The Blue Light Hazard Versus Blue Light Hype.

Martin A Mainster, Oliver Findl, H Burkhard Dick, Thomas Desmettre, Gerardo Ledesma-Gil, Christine A Curcio, Patricia L Turner

Journal: American journal of ophthalmology 2022;240():51-57

PMID: 35227699

Abstract

PURPOSE

The blue light hazard is the experimental finding that blue light is highly toxic to the retina (photic retinopathy), in brief abnormally intense exposures, including sungazing or vitreoretinal endoillumination. This term has been misused commercially to suggest, falsely, that ambient environmental light exposure causes phototoxicity to the retina, leading to age-related macular degeneration (AMD). We analyze clinical, epidemiologic, and biophysical data regarding blue-filtering optical chromophores.

DESIGN

Perspective.

METHODS

Analysis and integration of data regarding the blue light hazard and blue-blocking filters in ophthalmology and related disciplines.

RESULTS

Large epidemiologic studies show that blue-blocking intraocular lenses (IOLs) do not decrease AMD risk or progression. Blue-filtering lenses cannot reduce disability glare because image and glare illumination are decreased in the same proportion. Blue light essential for optimal rod and retinal ganglion photoreception is decreased by progressive age-related crystalline lens yellowing, pupillary miosis, and rod and retinal ganglion photoreceptor degeneration. Healthful daily environmental blue light exposure decreases in older adults, especially women. Blue light is important in dim environments where inadequate illumination increases risk of falls and associated morbidities.

CONCLUSIONS

The blue light hazard is misused as a marketing stratagem to alarm people into using spectacles and IOLs that restrict blue light. Blue light loss is permanent for pseudophakes with blue-blocking IOLs. Blue light hazard misrepresentation flourishes despite absence of proof that environmental light exposure or cataract surgery causes AMD or that IOL chromophores provide clinical protection. Blue-filtering chromophores suppress blue light critical for good mental and physical health and for optimal scotopic and mesopic vision.

Copyright © 2022 Elsevier Inc. All rights reserved.

Address: Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, USA. Electronic address: [email protected].; Vienna Institute for Research in Ocular Surgery, A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria.; Department of Ophthalmology, Ruhr University Eye Hospital, Science, Bochum, Germany.; Centre de Retine Medicale, Marquette-Lez-Lille, France.; Retina Department, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico.; Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.; Department of Ophthalmology, University of Kansas School of Medicine, Prairie Village, Kansas, USA.
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