Protecting patients’ eyes from UV rays – whether natural or artificial – is an important role for every eye care practitioner. Whether you’re prescribing contact lenses, Rx spectacles, plano or Rx sunglasses, or protective eyewear for sports and industry, it’s essential to recommend frames and lenses that minimise the risks of damage to the anterior eye, ocular surface, and surrounding areas.
Within the community there is enormous awareness of the dangers of exposing skin to UV radiation, but when it comes to UV and the eyes, awareness is limited and there is plenty of confusion.
One of the biggest areas of confusion surrounds UV radiation emitted from computer monitors. Some official macular degeneration information sources, like the American Macular Degeneration Foundation, state that ‘video display terminals’, among other sources, emit UV light/radiation.1 In fact, modern computer screens do not emit UV radiation – even old style CRT computer monitors only emit a small fraction of the potential UV damage caused by just a few minutes exposure to sunlight.
every photon of UV radiation is potentially damaging so should not be trivialised
Fluorescent, halogen, incandescent and LED lights are also sometimes cited as sources of UV radiation. Although technically most light sources create very low levels of UV radiation, much of it is filtered out. Even if some UV is emitted, the levels are very low and generally of little concern.
That said, every photon of UV radiation is potentially damaging so should not be trivialised.
BROAD SPECTRUM RADIATION
UV radiation forms part of the electromagnetic spectrum that is invisible to the human eye and comprises three different spectra: UVA, UVB and UVC.
Most UVC is absorbed by the atmosphere and as such, is of little concern to eye care practitioners. However, UVB and UVA rays are potentially damaging – the cornea absorbs most of the UVB spectrum with some penetration of UVA.2
UV exposure to the eyes is influenced by the time of day and time of year, with morning and afternoon presenting the greatest risk – with the sun low in the sky, unprotected eyes receive direct UV radiation. Many people do not realise that for this reason, winter is a high risk time of the year. All year round, reflected and scattered light contributes to total UV exposure to the eyes.
There is plenty of evidence for the damage that UV rays can do to the ocular surface, the anterior eye and the areas surrounding the eye.
A Royal Australian and New Zealand College of Ophthalmologists (RANZCO) fact sheet3 states that UV exposure is associated with basal cell carcinoma and squamous cell carcinoma of the eyelid.
Additionally, UV exposure is associated with photokeratitis, climatic droplet keratopathy, pterygium and cortical cataract.
According to RANZCO, “There is insufficient evidence to determine whether there is a clear causal link between UV exposure and age-related macular degeneration (AMD) but there does appear to be evidence showing greater sunlight exposure could increase risk. Theoretically this may be more due to effects of visible blue light rather than UV.”3
Blue light – or high energy visible light (HEV light), is emitted by televisions, computer monitors, a variety of light sources and smart devices, and of course in much higher doses via sunlight. Although this is a discussion for another milenses column, blue blocking filters can be considered as an adjunct to UV blocking spectacle lenses.
With this in mind, all the spectacle lenses we prescribe, including safety and protective eyewear, should offer maximum UVA and UVB absorption to protect the eyes, lids and adnexa from UV exposure and its potential damage. Back surface lens protection from UV rays should also be considered.
Of course spectacle lenses are only part of the protective equation – frame designs are imperative, particularly when it comes to outdoor use. Ideally we want to provide close fitting, wrap around designs to protect the eyes from UV exposure that may penetrate from above, below and around the sides of a person’s glasses. This will help avoid the peripheral light focussing (PLF) effect, which has been linked to pingueculae and pterygia (surfer’s eye) and may also be related to some forms of carcinoma in and around the inner canthus and nose bridge.
We must also remember to consider UV blocking contact lenses – not just for regular contact lens wearers – but also for those who need protection when spectacles and sunglasses are impractical, such as for water sports and so on. Of course sunglasses worn over UV blocking contact lenses are necessary for general use, to protect the parts of the eye and adnexa that are not protected by the contact lenses.
By taking steps to protect our patients’ eyes from natural UV we will also, by default, protect them from indoor sources such as UV emitting ‘black lights’ used to create fluorescence in night clubs, UV rays emitted from nearby welding, and even less common exposures such as broken mercury vapour lamps, and UV disinfecting systems that may be inadvertently left on in hotel rooms.
