Speaker Name [SPEAKER NAME] is affiliated with Essilor and Transitions Optical as a speaker. [SPEAKER NAME] has no direct financial or proprietary interest.

Speaker Name [SPEAKER NAME] is affiliated with Essilor and Transitions Optical as a speaker. [SPEAKER NAME] has no direct financial or proprietary interest in any companies, products or services mentioned in this presentation. [If so, disclose details] [SPEAKER NAME] has not received commercial support from Essilor and Transitions Optical. Discloser information for instructor: [SPEAKER NAME] is affiliated with Essilor and Transitions Optical as a speaker. [SPEAKER NAME] has no direct financial or proprietary interest in any companies, products or services mentioned in this presentation. [If so, disclose details] [SPEAKER NAME] has not received commercial support from Essilor and Transitions Optical. OR [SPEAKER NAME] has received commercial support from Essilor and Transitions Optical in the form of [INSERT].

Harmful Blue Light and Optical Solutions
For Long-Term HEV Protection Harmful blue light is at the forefront of public consciousness because of the increased use of digital devices in recent years. What most people don’t realize, though, is that harmful blue light is actually present both indoors and outdoors, and that the sun is the largest singular source of harmful blue light. This course will explore the nature of harmful blue light, its possible long-term phototoxic effect on vision, and the optical solutions available to help protect against harmful blue light both indoors and outdoors. COPE and ABO Approved

Low consumer awareness of blue light
Which are sources of blue light? 58% 45% 26% 17% Consumer have never heard of blue light (49%) or don’t know much about it (30%) People associate blue light with digital sources While there is considerable buzz about blue light the majority of consumers have never heard of blue light (49%), or don’t know much about it (30%). Not surprisingly what they do know is related predominately to digital devices and artificial sources. Sources: Transitions Optical Consumer Brand Tracking – US Feb/ Mar 2016; Wakefield Research, Nov 2015

ECP awareness of blue light
Which are sources of blue light? 90% 54% 26% 39% ECPs know a lot about blue light (36%) or know a little bit about it (49%) Predominately associate blue light with digital sources While eyecare professionals are more aware of the issue. They majority reporting to know a lot (36%) or at least a little about blue light (49%) they too are focused predominately on digital devices as the source of blue light and practitioners tend to incorrectly believe that digital devices are the major source. It could be interesting to hypothesize how this mistaken perception came to exist. There could be two reasons for this. First, for all the amazing things that smartphones and tablets do for us, in many ways, these technologies also bring upon many social ills. MIT professor Sherry Turkle, articulated how these technological advances negatively impact social behaviors in her book, "Alone Together". There is a growing desire among parents, to believe that digital devices are "bad", especially because their children are seemingly addicted to texting, Snapchat, and taking selfies. Second, our industry's early emphasis on digital devices and blue light hazard, created what psychologists call availability bias -- the same phenomena of how the general public believe the world is more dangerous than it really is because the media disproportionately covers airline accidents rather than safe landings. In the same way, practitioners have been led astray, believing digital devices are the main source of blue light. Sources: Transitions Optical ECP Brand Tracking – US Feb 2016

The fact that the sun is a strong source of blue light is new news and compelling to both ECPs and consumers When consumers and ECPs are made aware of the sun as a source of blue light, they find this to be compelling news. Focusing on protection from both sun and digital devices is a compelling concept and motivating to consumers. Source: Transitions Optical Qualitative Study – Tampa, Oct 2015

Let’s begin by looking at light and its role in processing sensory information to enable visual perception.

MAJOR FACTOR IN HUMAN DEVELOPMENT
LIGHT MAJOR FACTOR IN HUMAN DEVELOPMENT ESSENTIAL TO HEALTHY DEVELOPMENT NEEDED FOR OCULAR GROWTH IMPACTS THROUGHOUT OUR LIVES Light is a major environmental factor in human development. The acquisition of visual function is experienced as early as infancy and is essential to healthy development. Numerous deprivation experiments have demonstrated that ocular growth and refraction development are regulated by visual information. It plays a significant role in how we process sensory information, impacting our visual experience from the point of birth and throughout our lives.

