Tinted Lenses for Improving Comfort During Computer Use James Kundart OD MEd FAAO June 4-5, 2009 Tinted Lenses for Improving Comfort During Computer Use James Kundart OD MEd FAAO, Scott Cooper OD MEd FAAO, John R. Hayes PhD Pacific University College of Optometry June 4-5, 2009

James Kundart OD MEd FAAO June 4-5, 2009 Introduction Gunnar Optiks makes “digital performance eyewear”. According the company, these eyeglasses are designed to deliver the following to the eyes: Glare reduction Higher humidity Extraneous light diminution Screen magnification Convergence relief

Gunnar Optiks Lens Features #1 James Kundart OD MEd FAAO June 4-5, 2009 Gunnar Optiks Lens Features #1 Antireflective coating For glare reduction (on the lenses or display?)

Gunnar Optiks Lens Features #2 James Kundart OD MEd FAAO June 4-5, 2009 Gunnar Optiks Lens Features #2 +8D lens base curve and highly-wrapped frame Gunnar claims this makes a “microclimate” for dry eyes

Gunnar Optiks Lens Features #3 James Kundart OD MEd FAAO June 4-5, 2009 Gunnar Optiks Lens Features #3 Yellow tint (and UV protection) Gunnar calls this “Spectrum Contrast Tuning”

Gunnar Optiks Lens Features #4 James Kundart OD MEd FAAO June 4-5, 2009 Gunnar Optiks Lens Features #4 +0.50 D lens power For magnification, not accommodation Gunnar later changed the power to +0.20 D

Gunnar Optiks Lens Features #5 James Kundart OD MEd FAAO June 4-5, 2009 Gunnar Optiks Lens Features #5 Base-in prism For convergence relief Very slight (Prentice’s Rule)

James Kundart OD MEd FAAO June 4-5, 2009 Study #1 Design A crossover study of 36 subjects was conducted to study the difference between two pairs of spectacles: +0.50 lenses with a +8D base curve and a yellow tint Plano (no optical power) specs with the same base curve, but no tint

Subjects Participants had the following characteristics: James Kundart OD MEd FAAO June 4-5, 2009 Subjects Participants had the following characteristics: Between the ages of 22 and 39 Mean age: 24 years 37 subjects qualified for the study 36 completed it 18 were male 19 were female

James Kundart OD MEd FAAO June 4-5, 2009 Methods: Study #1 After a week of randomized spectacle wear, the participants were be called in to begin the study At the first of two visits, the subjects read under of the following conditions for 5 minutes each: With five 15W compact fluorescent lights, causing 300W equivalent glare These lights have a color temperature of 6500 K. With low (about 5%) contrast text With control text (12-point, full contrast)

Glare Lamp Setup

James Kundart OD MEd FAAO June 4-5, 2009 Symptom Surveys During reading, participants had their accommodation and pupil size measured with the Grand Seiko open-field autorefractor After each condition, the Digital Symptom Survey was administered, as well as periodically during the following week

Digital Symptom Survey

External Symptoms Surveyed James Kundart OD MEd FAAO June 4-5, 2009 External Symptoms Surveyed Irritation or burning of the eyes Tearing, or watery eyes Dry eyes Tired eyes Results: on Chi-square distribution testing, these external symptoms showed significant differences between the two pairs of glasses (Gunnar and placebo, p = 0.001)

Corporate Claims Surveyed James Kundart OD MEd FAAO June 4-5, 2009 Corporate Claims Surveyed Bothered by brightness Bothered by glare Computer screen colors are distorted Computer screen fonts look too small Computer screen clarity is poor Results: again, none of these symptoms showed significant differences between the Gunnar and placebo glasses

Objective Findings: Accommodation James Kundart OD MEd FAAO June 4-5, 2009 Objective Findings: Accommodation This analysis was by mixed model analysis of variance with condition and type of glasses However, there was a significant difference for the accommodative response standard deviation (p=0.01) with both pairs of glasses This indicates that accommodation was not particularly stable during the testing of either type of spectacles

Accommodation Variability is Significant James Kundart OD MEd FAAO June 4-5, 2009 Accommodation Variability is Significant For both pairs of glasses, at the 95% confidence interval: Accommodation (Diopters) Gunnar Lenses Placebo Lenses Mean 1.092 0.675 Standard Error 0.156 0.158 Difference 61.940 63.673 Upper Bound 0.780 0.359 Lower Bound 1.404 0.990

Pupil Size is Significantly Different James Kundart OD MEd FAAO June 4-5, 2009 Pupil Size is Significantly Different For the dependant variable pupil size, there was a significant difference (p < 0.001). For both pairs of glasses at the 95% confidence interval:

James Kundart OD MEd FAAO June 4-5, 2009 Exit Survey Results In an exit survey, 59% of the subjects preferred the yellow-tinted magnifying glasses (the Gunnar design) However, the subjects also admitted to wearing their glasses for less than one hour a day on their computers This can be most likely explained by the fact that these subjects were recruited from those least likely to wear corrective spectacles

James Kundart OD MEd FAAO June 4-5, 2009 Compliance Issues Compliance with either pair of computer spectacles was generally less than one hour a day, even among those who worked on computers at least four hours a day Compliance could potentially be increased by making prescription computer specs available to regular spectacle wearers, those who are accustomed to eyeglass wear and therefore more likely to use them

James Kundart OD MEd FAAO June 4-5, 2009 Gunnar Optiks Study #2 The second study will evaluate the following on a single visit, comparing the two specs designs: Tear evaluation (using the Zone Quick test) EMG for quantification of squint and blinks Stress conditions included : Neutral density (gray) tint compared to yellow tint, with glare +8 D base curve compared to +4 D (flatter) base curve, with forced air (fan)

Zone Quick Dry Eye Test http://www.fci-ophthalmics.com/files/pdf/zone_quick_web.pdf

Blink Rate Results (reflex tearing?)

External Symptom Results

James Kundart OD MEd FAAO June 4-5, 2009 Conclusions When using a computer, these low plus, yellow glasses had a clinically, but not statistically, significant effect on tear film and dry eye symptoms, including: Irritation or burning of the eyes Tearing, or watery eyes Dry eyes, and Tired eyes

Acknowledgement This research was made possible by a grant from James Kundart OD MEd FAAO June 4-5, 2009 Acknowledgement This research was made possible by a grant from Gunnar Optiks Corporation www.gunnars.com