As technology evolves, people grow more accustomed to a digital lifestyle—one that includes blue light exposure from devices such as smartphones, tablets, LED monitors and flatscreen TVs. Doctors of optometry play a key role in educating patients about blue light's effects on vision and health.
"Blue light is something we're getting exponentially more exposed to because of our transition to a digital lifestyle," says David Friess, O.D., a Philadelphia-based research consultant. "Digital reading is not something we were designed to do."
Ready or not, blue light is a reality. According to AOA's 2015 American Eye-Q® survey, 62% of respondents spend five or more hours on their digital devices every day, and 14% spend at least 10 hours a day on their devices.
More blue light, more problems
All this is leading to an increase in the amount of eye strain eye care professionals are reporting. For instance, VSP Global's survey of the group's providers found that 82% reported an increase in patients experiencing eye strain and other effects of blue light exposure.
In terms of research, a July 2015 study in the journal Free Radical Biology and Medicine found that the more chronic the exposure to blue-light-producing LED lights, the more free radicals in the eye, which further analysis associated with retinal injury. This may contribute to aging of the eye and age-related vision problems in younger patient groups. That's all the more reason manufacturers are creating new products—such as screen covers for filtering blue light, as well as contact lenses and eye glass lenses embedded with blue-wave-filtering pigment—in response.
Zzzs and disease
From eye health to systemic issues, now is the time for doctors of optometry to counsel patients on the overall effects of blue light. For instance, two recent studies associate blue light exposure with sleep problems.
A 2014 study in the journal Photochemistry and Photobiology found that just a week of increased exposure to blue light before bed cut sleep time by an average of 14 minutes. And it's not just blue light in ambient lighting. Reading on blue-lit e-reading devices before bed "prolongs the time it takes to fall asleep, delays the circadian clock, suppresses levels of the sleep-promoting hormone melatonin, reduces the amount and delays the timing of REM sleep, and reduces alertness the following morning," according to a January 2015 study in the Proceedings of the National Academy of Sciences. It also found that reading on such devices, unsurprisingly, increases alertness and delays bedtime without changing when people wake in the morning.
For years, researchers have studied the association between dysfunctional sleep-wake cycles and other health problems, such as diabetes and some forms of cancer. The systemic effect of blue light is something Bryan Rogoff, O.D., a private practice consultant in the Washington, D.C./Baltimore area, always talks to his clients about, especially for different practice models. As doctors of optometry join accountable care groups and move toward a coordinated care model, Dr. Rogoff urges them to screen patients for blue light eye damage—and conduct a thorough case history that incorporates patients' sleep patterns—and how it relates to metabolic and cardiovascular changes that affect their bodies.
"As optometrists, we are not just focused on the eye—we are primary care doctors," he says. "We're all worried about diabetes and high blood pressure in this country. Blue light is just another risk factor. When we talk to our patients, it's necessary to make those connections for them."
The information will inform the AOA Telehealth Council and AOA Board of Trustees on necessary changes to landmark telemedicine policy.