NEEDED TO REDUCE THE DEVELOPMENT OF MYOPIA
LIGHT MAJOR FACTOR IN HUMAN DEVELOPMENT NEEDED TO REDUCE THE DEVELOPMENT OF MYOPIA There may be a threshold of daily light exposure required in childhood to slow axial eye growth and in turn, reduce the development and progression of myopia. In an Australian study, those children who habitually spent less than 60 minutes in bright outdoor light levels were found to show significantly faster eye growth compared with those spending more time in bright outdoor light. This suggests that children need to spend more than one hour and preferably at least two hours a day outside to help prevent myopia from developing and progressing. There is no evidence either way that wearing glasses has no effect or hinders the protective effect of sunlight, but this has not been studied systematically. Source: Scott A. Read, Michael J. Collins, Stephen J. Vincent, Light Exposure and Eye Growth in Childhood, Investigative Ophthalmology & Visual Science October 2015 Source: S.A. Read et al., 2015

FUNDAMENTAL FOR VISUAL PERFORMANCE
LIGHT FUNDAMENTAL FOR VISUAL PERFORMANCE LIGHTING CONDITIONS LUMINANCE RANGE Daylight (Photopic) > 3 cd / m2 Nighttime (Scotopic) < cd / m2 Twilight (Mesopic) > cd / m2, < 3 cd / m2 The visual system as a whole is sensitive over a wide range of light levels from starlight to bright sunlight but, despite the regulation of the pupil aperture, it cannot operate over the entire range simultaneously. There are two primary lighting conditions with which the visual system has to deal: daylight, or photopic, and nighttime, or scotopic. Between photopic and scotopic levels is a range called mesopic, which corresponds roughly to twilight.

FUNDAMENTAL FOR VISUAL PERFORMANCE
LIGHT FUNDAMENTAL FOR VISUAL PERFORMANCE LIGHTING CONDITIONS LUMINANCE RANGE PHOTORECEPTORS (IN THE RETINA) PEAK SENSITIVITY CHARACTERISTICS Daylight (Photopic) > 3 cd / m2 Cones 555 nm Fine resolution, good color vision Nighttime (Scotopic) < cd / m2 Rods 507 nm No color vision, poor resolution, fovea "blind" Twilight (Mesopic) > cd / m2, < 3 cd / m2 Cones and Rods 555 nm nm Reduced color, Reduced resolution The human eye has three types of light sensitive cells (photoreceptors) in the retina that process sensory information – cones, rods and ganglion cells. Cones are highly concentrated in the central area of the retina (macula) and are responsible for providing daylight sharp image resolution and color detection. Rods are largely distributed in the periphery of the retina. Having high sensitivity, they are required for nighttime vision but provide low resolution and lack of color information. The ganglion cells are crucial for relaying light information from the retina to the brain to control circadian rhythm, pupillary light reflex and sleep. (Sand A. et al., 2012, Gronfier 2013) An adaptation (of the iris / pupil) is required to adjust the light sensitivity of the visual system to different light levels. When the adaptation is in progress, visual performance is reduced. Once the process is complete, visual capabilities depends on the new level of light. Sources: Sand A., Schmidt T.M., Kofuji P., Diverse types of ganglion cell photoreceptors in the mammalian retina Prog. Retin. Eye Res. 31 (2012) Gronfier, C., The good blue and chronobiology: light and non-visual functions, Points de Vue, International Review of Ophthalmic Optics, N68, Spring, Ganglion Cells – relay light information to the brain; controls circadian rhythm, pupillary light reflex and sleep Sources: Sand A. et al., 2012, Gronfier C. 2013

THE SOLAR SPECTRUM The sun emits a tremendous amount of energy in the form of wide electromagnetic radiation. From cosmic rays to radio waves, the majority of solar emissions are not visible to human photoreceptors.

THE SOLAR SPECTRUM Harmful blue light is centered around 435nm
Only a thin portion – at wavelengths between 380nm and 780nm – provides the visible light that interacts with the eye’s visual system, enabling us to see the world. Blue light (also known as High Energy Visible light – or HEV) is at the far end of the visible spectrum, close to ultraviolet radiation, with a wavelength of between nanometers. Harmful blue light is centered around 435nm. (Arnault E.) It is important to note that not all blue light is harmful. Blue-turquoise light, which is above harmful blue light, has benefits. (Gronfier, C.) Ultraviolet radiation – commonly referred to as UV – is beyond the visible spectrum. It is divided into UVB ( nm) and UVA ( nm). Sources: Arnault E. Barrau C, Nanteau C. Gondouin P, Bigot K, et al. “Phototoxic Action Spectrum on a Retinal Pigment Epithelium Model of Age-Related Macular Degeneration. Exposed to Sunlight Normalized Conditions.” PLoS ONE 8(*); e71398.doi: August 23, 2013. Gronfier, C., The good blue and chronobiology: light and non-visual functions, Points de Vue, International Review of Ophthalmic Optics, N68, Spring, The Low Down on Blue Light, Review of Optometry, February Sources: Arnault E. 2013, Gronfier C. 2013

