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The many uses of occupational lenses

05/03/2019By Myles Hume
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Eye problems brought on by prolonged screen usage are on the rise in Australia, and occupational lenses are promising to offer relief to workers. MYLES HUME examines this quickly developing market.

Digital devices are an inescapable part of modern existence; the average Australian now spends 10 hours of their day engaging with computers, smartphones and tablets. Collectively, we look at our screens more than 440 million times each day.

Although technology has vastly improved many aspects of life, for thousands of people the prolonged usage of electronic devices has come at a cost. Digitally induced eye problems such as computer vision syndrome (CVS) can result in eyestrain, headaches, burning, blurred vision and dry eyes.

CVS is a condition that, according to an Australian Government Comcare report, affects 48% of Australian office employees. Other studies suggest 65% of device users experience symptoms. With rates continuing to increase, more people are finding their concentration, productivity and sleeping patterns being gradually eroded.

With the emergence of conditions like CVS, people are increasingly turning to their primary eyecare provider for solutions. It is important optometrists can tune into the root causes of CVS for each individual, allowing them to correctly prescribe and dispense the various occupational and digital lenses now available, while also realising the financial benefit of additional spectacle sales.

Additionally, optometrists frequently report many patients suffer CVS due to the improper use of progressive power lenses (PPL) and regular reading glasses, which are unsuitable for sustained device use

Combined with an aging population and the prevalence of presbyopia and myopia, more people than ever before stand to benefit from the emergence of the occupational degressive lenses (ODLs) and digital assistance lenses (DALs), promoting positive eye health in technology-dependant lives for patients of all ages.

The market

The birthplace for this niche market was in Australia during 1996. Lens designers working for SOLA (now part of Carl Zeiss Australia) released the original ACCESS lens design, a full reading prescription offering two different power shifts (0.75+ or 1.25+) that reduced in power – or degressed – as the wearer looked up the lens.

These were known as extended focus readers, however as lens technology advanced they have come to be known as ODLs, and can be broken down into distinct variations and combinations.

ODLs, also known as office or vocational lenses, differ from regular PPLs due to a wider field of vision at near and intermediate distances. With 75% of Australians regularly multi-tasking across multiple screens at work, ODLs help to prevent strain on the eye’s ciliary muscles caused by fluctuating focus between a desk, monitors and a wider office space.

Although general patient awareness of ODLs continues to improve, optometrists continue to fight misconceptions about the effectiveness of PPLs and reading glasses in office environments. Many eyecare providers have discovered PPLs lead to neck pain, due to patients tilting their chin to peer through the lower ‘near’ portion of the lens. Additionally, reading glasses don’t offer sufficient depth of vision, promoting poor posture by forcing the wearer to lean forward for greater screen clarity.

Leading lens manufacturers, such as ZEISS, offer a range of ODL models that can typically be broken down into three categories, but also customised for each individual to ensure their eyes and neck remain in a natural, relaxed position.

‘Book’, ‘close’ or ‘near’ models have a stronger focus on the reading range, and can be used from 40cm to 1m. Compared with regular reading glasses, which are generally designed for a fixed and personal reading distance, these lenses offer a significantly larger field of vision for a more relaxed reading experience.

‘Screen’, ‘mid’ or ‘PC’ lenses offer a maximum distance of vision from 40cm up to 2m, providing vision from reading distance right into the intermediate range. This design is ideal for situations involving workstations and up close reading.

‘Room’ or ‘space’ lenses allow the wearer a maximum vision range of 40cm to 4m. It is designed for people whose jobs may alternate from working at a computer, to conversing with colleagues across the workspace.

Although its purpose differs slightly, YoungerOptics has also designed its DD Occupational trifocal lens to be suitable for tradesmen, pilots and librarians who frequently look up and down. This lens consists of a near vision lower portion, distance section in the middle and an immediate/near segment in the upper part of the lens. This allows the choice of having either intermediate or full vision in the upper half of the lens.

Digital lenses

A recent advance in workplace eyewear has been the development of DALs or ‘anti-fatigue’ lenses, aimed at pre-presbyopic patients aged between 18-40. These lenses cater for people who find the effects of extensive computer use tiring on the eyes, and are designed to reduce the fatigue of eye muscles by incorporating a small amount of positive power (0.4-0.8+) in the lower portion of the lens.



"My optometrist and optical dispenser didn’t specifically ask me if i used computers, laptops or other digital devices."
Steve Daras

These lenses are primarily used for everyday tasks involving the computer and concentrated activities. According to manufacturers, many pre-presbyopic patients find them particularly useful when using mobile phones, which now demand a ‘ultra near’ vision zone and place great demands on the ocular muscles.

Sydney Optometrist Narelle Hine, of HineSight, estimated 20% of younger people would benefit from such lenses because they were born with inherited binocular muscle function insufficiencies and struggle to comfortably read a screen for more than 20 minutes.

She also believed DALs could play an important role in managing myopia, a condition that many eye researchers at least partially attribute to increased screen use.

“Humans simply aren’t built for this obsessive screen viewing and the fatigue of the focus muscles creates symptoms of eye strain,” Hine said.

