Different tints for migraine headahces

[RetroRat]

Hi all,

I'm seeing to a patient who has developed a progressive sensitivity to light. This patient has been to neurologists and ophthalmologists and the cause is unclear but it looks like a systemic anomaly of some kind. Currently we're just looking to give symptomatic relief until we can figure out what is going on.

A full color vision work up was done for any cone anomaly/hypersensitivity was done but there was no remarkable results.

We've brainstormed some ideas, and I've given him a number of tint samples to try and get some anecdotal feedback on how different hues affect his photophobia (for better or worse) and I've asked him to pay special attention to a FL-41 rose colored tint to see if we can isolate a particular part of the spectrum that he is more sensitive to.

One interesting point our patient raised was that he seemed to cope better on clear blue-skied days than on overcast days - which makes me think perhaps there could be something to do with the scattered glare in the polarized light reflected off of clouds etc?

Any thoughts or past experiences with treating migraine would be much appreciated!

Retrorat

[Fezz]

Contact a fellow member, Ian Jordan. He is an authority on the subject of tints.


http://www.optiboard.com/forums/show...Jordan-FBDO-Cl

[RetroRat]

Thank you Fezz, I've just shot Ian an email now.

I'd also be interested to hear Chips'/others opinion towards a pin-hole rigid lens as a potential option for this patient, if he reads this!

[braheem24]

One interesting point our patient raised was that he seemed to cope better on clear blue-skied days than on overcast days

I would experiment various CFl lights in the home varying from 3000 to 6000 Kelvins.

[Craig]

We just started to work with the Chromagen lenses and based on what we have learned; Have you tried utilizing 2 different tints so the light is altered between the 2 eyes?
We seem to know that there is a strong correlation between light and migraines, so what if you trick the brain to see if any symptom relief is to be enjoyed?

This is an area that will be better understood in the future by folks much more educated on the subject than i am and I look forward to comments.

Craig

[optilady1]

What about driverwear? We've had a few patients who were super light sensitive who responded well to wearing all day long.

[braheem24]

One interesting point our patient raised was that he seemed to cope better on clear blue-skied days than on overcast days - which makes me think perhaps there could be something to do with the scattered glare in the polarized light reflected off of clouds etc?

BIG PS,

Barometric pressure may be a big culprit to the migraines instead of outside lighting.

[fjpod]

I don't think there are any scientific studies that claim tinted lenses of any color prevent, treat, or ameliorate migraine headaches, or the circumstances that cause migraine headaches.

I can believe that someone who is light sensitive might feel better with tinted lenses though...whether they have migraines or not. But the matter does deserve some clinical attention, observation and anecdotal evidence.

[Nikolay Angelov]

"If all you have is a hammer, everything looks like a nail."

I would advice the person to consult a Doctor about the headache. Run some tests MRI, CAT scan etc. let the pro's decide.
It could be nothing or it could be everything.

If his current "neurologists and ophthalmologists" can't figure it out he should consult different doctors.
Giving too much attention to symptomatic treatments, may slow down finding the actual cause.

[braheem24]

"If all you have is a hammer, everything looks like a nail"

This patient has been to neurologists and ophthalmologists and the cause is unclear but it looks like a systemic anomaly of some kind. Currently we're just looking to give symptomatic relief until we can figure out what is going on.

OP seems to have his toolbox in order ;)

[RetroRat]

OP seems to have his toolbox in order ;)

Yep, with my favorite screwdrivers in the top compartment!

Drivewear is a good idea, however I suspect an additional tint might be the way to go over the top as our px is still feeling sensitive to normal light with his brown 85% polarized lenses (prefers the brown over the grey!)

I'm currently working with Ian Jordan sourcing different filters with the intention of testing our patients sensitivity to different hues and saturation and work from what we find there - I'll be sure to post what we find as this is somewhat of a fascinating project.

I'll look into atmospheric pressure as well... who knows, our patient might appreciate being advised of his clinical need for a holiday to a cooler climate over the Christmas break ;) - Aussie summers; youch!

Thank you all for your replies!

Retrorat

[RetroRat]

Also - 100th post!

Time to celebrate with a century beer! :cheers:

[optilady1]

Maybe the patient should consider a frame with a magnetic clip on, and then have whatever special color you guys come up with put into the clips, and when he is feel especially bad he could put the clips on, so he's not walking around in some crazy purple hued lenses all the live long day.

[chip anderson]

I suspect that different tints for right and left would get you and the patient in a heap 'o touble in a hurry. I have an old pair of Georgio Armanis with clear lenses for Rx and flip over (from the side) lenses for shades. Flip one side over to tint, leave the other at clear and you will find you are going crazy in a hurry.
As far as pinhole contacts, I have used them for several things but never migrain. Did have some limited success with nystagmus though.

Chip

[kdavenport]

You may want to look into the ziess Z1 blue glass lenses.

[cocoisland58]

I was glancing through this thread while eating lunch today and oddly enough a patient asked me this afternoon if I knew anything about migraines and tints. I told her that I would look again tonight to see if anyone had come up with something. Wish I could help her.

[Steve Machol]

I don't think there are any scientific studies that claim tinted lenses of any color prevent, treat, or ameliorate migraine headaches, or the circumstances that cause migraine headaches.

I can believe that someone who is light sensitive might feel better with tinted lenses though...whether they have migraines or not. But the matter does deserve some clinical attention, observation and anecdotal evidence.

I think there have been some studies but it's been a long time since I had access to that info. My recollection is a light blue tint is supposed to help with migraine sufferers.

[RetroRat]

Maybe the patient should consider a frame with a magnetic clip on, and then have whatever special color you guys come up with put into the clips, and when he is feel especially bad he could put the clips on, so he's not walking around in some crazy purple hued lenses all the live long day.