CLIMATIC DROPLET KERATOPATHY
UV RADIATION RISKS ASSOCIATED TO EXPOSURE PREMATURE AGING SKIN CANCERS EYELID MALIGNANCIES PHOTOKERATIS CLIMATIC DROPLET KERATOPATHY PTERYGIUM CORTICAL CATARACT Both UVA and UVB penetrate the atmosphere freely and play a critical role in advancing more severe health conditions like premature skin aging (wrinkles) and certain skin cancers like carcinoma, which can affect the eyelids and facial skin. Exposure to UV radiation is well established as a major cause of eyelid malignancies, photokeratis, climatic droplet keratopathy, pterygium and cortical cataract. Sources: Yam J.C., Kwok A.K., Ultraviolet light and ocular diseases, Int. Ophthalmol. 34 (2014) Behar-Cohen F., Baillet G., De Ayguavives T., Ortega García P., Krutmann J., Peña-García P., Reme C., Wolffsohn J.S., Ultraviolet damage to the eye revisited: eye-sun protection factor (E-SPF®), a new ultraviolet protection label for eyewear, Clin. Ophthalmol. 8 (2014) Sources: Yam 2014, Behar-Cohen et al. 2014

While the impact of UV exposure is well documented there is more to be learned about harmful blue light

HELPS TO REGULATE SLEEP PATTERNS
BLUE LIGHT HELPS TO REGULATE SLEEP PATTERNS Blue-turquoise light (~460 to 485 nm) First, it is important to note again that not all blue light is bad. In fact, our body actually needs some blue light, specifically blue-turquoise light (blue light with wavelengths of approximately 460 to 485 nanometers). Exposure to blue-turquoise light during the daytime helps to modulate melatonin production in our bodies which sets our circadian rhythms and regulates our sleeping patterns. When there is an absence of blue light, our eyes sense it and the ganglion cells (mentioned earlier) stimulate the pineal gland to release melatonin, a hormone which lets our bodies know it is time for sleep. When blue light is present, melatonin production is suppressed and our bodies are alert, energized and ready for work and play. In this way, blue-turquoise light is good if we are exposed in reasonable doses during the daytime. It has been shown to enhance attention levels making us feel more awake, and can even have psychological effects like positively enhancing our mood. But if we are exposed to it at night, we are setting ourselves up for trouble sleeping which could lead to problems in our health. Sources: Gronfier, C., The good blue and chronobiology: light and non-visual functions, Points de Vue, International Review of Ophthalmic Optics, N68, Spring, The Low Down on Blue Light, Review of Optometry, February Source: Gronfier C. 2013

POTENTIALLY HARMFUL TO THE RETINA
BLUE LIGHT POTENTIALLY HARMFUL TO THE RETINA As a part of visible light, blue light passes through the eye structure, reaching the retina As a part of visible light, blue light passes through the eye structure, reaching the retina. Due to its higher level of energy than the other wavelengths in the visible spectrum, blue light is potentially harmful to the retina. While UV transmittance is blocked primarily by the cornea and crystalline lens in healthy adults, as a part of visible light, blue light passes through the eye structure, reaching the retina. The amount of blue light reaching the retina depends on the age of the eye as, during a lifetime, there is a slight yellowing of the crystalline lens that would typically provide some absorption in the blue violet region. The central part of the retina is covered by yellow pigments, which serve as a filter for incoming blue light. Due to assorted factors, macular pigment density can be variable from one individual to another and its ability to absorb light evolves during a lifetime.