ALL ABOUT EDUCATION
Optometrists can play an important role in educating patients, across all ages and at every opportunity, about what they need to do and what they shouldn’t do, to minimise their risk of ocular disease and carcinomas.
Comprehensive advice should include messaging about general sun smart behaviour and the importance of wearing a sun hat – after all, sun hats help protect both the skin and the eyes from the dangers of UV radiation.
A useful resource to refer them to is the Cancer Council website,4 which provides valuable evidence based information about the dangers of UV exposure and the eye.
Take a look at the lens offerings on the following pages and contact providers to find out more about how you can work with them to provide your patients with maximum protection against dangerous UV rays.
- American Macular Degeneration Foundation: Sources of UV Light. www.macular.org/ultra-violet-and-blue-light
- Lajos Kolozsvári; Antal Nógrádi; Béla Hopp; Zsolt Bor. UV Absorbance of the Human Cornea in the 240- to 400- nm Range. Investigative Ophthalmology & Visual Science July 2002, Vol.43, 2165-2168
- RANZCO: ranzco.edu/wp-content/uploads/2016/04/ RANZCO-UV_Eye_protection_Position_ Statement_201803_FINAL.pdf
- Cancer Council Australia: wiki.cancer.org.au/policy/ Position_statement_-_Eye_protection
UV Protective Offerings
Standard anti-reflection coatings are only calculated to reduce reflections for one beam of light hitting a lens anywhere 15° either side of primary gaze. To avoid side reflections in photos or meetings, patients must turn their head to compensate.
Crizal Sapphire UV’s Multi-Angular Technology uses advanced algorithms that account for all beams of light for 45° either side of primary gaze, providing patients with clearer lenses from every angle.
Crizal Sapphire UV not only optimises the appearance of spectacles, but offers best-in-class UV protection with an E-SPF rating of 35.* Endorsed by Cancer Council Australia for their UV protecting properties, Crizal Sapphire UV lenses block UV transmission from the front plus the back surface, so patients can enjoy all their daily activities carefree.
Contact: Essilor Account Manager
*Except for index 1.5 = ESPF 10
Rodenstock Colormatic IQ 2, with any of the Solitaire family of coatings, provides maximum UV and glare protection.
While all Colormatic materials reduce the transmission of UV light, Rodenstock’s Colormatic IQ 2 provides customers with UV protection along with a choice of clear to 85% absorption tints in pure grey, racing green and chocolate brown.
When improved contrast is required, consider Colormatic IQ Sun Contrast, available in three colours, starting with a 50% tint reacting to 90% absorption. For a flexible sunglass option, choose Colormatic IQ Sun Fashion, again starting with a 50% tint and reacting to 90% absorption.
Dispensing with any of the Solitaire Protect 2 family of coatings will also stop the danger of reflected UV from the back of the lens. Choose Solitaire Protect Plus 2 with X-tra Clean for spectacles, or for sunglasses, choose Solitaire Protect Sun 2 with X-tra clean.
Contact: Rodenstock (AUS) 02 9748 0988
Opticare offers a two-combination upgrade to all single focal, bifocal, trifocal, multi-focal, and even progressive lenses. This upgrade comprises:
Blue Guardian, a blue light-blocking lens providing UVA and UVB protection, which also helps prevent digital eye strain making it highly recommended for professionals.
Sunmatic Blue Guardian, a unique lens for outdoor use that blocks high-energy blue light from further entering the eyes. Through its photochromic technology, this lens automatically adapts to outdoor lighting while giving the same UV protection.
Contact: Opticare (AUS) 1800 251 852
Transitions light intelligent lenses offer ultimate light protection from exposure to UV rays that can lead to cataract, skin cancer of the eyelid and around the eye, pterygium and photokeratitis. All Transitions lenses block 100% UVA and UVB rays. In addition to blocking UV rays, the ultimate light protection of Transitions lenses also filters blue light – both indoors and outdoors – and automatically darkens outdoors to reduce glare. Transitions lenses are an effortless and everyday light intelligent solution to help safeguard eye health now and in the future.
Contact: Transitions (AUS) 08 8238 3257
Shamir Australia and Shamir OHS
Shamir Australia and Shamir OHS, have created a comprehensive range of eye protection for the most demanding situations that includes solutions for 100% UV protection to maintain eye health and improve visual experiences.
