Tinted Lenses post Brain Injury

[kmjackson]

Colleagues,

There is very little literature on this topic and every optometrist (and I suspect optician) who encounters these patients has an opinion (sometimes a strong one) on this issue. FL-41 lenses have some (limited) mention in the headache literature. For those who are inclined to include tint in lenses for post-brain injury patients - how do you determine the tint and the density of tint for the lenses? Is there any science behind your practice on this?

(By the way, if there is no science in selection you are in the majority so no judgement.)

Kevin

[Jason H]

I know specialists in this field. PM me for referrals.

[drk]

It can't be a certain density. Everyone is different.

It probably can't be a certain wavelength. Everyone (and everywhere in the environment) is different.

So...what do you do, practically-speaking?

You have TWO and only TWO versions of only one tint and it works or it doesn't.

The better versions I've seen are dark, like...sunglass dark (80%-ish absorbtion, but 70 or 65 would be OK, right?). They would wear them outside, probably. Some would wear them indoors, too.


NOW, could everyone tolerate a dark pinky-purple tint all the time? Would all migraines require all that darkness? Do people want to look weird? NO!

So for that you have "option 2" or, FL-41 "lite". Maybe 20% (maybe 15%, maybe 25%) absorbtion for them.

[Uilleann]

It still surprises me how few prescribers and dispensers alike are familiar with what a "true" FL-41 tint looks like. Given that it was developed in the early 90's, and was primarily developed and used for crazy flickering greenish fluorescent tubes, and single color CRT computer monitors, it could definitely stand a refresh to an actual modern working environment.

But as the good Doctor points out, a "true" FL-41 is crazy dark, and you'll be guaranteed an almost 100% rejection rate.

[mervinek]

I've been doing this for decades and just found out about the FL-41 last year. I was shocked that I had never heard of it. That being said, I had a TBI patient with chronic headaches and it helped her tremendously! She had been to several places before trying this with us and it was the only thing that helped.

[drk]

Hey, Merv!

I'm gathering experience, too. How dark do you think that helpful tint was? (I'm hoping you say "well, not all that dark".)

[drk]

[mervinek]

Hey, Merv!

I'm gathering experience, too. How dark do you think that helpful tint was? (I'm hoping you say "well, not all that dark".)

To be honest, I had never heard of it and had my lab send me a sample before I met with the patient. (The patient had called asking for it as it was recommended by the neurologist). So the lab sent me a sample and it was darker than I thought it would be. It was also more orangey than I thought it would be.

[mervinek]

I just spoke to my lab and they said it really needs to be at 80-90% density in order to guarantee the therapeutic properties. The tint itself is more expensive and not a standard tint charge. Probably more like double that. We kept it on the lower side here since people really need it, but we did charge more than the usual tint.

[Uncle Fester]

I fear the worst for Ian Jordan who I can no longer locate. I hope he is well and no longer posting due to an ongoing legal battle with the opticians UK Guild. His shop in Ayr Scotland is no longer open. He was outside the box in his work with tints for many conditions and his web site is no longer accessible.
Here's an article sure to be dismissed by many here:

http://www.sulamot.ru/files/5.pdf

And the book "A Professionals Guide to Prescribing Tints and Filters", which I bought a while ago, I can no longer find with a google search.


Can anyone more savvy than me find one on line?

[mervinek]

When I googled him, I found more legal issues that were not optical in nature.

[Uncle Fester]

When I googled him, I found more legal issues that were not optical in nature.

Wow! I haven't goggled the name but just his sites and shop and thought it might be covid related. Obviously not!
That answers that.
What a shame for someone I admired as I thought his work was akin to a Faraday waiting for a Maxwell.

[mervinek]

Yes, that definitely not what I was expecting to see! Sad situation.

[drk]

https://healthcare.utah.edu/moran/optometry/fl41-lenses.php

https://cocoonseyewear.com/product-category/cocoons/sidekick-uv-filters/

https://cocoonseyewear.com/shop/cocoons/fitovers/cocoons-low-vision-uv-filters/cocoons-low-vision-mini-slim-ms-black-frameboysenberry-uv-filters/

[mervinek]

interesting. The FL-41 my lab uses is more of a red orange color than those shown in the article. Those are more purple. I think my lab gets the tint from BPI and it is not a mix of colors that they do in house. They did tell me the tint itself is more expensive than a normal tint so we do charge more. (We don't upcharge our normal upcharge though because it is therapeutic and we just want people feeling better!)