POTENTIALLY HARMFUL TO THE RETINA
BLUE LIGHT POTENTIALLY HARMFUL TO THE RETINA Photochemical lesions Laboratory experiments show that exposure to blue light with a maximum peak centered on 435+/- 20 nm can induce irreversible cell death in the retinal pigment epithelium (RPE) Long term exposure has been linked to increased risk of developing AMD AMD has a multifactorial pathogenesis Depending on exposure conditions (light intensity, duration, periodicity) it may induce different types of reactions, including photochemical lesions (Rozanowska et al., 2009) Laboratory experiments showed that blue light is harmful (Sparrow et al., 2000) and particularly it has been demonstrated that exposure to blue violet light with a maximum peak centered on 435+/- 20 nm can induce irreversible cell death in the retinal pigment epithelium (RPE), located in the external layer of the retina (Arnault et al., 2013). ((When we apply photosensitisers like A2E on the retinal pigment epithelium (RPE) cells the toxicity is from 415 to 455 nm)) Long term exposure to harmful blue light has been linked to increased risk of developing age-related macular degeneration (AMD) (Arnault 2013) Of course, AMD has a multifactorial pathogenesis: age, genetics, smoking, diet low in vitamins, retinal phototoxicity, obesity and hypertension are all likely to play a role. Sources: Arnault E. Barrau C, Nanteau C. Gondouin P, Bigot K, et al. Phototoxic Action Spectrum on a Retinal Pigment Epithelium Model of Age-Related Macular Degeneration, PlosOne 8 (2013) Rozanowska M., Rozanowski B., Boulton M., Light-induced damage to the retina (2009) Sparrow J.R., Nakanishi K., Parish C.A., The Lipofuscin Fluorophore A2E Mediates Blue Light-Induced Damage to Retinal Pigmented Epithelial Cells, Invest. Ophthalmol. Vis. Sci. 41 (2000) Source: Rozanowska 2009, Sparrow 2000, Arnault 2013

288MM 196MM PROJECTED INSTANCES OF AMD WORLDWIDE 2020 2040
More research is needed to understand the relationship between harmful blue light and AMD. Especially when you consider that … AMD is the leading cause of vision loss in adults over the age of 50 (National Eye Institute) And worldwide, the projected number of people with AMD by 2020 is 196 million, increasing to 288 million by 2040, a further 45 percent jump. Sources: National Institutes of Health National Eye Institute. Facts about Age-Related Macular Degeneration. Retrieved from: Wong W.L., Su X., Li X., Cheung C.M., Klein R., Cheng C.Y., Wong T.Y., Global prevalence of age-related macular degeneration and disease burden projection for 2020 and 2040: a systematic review and meta-analysis, Lancet Glob Health (2014) Sources: National Eye Institute, Wong 2014

1 in 4 SPEND 3+ HOURS 2 in 5 SPEND 9+ HOURS
BLUE LIGHT AT FOREFRONT OF PEOPLE’S MINDS 1 in 4 SPEND 3+ HOURS 2 in 5 SPEND 9+ HOURS Blue light at the forefront of people’s minds because of the increased use of digital devices. Nearly 1 in 4 children spend more than three hours a day using digital devices. (The Vision Council) Nearly 2 in 5 Millennials spend more than nine hours a day using digital devices. (The Vision Council) While the human eye was meant to receive a portion of blue light, it is possible that increased exposure can have an impact. The best case scenario is a bad night’s rest: Since we’re receiving extra doses of blue light, our bodies might think that they’re in a state of perpetual daylight. The worst case scenario? The jury’s still out. Source: The Vision Council Digital Eye Strain Report Source: The Vision Council

Often associated exclusively with electronic devices and screens, harmful blue light is actually present both indoors and especially outdoors.

MORE INTENSE THAN ELECTRONIC DEVICES AND SCREENS
BLUE LIGHT SOURCES LED Lights Digital Devices Metal Halide Lamps INDOORS OUTDOORS OVER 100 TIMES MORE INTENSE THAN ELECTRONIC DEVICES AND SCREENS THE SUN Harmful blue light can be emitted by LED lights, halide lamps, digital devices and especially the sun. What most people don’t know is that the sun is the largest singular source of harmful blue light, emitting over 100 times the intensity of electronic devices and screens. --- Source: Baillet G., Granger B., How Transitions® lenses filter harmful blue light, Points de Vue, International Review of Ophthalmic Optics, online publication, March 2016