All Shamir lens materials above 1.5 index are fully UV4OO protected. Shamir Blue Zero material adds to the UV rating, ensuring 1.5 Shamir Blue Zero also has built-in protection against blue light.
By applying Shamir Glacier Plus UV AR Coating, the lenses are comprehensively UV protected from incoming and reflected light, providing double-sided UV protection on both the front and back lens surface.
Most sunglass frames sold in the prescription market are flat by design, potentially exposing wearers to damaging lateral UV rays. Shamir OHS Eyres Safety Eyewear/Sports Sunwear frames provide UV protection against light coming in from the front and lateral areas of the eyes.
No UV solution can claim to be complete if it doesn’t address both direct and indirect UV radiation sources, all the way to 400nm.
Zeiss was the first manufacturer to offer a lens technology that provides full UV protection up to a level of 400nm as standard, in combination with a back-surface UV protection coating for all its plastic lenses.
Today all clear plastic Zeiss lenses also protect the eyes with UVProtect Technology by Zeiss.
Contact: Zeiss Account Manager
SunSync lenses provide everything needed in a base lens, with dark outdoor colour, exceptional indoor clarity, fast reaction times, and excellent temperature stability. Additionally, these lenses offer 100% UV protection and targeted blue light filtration to protect eye health. Exceptionally durable, they come with a one year, 100% satisfaction guarantee.
VSP Optics’ tinted lenses offer solid uniform colour throughout the lens and a consistent level of light absorption and transmission with 100% UV protection. Available in grey (85%, 50%, 25%), brown (85%, 50%, 25%), and green (85%).
VSP Optics’ gradient tint has a solid tint on top and gradually fades to a light tint at the bottom. Available in grey (85%, 50%, 25%) and brown (85%, 50%, 25%).
VSP Optics’ polarised lenses block horizontally oriented light to eliminate glare from snow, water and other surfaces, giving uncompromised clarity. Available in grey (85%), brown (85%), and green (85%).
Mirrored lenses, in orange, silver, blue, gold and green, and Flash lenses in silver, give a fresh fashionable look and reflect more sunlight from the eye.
Contact: VSP Optics (AUS) 02 9697 8080
Bonastar supplies full UV protection up to 400nm in mid and high index clear lenses, photochromic, Transitions, and polarised lenses.
Bonastar’s blueEase lenses can block UV as well as high energy blue light. They are available in 1.56, 1.60, 1.67, and 1.74 index.
In addition to classic sun tints, Bonastar introduces light style tinted plano and prescription lenses with 20 colour variations and with 100% UV protection. Light tints work well on sunny and cloudy days, as well as indoors, so people wear them not only for fashion, but also to protect eyes.
Contact: Bonastar (AUS) 02 9310 1688
Hoya UV Control is a unique coating applied to the back surface of the lenses to block the reflection of harmful UV into the eyes. Together with Hoya’s UV resistant lens materials, UV Control offers lenses that are as clear as crystal yet still offer 100% protection against the harmful effects of UV and UV related eye diseases.
UV Control is available in combination with Diamond Finish multi-coat. According to the company, Diamond Finish is one of the hardest anti-reflection coatings available on the market today. Its long-lasting, anti-reflective, scratch resistant, water, dirt and dust repellent properties provide spectacle lens wearers with extra comfort and relaxed, clear vision.
Contact: Hoya Account Manager
Transitions Light Intelligent Lenses automatically adapt to changing light conditions. Intelligently responding to light and UV, they change from clear to dark outside and back to clear when indoors. Driving today’s Transitions Signature range is the seven vibrant, on-trend colours that allow your patients to personalise their look with any frame to match their style and personality. This dynamic colour palette has broadened Transitions’ appeal across all age groups. By optimising the amount of light the eyes receive, Transitions lenses also help reduce glare, fatigue and strain, and block 100% of UVA and UVB rays, even in 1.50 index.
Contact: Essilor Account Manager
NuPolar polarised lenses offer wearers crisp, vibrant vision and an optically superior lens. These lenses enhance comfort and safety by blocking dangerous blinding glare produced from light reflected off smooth and shiny surfaces, wet roads, water and car bonnets. They also help protect eye health with 100% UVA and UVB blockage. NuPolar is available in a regular solid tint, NuPolar Gradient and in the polarised photochromic sunglass NuPolar Infinite.
Contact: Younger Optics (AUS) 08 8241 9800