I like this idea too - my thought was a light polarized grey or something which would be tinted with a crazy purple hue over the top, but your idea makes more sense than that!

I suspect that different tints for right and left would get you and the patient in a heap 'o touble in a hurry. I have an old pair of Georgio Armanis with clear lenses for Rx and flip over (from the side) lenses for shades. Flip one side over to tint, leave the other at clear and you will find you are going crazy in a hurry.
As far as pinhole contacts, I have used them for several things but never migrain. Did have some limited success with nystagmus though.

Chip

As an interesting aside, I too have seen some success with pinhole sclearal contacts (or wide diameter rigids, 15mm+ sort of things) in patients with albinism presenting with nystagmus - I think there is some tactile response that retards nystagmus and an increase in acuity was recorded compared to that in specs. Duly noted about the different tints right and left too, thanks.

You may want to look into the ziess Z1 blue glass lenses.

I think there have been some studies but it's been a long time since I had access to that info. My recollection is a light blue tint is supposed to help with migraine sufferers.

Incidentally, I've gotten some feedback from this patient about how the different tint samples have treated him - he randomly sampled them at different times and this is what he thought;

"I went to the shopping centre last night:
The Amber, Rose & CPF 550 all offered a fair amount of relief/protection - I wouldn't like to rank them in effectiveness.
The green & grey provided some relief but not near as much as the previous one
The blue was better than nothing but not very effective.
And again, the yellow was aggravating."

Sounds to me as though the mid to low end of the spectrum is causing greater photo-phobia than the high end. I put the yellow tint down to the perceived increase in brightness - like a night driving tint is designed to do.

[Fezz]

Thanks for the continued follow up RetroRat!

This is very interesting and I hope it gets worked out!

Keep us in the loop!

[braheem24]

A little left field but is the patient light sensative with either eye patched?

If there is no reason for the sudden light sensativity, it may be an undiagnosed muscle/nerve issue, it would explain uncomfortable lighting as well as the
headaches.

[RetroRat]

A little left field but is the patient light sensative with either eye patched?

If there is no reason for the sudden light sensativity, it may be an undiagnosed muscle/nerve issue, it would explain uncomfortable lighting as well as the
headaches.

Interesting you should say that, I am going to look into this as well. I was thinking something like an interocular latency difference (or one eye processing data at a different rate to the other) as a potential explanation.

I was also going to see if flooding his other senses makes any difference as well, see if his eyes are just trying to process too much data at once. Perhaps something distracting, like music through an ipod, will make a difference.

At this stage, until I can set up a proper color space to assess his tolerances in, the 'left field' is something I'm willing to worth within


Will keep you posted

[chip anderson]

From what I have read certian filters may cause migrane, others may filter out the offending wave lengths.
I have also read that the "Certian filters" may vary a lot from case to case and can only be determined with a lot of experimentation and evaluation.

I've also read that the above is a lot of BS like dyslexia tints and the Bates method.

Depends on which "scientists" really are scientists whom you believe.

Chip

[RetroRat]

From what I have read certian filters may cause migrane, others may filter out the offending wave lengths.
I have also read that the "Certian filters" may vary a lot from case to case and can only be determined with a lot of experimentation and evaluation.

I've also read that the above is a lot of BS like dyslexia tints and the Bates method.

Depends on which "scientists" really are scientists whom you believe.

Chip

Only time will tell Chip.. I like to believe in 'whatever makes the darn thing work again'!

[sharpstick777]

I don't think there are any scientific studies that claim tinted lenses of any color prevent, treat, or ameliorate migraine headaches, or the circumstances that cause migraine headaches. I can believe that someone who is light sensitive might feel better with tinted lenses though...whether they have migraines or not. But the matter does deserve some clinical attention, observation and anecdotal evidence.

I managed a clinic with a teaching Opthalmologist who saw many post accident victims and neurological surgury patients who exibited extreme light sensitivity. Although the study did was in-house and small, we did apply general study prinicples and there is evidence that a significant amount of photo-phobic patients benifited from tints. Over 60% of the patients exibited some relief, and in 40% that relief was significant.

Corning did the only study I could find, and it was done in the 1970's. They found 4 colors had the most effect and developed 4 tinted lenses in response. I cannot remember their total outcome percentages.

We found that taking a Brown A Polarized and adding red and yellow of various hues was more effective than the Corning lenses, at reducing occular pain and headaches. Over all among photo sensitve patients we found 3 causations that effected discomfort. Blue-light (in varing spectrums), Polarized light, and total amount of light. Different patients exibited varing degrees. One patient was so bad that we ended up doing fit-overs on top of very red 3 lenses to reduce discomfort.

There was a higher rate of success with patients who were post accident or trauma (some type of neurological damage or tumor, etc) than patients who were idiopathic for photophobia. Idiopathic patients had only half the success rate of patients with some kind of pathology or trauma. Thankfully many patients had a decrease in sensitivity over time.

The difficulty was that different patients seemed to benefit from different colors, so some experimentation was involved for each patient. The tints most benificial were yellow, oranges and reds. Corning used to sell a set to allow screening. We tinted our own lenses and held them over the patient in different combinations to find out what colors brought the most relief.

Hope that helps. No copy of the Corning study, but they used to sell a set of 4 color lenses to treat photophobia and had a white paper along with it. Maybe someone else has that box still kicking around?

[Steve Machol]

I did find this article which claims that POTs (precision optical tints) are effective in reducing migraine symptoms:

Science shows how precision-tinted lenses fight migraines

The abstract is here, but they charge for the full article.