DIFFERENT LEVELS OF EXPOSURE
BLUE LIGHT DIFFERENT LEVELS OF EXPOSURE Sun Plasma TV Smart Phone LCD Monitor CRT Monitor 3.71 0.035 0.007 0.013 0.025 Viewing Distance Indirect 6ft 1ft 2ft nm integrated irradiance values (w/m2) of common artificial light sources against solar diffused light Here you see the amount of harmful blue light coming from some common sources, taking into account average viewing distance. You can see that compared to a Plasma TV, the amount of harmful blue light coming from the sun is 100 times greater. Source: Baillet G., Granger B., How Transitions lenses filter harmful blue light, Points de Vue, International Review of Ophthalmic Optics, online publication, March Source: Baillet G., Granger B. 2016

THE SUN IS THE LARGEST SOURCE
BLUE LIGHT THE SUN IS THE LARGEST SOURCE IT’S THERE The TV plot area is so small you can’t see it on this graph. And this number is conservative. There is a significant difference in the level of harmful blue light when facing into the sun directly and facing away from the sun. If you are facing the sun, it can be 500 times more intense than a plasma TV.

BLUE LIGHT SCATTERS (Rayleigh Scattering)
Makes the sky blue. Glare is caused by light scatter. The result is visual discomfort and fatigue. Blue light from the sun scatters through the atmosphere. This is why the sky is blue. When visible solar radiation reaches the Earth’s surface it is scattered throughout the atmosphere. Since blue light is higher in energy than other wavelengths in the visible spectrum, it scatters more (Rayleigh scattering) creating haze and glare, interfering with vision, causing eye fatigue and reducing contrast sensitivity. (Stenson S.) In fact, depending on the time of day, a majority (25-30%) of outdoor visible light you receive is blue light. Source: Stenson S., Contrast Sensitivity, Glare, and Quality of Vision, 2004:7

INVOLUNTARY NATURAL DEFENSES
This is why we squint in sunlight. However, squinting, eye fatigue and eye strain are actually indicators you are getting more light than you need. There are other natural defenses … We’ll naturally turn away from glare Physiological structures around the eye, like eyelids and eyelashes, provide some protection against intense light. The pupil also contributes by using constriction to decrease the amount of entering light. Yellow pigments in the macula absorb some of the light, and The natural yellowing of the lens as we age. Our eyes and skin are the only parts of our bodies directly exposed to the sun’s benefits and hazards. Damage from sunlight cumulates[1], just like skin damage. And as we live longer the damage may be greater. Source: [1] Cumulative damage from harmful UVA and UVB radiation may contribute to serious eye conditions or diseases of the eye and sensitive areas around the eye. It has been documented that chronic UV radiation exposure has been linked to cataracts and may be linked to age-related macular degeneration. Source: Taylor HR, West S, Munoz B, et al. The long-term effects of visible light on the eye. Arch Ophthalmol. 1992;110,

Harmful Blue Light Protection
UVA and UVB Protection Harmful Blue Light Protection + It is worthy to propose blue light protection even if there is no definitive in vivo proof linking it to eye disease. Providing harmful blue light protection is simple, and low cost relative to the potential consequences. Still, the practitioner's emphasis should first and foremost be to recommend UV protection.

Now that you understand the risks associated with outdoor conditions and the natural protections of the human eye, let’s look at the technical solutions available within the eyewear industry to help prevent the long-term effects of harmful blue light. As stated, UV protection in eyewear it is also important to remember.

MEASURING HARMFUL BLUE LIGHT FILTERING
No industry standard Could be measured at a specific wavelength or calculated using an average between a specific range When looking at the different solutions available it is important to note that there is not an industry standard for how to measure harmful blue light filtering so different companies use different methodology. Some might measure the % filtered at a specific wavelength, others might use an average between a specific range Keep in mind when you evaluate products that the numbers reported by different companies may not be an apples to apples comparison

REFLECTIVE COATINGS Two Options – please pick left or right
Blue light reflective properties can be effective up to 20% or more There are anti-reflective coatings that offer enhanced protection in the blue-violet light region. These are developed by adding a specific reflection element at the wavelength to be rejected, in this case nm. The blue-filtering reflective properties of these coating can be effective up to 20 percent or more. These ophthalmic lenses display high clarity indoors and outdoors, and offer reliable indoor protection against harmful blue light emitted by electronic devices and artificial lighting while providing moderate outdoor protection as well. There are many options for reflective coatings with blue-filtering benefits Many labs offer their own solutions. And many lens casters offer products including – ((Speaker please fill in products you recommend such as Essilor’s Crizal Prevencia)) You have probably heard about these products and there are multiple industry articles available to learn more about them. The important thing to understand is that these all reflect the harmful blue light, there are other technical solution…

