Photochromic Perspective
Welcome to our continuing series of Credit Education Courses for Opticians.
This course has been approved for one hour of credit by the American Board of Opticianry. No fee is required for ABO credit.
At the conclusion of this credit education course, participants should be able to:
- Understand and apply eye health messages to prescribing and dispensing initiatives.
- Correlate and articulate UV radiation with eye damage and reflected glare with visual comfort.
- Identify at-risk groups for UV damage and how to approach these groups regarding UV protection.
- Be able to develop internal and external communications that address patient eye health issues.
Test procedures: Read the article and then click on the link below to take the test . This will open a new window with a test consisting of 15 questions. To receive ABO continuing education credit, respondents must correctly answer 12 of 15 test questions. Simply click on the best answer for each question and click the submit button at the end of the test. Your test answers will be automatically sent to Seiko Optical and we will send your CEC or notify you of test failure within 7 to 10 business days.
Note: Some states do not accept home study courses for continuing education credit. Check with the licensing board in your state to see if this course qualifies.
Photochromic Perspectives
The medical approach to selling, marketing, and dispensing UV-protective eyewear is simple: healthy eyes equal healthy vision, and eyewear designed for optimal visual acuity, comfort, and protection is a must-have for patients.
Studies show that photochromic lenses and patient satisfaction go hand-in-hand. Photochromics deliver better patient eyewear compliance, more usage, enjoyment, and better vision care overall. Photochromics are a pivotal way to get patients to think about eye health care via lens technology.
SUNSCREEN FOR THE EYES
We in the optical industry know that most people protect their skin from harmful UV rays by applying topical sunscreen when they're outside. We know, too, that like sunscreen protects skin, photochromic lenses help protect eyes from UV rays. But we still have a job to do when it comes to educating consumers about the eye health risk factors of UV and getting them to take action to protect their eyes.
According to recent Transitions Optical research, worldwide consumer awareness of UV and other risks to healthy sight are "extremely low." In the U.S., consumer awareness of the harmful effects of extended sun exposure for skin problems is 70 percent, while eye problems only 13 percent. Additionally, the study found that most people are unaware that many medications in common use can affect their quality of vision and/or long-term eye health (see Kids & Grownups section).
It's important for the health of your practice and the health of your patients to make it a policy to mention UV's affect on the eyes and how to protect them. Successful practices impart a UV message to at least 85 percent of their patients. Winning approaches include correlating UV blocking photochromic lenses to SPF sun block for the eyes: "You wouldn't go outside without sun block on your skin. UV blocking eyewear offers the same protection for your eyes that sun block does for your skin."
UV radiation is reflected off all surfaces, particularly snow, concrete, and white sand. Exposure to UV is highest during the mid-day hours from 10 a.m. to 3 p.m. and during the summer months. UV levels also increase nearer the Equator, and at higher elevations.
The National Women's Health Resource Center The Sun &
Your Eye: Fast Facts for Your Health publication mentions that while grass, soil, and water reflect less than 10 percent of UV,
fresh snow reflects as much as
80 percent, dry sand about 15 percent, and sea foam about 25
percent. The publication notes that this makes a difference in the amount of UV eyes receive,
because someone is more likely to look down than
up, so light reflects directly into eyes.
UV radiation is part of the electromagnetic spectrum that reaches the Earth from the sun. The American National Standards Institute and ISO have divided UV into three segments:
| Wavelength | Type | Energy Level |
| 315-380nm | UVA | Lowest |
| 280-315nm | UVB | Midrange |
| 200-280nm | UVC | Highest |
UVC (200-280nm) has the most potential for damage to the eye, but is fully absorbed by the stratospheric ozone and doesn't reach Earth's surface.
UVB (280-315nm) causes skin sunburns, and has been documented to cause some eye damage, including
cataracts.
UVA (315-380nm) is not considered as harmful to the eyes as UVB, but is still looked at as a potential factor in damage to the eyes.
Photochromic lenses with 100 percent UV protection are being positioned by savvy practices as the ideal solution to optimize vision for everyday wear. Photochromics automatically change to be dark or clear as necessary in proportion to the intensity of UV rays, plus help curb excessive visible light that can cause squinting, eye fatigue, and diminished vision.
