn to ask questions because what journalist does read far more than average? What journalist does stare at computer screens for endless hours a day?  What journalist doesn’t experience eye strain or where spectacles?  This story is personal.  Nevertheless, it affects everyone if not now, it will.

For example, if you are asking an Indiana optical salesperson, a Doctor of Optometry known as either an Optometrist or Ophthalmologist, or a non-licensed Indiana Optician, about blue light filtering you will likely get a much different answer.  Why?

Let us look at the big box option for eyecare -- one of largest retailers, Costco’s website says, “Costco Optical prides itself on having some of the most knowledgeable employees in the industry. Our staff consists of trained opticians that are well regarded in the optical industry. You can feel confident that you are receiving the best possible care when visiting the Costco Optical department.”  But who trains opticians in Indiana? Is not eyesight important? If so, why leave it solely to the profit seeking industry.  Other than what are called “corporate,” the independent providers are not really so independent when Essilor-Luxottica has the power to sell everyone anti-reflective coatings, their trademarked brand name “Transitions,” and on topic here: Blue Light Filtering Lenses.

Then there is the impact on this market by vision insurance companies.  Often, they pay part or for all of the lowest quality eyewear.  Upselling seems to be the name of the game in optical.  So, what about adding Blue Light Filtering for $50.00-$150.00.  Is it worth it? Now here is where HE needs to disclose the obvious: This post is for informational purposes only and is not intended to provide specific patient or medical advice. The content presented herein should not be interpreted as a substitute for professional consultation. As always, individuals should seek the advice of their primary care physician (PCP), optometrist (OD), or other qualified healthcare providers before making any healthcare decisions or changes to their treatment plan. The authors do not assume any responsibility for the outcomes of decisions made based on the information presented in this paper.  Annual eye examinations are recommended by the various national optical professional associations in the United States.

But here is the rub. Everyone seems to have a different opinion among the three O’s, at least in Indiana. So, HE hit the library to research is better to have blue light filter and not need it, or better to have blue light glasses and not need them? The current research literature HEsurveyed the effectiveness of blue-light-filtering lenses, focusing on their optical performance, their impact on eyestrain, including computer vision strain and symptoms as well as the “circadian clock,” which refers to the internal biological mechanism responsible for the daily sleep-wake cycle and other physiological rhythms in humans.

“Blue light is part of the visible light spectrum, meaning what the human eye can see. “Vibrating within the 380 to 500 nanometer range, it has the shortest wavelength and highest energy” (UC Davis Health, 2022, p. 1). This blue light component of the visible light spectrum has garnered significant attention due to its prevalence in digital devices and potential effects on ocular health and sleep patterns that when interrupted have significant adverse health consequences (Tosini, 2022, citing Sletten, et al., 2020). The direct correlation between sleep and health is outside the scope of this paper, but it is well accepted science.

The common believe regarding blue light is that the rise of digital technology has led to increased exposure to the blue light emitted from screens of computers, smartphones, and tablets. Concerns have been raised industry-wide about the potential adverse effects of this exposure, prompting the optical industry to develop such offerings as filtering lenses and coatings.

These lenses have been promoted and marketed as solutions to reduce eye strain, improve sleep quality, and protect against retinal damage. But for more than a few years, there are the conflicting viewpoints about those claims from highly respected sources such as the American Academy of Ophthalmology (Vimont, 2021).

This raise the relevant and timely question central for this research paper: Is it better to have blue light filtering lenses and not need them, or worse to need them and not have them?

OPTICAL AND CLINICAL PERFORMANCE

Lenses without Blue Light Protection

Traditional lenses without blue light filtering allow the full spectrum of visible light to reach the eyes. While they provide clear vision, they do nothing to address concerns related to blue light exposure, absent some filter or a photochromic option ("Living with the Blues," 2016).

According to the American Academy of Ophthalmology and other studies, there is a lack of scientific evidence supporting the necessity of blue light-blocking glasses for eye health, suggesting that the samples impact outcomes requiring more adult studies (Singh, et al., 2023).

Lenses with Blue Light Protection

Blue light-filtering lenses are designed to reduce the amount of blue light entering the eyes. However, their effectiveness is subject to debate. A systematic review published in Ophthalmic & Physiological Optics and also reported in the American Journal of Ophthalmology concluded that there is a lack of high-quality evidence supporting the use of blue light-blocking lenses for improving visual performance or sleep quality (Davidson, et al., 2017).