ABSORPTION WITH DYES Blue light absorption with yellow dyes in substrate (left) and neutral color-balanced substrate (right) Another way to prevent harmful blue light from entering the eye is to reduce the unwanted wavelengths by absorbing them with yellow dye. Dyes provide absorption in the visible part of the light spectrum of its complementary color: in this case, yellow absorbs blue. This is why most blue-absorbing lenses appear more or less yellow depending on the level of their blue-filtering properties. The advantage of the yellow dye solution is that it can reduce a significant amount of harmful blue light, but the intense yellow color detracts from color perception and may not be aesthetically appealing to everyone. There is a way to circumvent the yellow color of an absorbing filter that involves “color balancing” the tint by adding a small proportion of another dye. The complementary dye absorbs in another region of the visible spectrum, creating a neutral filter. As with reflective coating solutions, there are multiple manufacturers and labs that offer lenses that lenses that use filters to absorb ((Speaker fill in an example you recommend such as Smart blue filter)). Many of these are sunglasses designed for outdoor use only. ((Speaker please fill in blue-blocking sunglass products you recommend))

SUNWEAR – REFLECTION OR ABSORPTION
By definition and usage, sun lenses are made exclusively for outdoor purposes. In the fashion and high-performance sunwear business, one finds mirrored lenses manufactured on the principle of interferential light reflection stacks and/or a mix of tinting by absorption and reflection mirror technologies. The dark intensity of the lenses, both plano and Rx, effectively filters harmful blue light, especially brown lenses where the yellow dye content in the mixture is in the majority.

PHOTOCHROMICS – ADAPTABLE ABSORPTION
BLUE FILTERING ZONE Photochromic lenses are highly efficient in protecting against glare, since their darkness automatically adjusts to the amount of outdoor light, whether overcast, in shadow or in bright sunlight. Because they darken in various lighting conditions, they help the visual system to adapt without compromising visual performance or comfort. The advantage of photochromic lenses, is that they are dark outside when sunlight is bright and intense and can be worn indoors. Looking at the leading photochromic lens, Transitions Signature lenses, you can see on the graph that indoors at least 20% of harmful blue light is filtered (the area above the line is filtered), and outdoors (when darkened) even more harmful blue light is filtered – over 85%. Source: Baillet G., Granger B., How Transitions® lenses filter harmful blue light, Points de Vue, International Review of Ophthalmic Optics, online publication, March Blocks at least 20% indoors Blocks over 85% outdoors 1Transitions® lenses block 20% to 36% of harmful blue light indoors excluding CR607 Transitions® Signature® VII products which block 14% to 19%. Source: Baillet G., Granger B. 2016

UV AND HARMFUL BLUE LIGHT PROTECTION BUNDLED
INDOORS OUTDOORS Transitions® lenses block at least 20% of harmful blue light indoors – 2X times more than a typical clear 1.50 and polycarbonate hard-coated lens1 Transitions® lenses block over 85% of harmful blue light outdoors – and 100% of UVA and UVB Transitions lenses filter blue light indoors because the photochromic molecules in the unactivated indoor state still absorb some light without compromising indoor vision clarity. Because Transitions has control over the structure of the photochromic molecules, they can provide the benefit of blue light filtering while the lenses are still seen as clear. Outdoors, they darken, filtering more visible light, which helps to provide extra protection from the sun by shielding eyes from glare, intense harmful blue light and UV rays. The advantage of Transitions lenses is that UV and harmful blue light protection is bundled together. 1Transitions® lenses block 20% to 36% of harmful blue light indoors excluding CR607 Transitions® Signature® VII products which block 14% to 19%. The 2 times comparison refers to typical clear 1.50 and polycarbonate hard-coated lenses.

