Optometric practices offer tinted and colored contact lenses to aid in cosmetic enhancement; however, many eyecare practices are unaware of the therapeutic effects that tinting a lens (contact or spectacle) can offer. It is in our best interest to use our comprehensive knowledge and skill set to design therapeutic lenses and fit them appropriately. The reward of a successful fit and life-altering experience for the patient is priceless.
Color’s effects on the visual system have been discussed dating back to the late 1800s and early 1900s. Edwin Babbitt and Carl Loeb used colored light to treat physical and psychological conditions, including jaundice, weaknesses in the body, ailments, and mental affective disorders. Today, colored lenses have been shown to help patients with a variety of different conditions. Some of the patients who were identified were those who suffered from photophobia, migraines, retinal dystrophies, oscillopsia, reading difficulties, and visual changes related to vestibular conditions.1-5
Fluorescent lighting-induced migraines
D.B., a 57-year-old male presented to The Eye Center at Southern College of Optometry with severe migraines, including auras that triggered when exposed to fluorescent lighting for as briefly as 15 minutes. At the time of first presentation, he wore very dark sunglasses and a baseball cap at work to help prevent the onset of migraines. To reduce overall brightness, he removed half of the tubes in each fixture. Occasionally, he needed to shut off all the lighting to prevent triggering the migraines.
D.B. was seen by a neurologist for his headaches, but his medical and ocular histories were otherwise unremarkable. D.B. was experiencing migraines daily which would last for up to four hours. These migraines were so debilitating that he remained in bed, losing days of his life. He takes 100 mg of Imitrex (sumatriptan, GlaxoSmithKline) for his migraines to help with the pain. He is allergic to aspartame, caffeine, cheese, monosodium glutamate, and tryptophan. Upon examination, his uncorrected distance visual acuities was 20/20 OU, and all other preliminary testing was normal. Refraction revealed OD: +0.50 -0.75 x 110 OS: +0.25 -0.50 x 110 with an add of +2.00 D OU. Anterior and posterior segment health is unremarkable.
We performed color sensitivity testing using the Intuitive Colorimeter (Cerium Optical Products). This logically and sequentially explored color space and helps find the optimal precision tint for the relief of perceptual distortions, or in this case, migraines. The Intuitive Colorimeter changes three parameters of color: hue, saturation, and brightness. The patient views colors, which are projected onto text or other targets, through the instrument while the examiner changes the parameters and records graded subjective responses from the patient. Based on the responses, a computer program helps to determine which combinations of filters will produce a color combination unique to the patient’s visual needs. There are 42 different reference filters, which can be used one at a time or, in rare cases, in combinations of four to five different reference lenses. The program gives a specific transmission curve for the lens combination, which is testable and reproducible. Using the filters allows the patient to see the color suggested for him before tinting.