Additionally, a 2023 study found inconsistent results regarding sleep improvements, with some studies reporting benefits and others finding no significant difference (Pannell, et al., 2023).

Do Blue-Light Filtering Glasses Help With:

A. Eyestrain  

Digital eye strain, characterized by discomfort after prolonged screen use, is often attributed to factors such as decreased blinking and prolonged focus rather than blue light exposure. The Mayo Clinic reports no significant improvement in visual performance or alleviation of eye strain symptoms from using blue light-blocking lenses (Kelly, 2022).  

Experts recommend strategies like the 20-20-20 rule—taking a 20-second break to view something 20 feet away every 20 minutes—to alleviate eye strain (Sharma, et al., 2022).

B. Computer Vision Syndrome

“Up to 69% of computer users report eyestrain, also known as computer vision syndrome” (Kelly, 2022).  Computer Vision Syndrome also known as “CVS” encompasses a range of eye and vision-related problems and symptoms, which result from prolonged computer use and possibly the resulting blue light exposure. While blue light may play a role, the primary causes include poor lighting, screen glare, and improper viewing distances (University of Melbourne, 2023). A 2023 review found no advantages of blue-light filtering lenses to reduce eye strain associated with computer use compared to non-filtering lenses (Singh, et al., 2023).

C. The Circadian Clock

Exposure to blue light, particularly in the evening, can disrupt the circadian rhythm by suppressing melatonin production, potentially affecting sleep quality. However, the extent of this impact from screen exposure is debated. A 2021 article from Harvard Health suggests that while blue light-blocking glasses may help individuals with sleep disturbances, the overall benefit for the general population remains uncertain (Corliss, 2021).  Certainly, each person has a spectrum of exposure as part of their work and lifestyle to consider as part of their own buying decision.

Reducing screen time before bed and using device settings that minimize blue light emission are alternative strategies recommended for improving sleep hygiene (Corliss, 2021).

CONCLUSION – “THE BLUES”

The term "BLUES" here refers only to the fact that, until there is more conclusive science, opticians are still unsure of what they should tell customers, therefore, leaving the final choice to the customers and their physicians.

While the proliferation of digital devices has heightened concerns about blue light exposure exists, and there is likely the potential of real effects on eye health and sleep patterns, the science is not clear (no pun intended).

Someday in the future, it may also be found that blue-light filtering spectacles make no significant difference on eye strain, visual performance, improve sleep quality, or provide significant protective effects on retinal health.  Until then patients can decide to filter out exposure with lenses that protect from the front and back, or perhaps even more effectively by choosing an option of wearing photochromic lenses that filter out perhaps more blue light than the competing options on the market. A 2016 study found, “Transitions Optical's Signature VII lenses blocked 20% of blue light indoors and 85% outdoors” while “XTRActive lenses blocked 34% indoors and 88% outdoors” ("Living with the Blues," 2016). These numbers are high if one seeks to avoid this light spectrum for personal reasons or based on prior experience.

While the optical industry offers blue light-filtering lenses as a protective measure, current scientific evidence does not completely support the efficacy of blue light lens filters in alleviating 1) eyestrain, 2) preventing computer vision symptoms or syndrome, or  3) improving sleep quality.  Accordingly, unless you have excessive screen time or sun exposure, it may not be better to have them and not need them, if sleep quality is or could be, in fact, interrupted and not helped.  Is this an industry overreaction, or simply a move to have it even if not needed?

As such, it may be prudent to consider the economics of one’s particular situation as well as alternative strategies, such as regular screen breaks, blinks one’s eye more frequently, and proper screen ergonomics including blue light filters on the computer screen itself, before investing in blue light-blocking eyewear.

Ultimately, the decision to use these lenses has been left to the marketplace and should be if informed individuals have personal experiences and preferences, keeping in mind the current limitations of scientific evidence (Singh, et al., 2023).

Once again, it is worth HE notes in Indiana “caveat emptor – buyer beware,” since  it may be possible to determine that the optical industry’s history of its late understanding of the damages from UV light rays, now an overreaction with blue light precautions has resulted, justifying profiting from recommending widespread blue light filtering without sufficient scientific evidence.  It is also likely that Indiana needs to license Opticians that serve the front line of eyecare, rather than leaving up to the market, private industry lobbyists, and monopolists.