Matrix of blue light filtering delivered by optical solutions in the eyewear industry in normal indoor / outdoor usage PHOTOCHROMIC LENSES This matrix shows the blue light filtering delivered by optical solutions in the eyewear industry in normal indoor and outdoor usage. Transitions Signature VII lenses filter a similar amount of harmful blue light indoors compared to many blue-filtering AR coatings and offer extra protection where you need it the most: outdoors in the sun. Transitions XTRActive lenses provide additional protection indoors compared to many blue-filtering AR solutions. Transitions lenses are compatible with many AR coatings that filter harmful blue light. When used together, these products may be complementary. The resulting level of protection may vary depending on the absorption spectrum of Transitions lenses and reflection spectrum of the blue-filtering AR.

INDOOR AND OUTDOORS PROTECTION IS IMPORTANT In conclusion.
Visible light reaching the retina is essential for visual perception. Despite several self-protection mechanisms, the retina in the human eye can be exposed to light levels that exceed its natural defenses and can cause long-term irreversible damage. Like protection from UV, reducing exposure to harmful blue light indoors – and especially outdoors – should be a key consideration when recommending lenses to your patients. Source: Arnault E. Barrau C, Nanteau C. Gondouin P, Bigot K, et al. Phototoxic Action Spectrum on a Retinal Pigment Epithelium Model of Age-Related Macular Degeneration, PlosOne 8 (2013)

Adopt doctor-driven dispensing
PROTECTION IS IMPORTANT PUTTING IT INTO PRACTICE Promote "sun protection" so that UV and blue light aren't un-bundled as separate entities but lumped together "I'm prescribing you Transitions lenses because they effectively protect your eyes from harmful UV and short-wavelength light." "Recent evidence shows that excessive blue light exposure may damage your eyes, like UV light, and that is why I am prescribing you ______" Adopt doctor-driven dispensing How can you put this into practice? In my own practice I aspire for each patient to have UV protective eyewear. The paradigm shift for myself and our profession should be toward promoting "sun protection" so that UV and blue light aren't un-bundled as separate entities but lumped together. It could be as simple as the doctor saying, "I'm prescribing you Transitions lenses because they effectively protect your eyes from harmful UV and short-wavelength light." Or, "Recent evidence shows that excessive blue light exposure may damage your eyes, like UV light, and that is why I am prescribing you ______" Consider scripting that is going to accommodate your style. Are you more aggressive and direct, or more mild-mannered and like to soft-pedal product? In a perfect world, all practices would adopt doctor-driven dispensing so the optician should take the baton pass from the doctor and run with it.

REFERENCES Arnault E. Barrau C, Nanteau C. Gondouin P, Bigot K, et al. Phototoxic Action Spectrum on a Retinal Pigment Epithelium Model of Age- Related Macular Degeneration, PlosOne 8 (2013) Baillet G., Granger B., How Transitions® lenses filter harmful blue light, Points de Vue, International Review of Ophthalmic Optics, online publication, March transitionsr-lenses-filter-harmful-blue-light Behar-Cohen F., Baillet G., De Ayguavives T., Ortega García P., Krutmann J., Peña-García P., Reme C., Wolffsohn J.S., Ultraviolet damage to the eye revisited: eye-sun protection factor (E-SPF®), a new ultraviolet protection label for eyewear, Clin. Ophthalmol. 8 (2014) Gronfier, C., The good blue and chronobiology: light and non-visual functions, Points de Vue, International Review of Ophthalmic Optics, N68, Spring, chronobiology-light-and-non-visual-functions National Institutes of Health National Eye Institute. Facts about Age- Related Macular Degeneration. Retrieved from: O'Hagan J.B., Khazova M., Price L.L.A., Low-energy light bulbs, computers, tablets and the blue light hazard, Eye (2016) Reuters Health, Blue light from screens, bulbs may be too weak to damage eyes (2/1/2016) blue-light-idUSKCN0V727H Sand A., Schmidt T.M., Kofuji P., Diverse types of ganglion cell photoreceptors in the mammalian retina Prog. Retin. Eye Res. 31 (2012) Scott A. Read, Michael J. Collins, Stephen J. Vincent, Light Exposure and Eye Growth in Childhood, Investigative Ophthalmology & Visual Science October Sparrow J.R., Nakanishi K., Parish C.A., The Lipofuscin Fluorophore A2E Mediates Blue Light-Induced Damage to Retinal Pigmented Epithelial Cells, Invest. Ophthalmol. Vis. Sci. 41 (2000) The Vision Council Digital Eye Strain Report Yam J.C., Kwok A.K., Ultraviolet light and ocular diseases, Int. Ophthalmol. 34 (2014)

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