Cutting glare helps increase visual contrast, making objects easier to distinguish. Photochromic lenses for everyday wear, combined with polarized lenses for intense glare, are a one-two eyewear punch to help patients maximize their visual acuity and comfort, while warding off the harmful effects of UV radiation.
Get Engaged Do you know what type of interaction your patients prefer? Some relationship building topics to discuss with
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Safety Guard
Currently, the best protection against UV radiation for the eyes and tissues surrounding the eyes is the combined use of UV-protective contact lenses, UV protective eyewear, and a wide-brimmed hat.
Not all contact lenses protect against UV, and not all provide similar absorption levels, so it's important to find out from contact lens manufacturers what UV blocking properties their lenses have. Likewise, not all spectacle lenses provide UV protection and offer different levels, so checking with lens manufacturers for their UV protective abilities for various lens materials and designs is important.
Brimmed hats, while offering some protection from UV rays, provide no protection from UV reflected up from surfaces such as pavement, sand and water. Contact lenses help protect eyes from unfiltered rays which can enter from around the edges of frames. Wrap-style eyewear that fits close to the face is the best UV protective
eyewear choice for outdoor use.
HEALTHY PHOTOCHROMIC MARKETING
Start by positioning photochromics in your practice as a healthy alternative to clear lenses. This phrase can be used as the opening phrase in photochromic conversations with patients, as a practice tagline, and in advertising and marketing efforts.
For example: "Ask us about special options that protect your sight, like anti-reflective, photochromic lenses. Learn how to enhance your vision today to help preserve healthy sight for a lifetime."
The following is a suggested 10-point checklist for practices that highlights healthy vision care and vision wear.
- Identify and address each patient's chief complaint. Pay close attention to how patients describe their vision problem.
- Take a prior ophthalmic history. This includes eye history, such as near/farsightedness, previous eye trauma, eye surgery, light sensitivity, family history of eye disease, astigmatism, and conditions such as glaucoma and strabismus.
- Also take a medical history. This includes diabetes, cancer, chronic conditions or diseases, family illness, smoking, and a list of all prescription and over-the-counter medications and vitamins.
- Plus, take a lifestyle assessment, including computer use, outdoor activities, high-impact sports, leisure activities, work style, sun exposure, and night driving.
- Personally review the results of ophthalmic, medical, and lifestyle histories and assessments with the patient. In particular, ask patients about their daily UV exposure and the activities that subject them to glare.
- Perform a comprehensive eye examination, including quantity of vision measure by Snellen acuity and the quality of vision with contrast sensitivity and glare testing. Then prescribe a customized eyewear Rx, including lens recommendations.
- Remember when prescribing eyewear, that not all lenses are right for all patients. It's imperative to address each individual's specific needs based on visual lifestyle. Review single vision and PAL designs, impact-resistant lenses, UV blockage, anti-reflective lenses, photochromics, and polarized lenses. The patient may require more than one pair of eyewear to effectively address multiple visual lifestyle needs.
- Make sure patients are aware of how to maximize the quality of their everyday vision and how to preserve the health of their eyes. Explain the importance of preventative eyecare, especially with children.
- Ensure the patient is satisfied with the encounter. Review previous points to make sure both you and the patient are comfortable and confident that the visit has been as productive as possible.
- Utilize audio, visual, and print media to make an impact with patients and affirm your recommendations. These can include materials available from manufacturers, labs, and even practice customized media.
The patient's everyday pair of eyewear must perform well in most environments. Your primary ecommendation should include AR lenses, photochromics in a superior single vision or PAL that performs well in most everyday tasks. To top off your lens recommendation, select a fashionable frame that suits most occasions, including business and leisure situations.
The patient's second pair should be polarized sunwear. Polarized lenses are necessary for safety while driving and participating in outdoor activities, protecting against harmful UV rays and disabling glare. Impact-resistant polarized lenses are the top choice for active patients. A wrap-style frame helps keep the harmful, dangerous elements of sunlight at bay.
The patient's third pair should be geared to their occupation, specifically computer or office lenses. This pair of
eyewear is essential for visual comfort and the best ergonomics
at the workplace.
A fourth pair could be another pair of everyday eyewear that is of a different style frame than the first pair. This allows patients to change their appearance, so they don't look the same day in and day out. Or, this pair could be specifically crafted to their hobby or prime leisure activity.
KIDS & GROWNUPS
Everyone is at risk; no one is immune to sun-related eye disorders. Any factor that increases sunlight exposure of the eyes increases the risk for ocular damage from UV radiation. Those who spend lengthy time outdoors are at the greatest risk.