“Excessive near strain is strongly suspected to be a driver for accelerated myopia development in young people too, so anti-fatigue lenses are important to have in our armoury for myopia control,” she said.

TAFE NSW optical course coordinator Steve Daras said the DAL market offered an abundance of untapped potential, particularly among young people and avid videogame players. However, he warned against practitioners marketing them as “training wheels” for PPLs.

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“These lenses don’t have a progressive corridor, in fact they are closer to a seamless or invisible round segment bifocal,” he said.

“I challenge my [TAFE NSW] learners to use this knowledge to improve the opportunities for their wearer’s sight and to grow their business.”

Blue light and other coatings

Refractive correction is not the only factor optometrists need to consider when prescribing occupational lenses. Indoor workplaces are artificially lit environments that can have a further detrimental effect on eye health.

To mitigate this, lens manufacturers offer various coatings for office-related lenses, including; protective, anti-scratch coatings to ensure durability and vision clarity, clean coatings to improve cleaning properties of the lens and anti-reflection applications, which can increase light transmission up to 98% clarity.

However, Hine said blue light filters are perhaps the most important lens addition manufacturers offer and recommend.

“Optometry now sees cumulative high energy blue light exposure as a public health risk and most optometrists now recommend an inexpensive blue light control filter be added to lenses for use at the computer,” she said.

Blue light is the shortest wavelength in the visible spectrum and carries the highest amount of energy per photon. It has been linked to retina damage and other severe conditions, such as macular degeneration. However, the long term ramification of digital-related blue light exposure remains up for debate, with a number of studies stating the amount of blue light emitted form devices is below the threshold that would cause damage.

Despite this, eyecare providers have come to a consensus that blue light filters can help alleviate CVS-related complaints, largely due to reduced glare.

In promoting the use of blue light filters, manufacturers and optometrists also highlight the positive impact such coatings have in maintaining healthy sleep patterns, particularly if devices are used before going to bed.

Research shows high levels of blue light, generating high-energy wavelengths between 420–480 nm on the visible light spectrum, can naturally suppress the body’s melatonin production and boost alertness and attention. After sundown, this effect can disrupt the body’s circadian rhythm and potentially lead to associated problems such as obesity, depression and diabetes.

Untapped market

Although ODL and DAL technology has progressed over the last two decades to accommodate for an array of technological settings, many industry leaders believe such lenses remain heavily under-prescribed. In 2015, lens manufacturer Rodentock went as far to suggest it was “a major untapped market that provides great potential for savvy practitioners”.

Rodenstock’s own research found 89% of people between 45-59 use computers, yet only 10% wore computer specific glasses.

Daras, a popular conference speaker and co-author of Australia’s best-selling optical dispensing text books, uses three separate sets of ODLs for his laptop, workstation and general office space, however, getting to this point was fraught with frustration.

He previously used PPLs for office use, but the viewing angle and height did not allow him to access the correct part of the progressive corridor to see the screen and keyboard clearly. This led to his ciliary muscles locking up, and poor distance vision for up to 30 minutes until his eyes settled.

“My optometrist and optical dispenser didn’t specifically ask me if I used computers, laptops or other digital devices; they just assumed I was happy with what I was wearing,” he said.

“PPL by their very design cannot offer wide or long progressive channels for near and intermediate use. Only by removing the distance component can the near and intermediate lengthen and widen to offer unparalleled computer use. Maybe the people who served me thought that if I wanted them I’d ask for them, which led me to wonder whether they treat all people this way.”

To reinforce his point, Daras cited a recent American Vision Council report suggesting that 90% of patients don’t discuss their digital usage with their eyecare practitioner, while most also did not know there are alternatives to PPL for device use.

“Optometrists and opticians may not always ask the right questions, and we know that some patients don’t volunteer additional information about their visual needs, assuming that the practitioner already knows,” he said,

Daras said it was vital practitioners ensured patients understood separate eyewear was available for different tasks, much like footwear. A patient could start with a progressive lens plan, before returning at a later date have occupational lenses fitted.

“This will only happen if they get good professional dispensing advice and not the sales patterns that most of the industry uses. Once people understand what’s available and how easily you can help with a dispensing plan, then they’ll be more receptive to this,” he said.

Get to know your customer

According to US optometrist Courtney Dryer, key questions to consider asking patients are:

  • Do they already own progressives, but express difficulty with computer use?

  • What is the patient’s occupation? What do they spend their time doing throughout the day?

  • How is their desk arrangement set up at work? At home?

  • Do they use a laptop? Desktop? Both? Simultaneously?

  • Do they spend time in conferences? Meetings? View powerpoint presentations?

  • Are they involved in sales? Spend time interacting with clients?

  • Do they have any neck or back problems?

  • Do they have to enter data into a computer? This indicates need for multiple distances.

  • Do they complain about any difficulty with distance? Any difficulty with driving at night?

  • Do they own progressives, but prefer over the counter readers for computer use?

  • Personality-wise, any indications they may have difficulty adapting to a progressive lens?

 

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