Many studies have shown that although both adults and children are subject to the effects of ultraviolet radiation (UV), younger eyes are more susceptible to harmful UV rays. Children have larger pupils which allow more light into their eyes. They have clearer lenses, and are outside without eye protection more frequently and for longer periods of time than most adults. It's estimated that children's annual dose of UV radiation is three times that of adults. UV damage is cumulative over a person's lifetime and UV exposure can cause irreversible damage to the eyes and surrounding tissues.
Those who have had cataract surgery are more susceptible to retinal injury from UV unless a UV absorbing intraocular lens was inserted during surgery. Individuals with retinal dystrophies or other chronic retinal diseases may be at risk since their retinas may be less resilient to normal exposure levels, reports the American Optometric Association.
Short-term UV effects include photokeratitis, "eye sunburn," and photoconjunctivitis, inflammation of the membrane that lines the outside of the eye. A somewhat minor reaction to too much UV exposure is eyes that are tired, sore, and gritty. A more major result is sunburned eyes.
Long-term UV effects are still being researched, but what's known right now is that most of the sun's damage to the eyes can take years before its affects are realized. Longterm UV exposure has been linked to cataracts and age-related macular degeneration. According to the American Optometric Association, age-related macular degeneration is the major cause of reduced vision in the U.S. for people over 55.
Some over-the-counter and prescription medications can alter the quality of vision. These include photosensitizers, which increase energy absorption from UV and increase sensitivity to light; mydriatics, which dilate pupils, increasing the amount of light entering the eye and enhancing light sensitivity; and miotics, which constrict the pupil, limiting the amount of light and impairing light-to dark adaptation and distance judging ability. Be sure to ask every patient to list the drugs they are taking (see sidebar), and inform them if there are possible ocular side effects that they may encounter. Also be sure to recommend photochromic lenses, since for these patients, protecting their eyes from UV, glare, and reflections is a more acute need.
The list of drugs affecting quantity and quality of vision and that may contribute to ocular disorders is long. Some classes of drugs that may blur vision or alter the refractive and/or accommodative state include antihistamines, antidepressants, cardiac agents, dermatologic agents, diuretics, and erectile dysfunction agents. Some classes of drugs that may cause photosensitivity are antibiotics, antidepressants, antihistamines, central nervous system stimulants, herbs such as St. John's wort, oral contraceptives, non-steroidal anti-inflammatory drugs, and retinoids. Selected classes of drugs implicated in the development of ocular diseases include antiarrhythmic agents, antineoplastic agents, antipsychotics, bisphosphonates, corticosteroids, dermatologic agents, and HIV/AIDS related agents. Visit www.transitions.com/medications for an online database of drugs that can cause ocular side effects.
PHOTOCHROMICS & AR
A recent study conducted to determine how patients' quality of vision improved using photochromic lenses with AR found that three-fourths of the participants indicated that photochromic lenses were preferable for overall visual comfort and their ability to adapt to different lighting situations.
In the normal eye, increasing levels of glare increase baseline incident light scatter and adversely affect contrast sensitivity, resulting in visual discomfort and fatigue. By eliminating reflections on the lens surface and increasing lens transparency, AR was cited by participants for its ability to reduce distracting glare and to enhance visual comfort. Optimal vision, based on a combination of acuity, comfort, and protection, was achieved by using premium Rx lenses with photochromic and AR technology.
Demonstrate how photochromic and AR technologies work. Explain that photochromic lenses offer 100 percent UV protection. By activating with UV exposure, photochromics darken, which changes lens density, protected eyes from UV damage, and reducing squinting, stress, and eyestrain.
ChecklistThese questions are geared to help you find out the level of UV exposure that each of your patients has to UV, so you can recommend appropriate UV protective eyewear that suits their unique needs.
Full SpectrumThe American Optometric Association recommends lenses that absorb 99 to 100-percent of the full UV spectrum (UV-B and UV-A) to 400nm for outdoor use in bright sunlight. ANSI Z80.3 Sunglass and Fashion Eyewear Standards, a voluntary labeling code for manufacturers, defines UV requirements in three categories:
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Ultimate UV ApproachesThese practice-wide UV tips offer patients enough information to keep them informed, but not so much information that they become overwhelmed.
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