Tints for Migraine patient?

[SharonB]

This patient has a problem with fluorescent lighting - it seems that the flicker effect triggers headaches that can leave her totally debilitated for hours. The on-line research I did gave me some sketchy results (like using Irlen filters....generally done for dyslexia), but then you need an array of tint samples to see what works, and for Rx lenses that is not practical.I know that the flicker issue can also trigger epileptic seizures, and usually very dark lenses can help, but she can't wear dark sunwear in the working environment. Anyone have better ideas?

[fjpod]

A tint will definitely lower ones ability to detect flicker. (Look up critical flicker fusion frequency). I'm not so sure any color is better than another, but I would try a neutral gray...maybe 20%. Can't hurt to try.

[Sledzinator]

BPI says there FL-41 helps.
http://www.callbpi.com/htm_cat/fl41info.htm

[obxeyeguy]

I have some old research on this someplace, and will look for it tomorrow. It was using polarized lenses with higher transmission. IIRC, it also had info on placing the polarized angles 90 off to help alleviate this. I know it doesn't help much for now, sorry.

[SeaU2020]

I have had good luck with polarized "A" tints(they are still pretty dark) and just recently had a teacher tell me she wears her brown photo polar in the classroom and the grocery stores when she has migraine issues. Also we have someone here at the office who is prone to migraines. For her we do not put the flourencent bulbs in the lights directly above her head. Good luck with your patient!

[Robert_S]

Maui HT should do the job, or Vistamesh.

[rinselberg]

Maui HT should do the job, or Vistamesh.

Maui HT:
http://www.prleap.com/pr/122743/

With 25 percent visible light transmission and 75 percent absorption, Maui Jim's new High Transmission lenses – a mellow amber shade – are perfect for early morning and late afternoon activities, for overcast or foggy days – or when the light conditions are extremely changeable. The Maui HT color option provides greater visibility even as it boosts color, contrast and depth of field.

Maui HT lenses are polarized.

Drivewear:
http://www.optiboard.com/forums/show...l=1#post156540
http://www.drivewearlens.com/

Unactivated yellow/green polarizer 37% light transmission. Visible light activation copper color behind windshield ~25%.. UV activation outdoors dark reddish brown ~10%.

So I would think that in this patient's indoor setting, Drivewear lenses (which are polarized) would be somewhere from 37%, down to about 25% light transmission.

If Maui HT lenses would appear to fit the bill here, what about Drivewear lenses? I use them myself. That's why I wanted to offer this comment. But I don't have this patient's symptoms.

Note: I am not a practitioner.

Vistamesh, that's something else entirely:
http://www.hdickinson.co.uk/product_page.php?id=240

[Craig]

This patient has a problem with fluorescent lighting - it seems that the flicker effect triggers headaches that can leave her totally debilitated for hours. The on-line research I did gave me some sketchy results (like using Irlen filters....generally done for dyslexia), but then you need an array of tint samples to see what works, and for Rx lenses that is not practical.I know that the flicker issue can also trigger epileptic seizures, and usually very dark lenses can help, but she can't wear dark sunwear in the working environment. Anyone have better ideas?

We use the FL-41 from Pech and it does help. There is help for these folks, but it needs to be FL-41- not close enough color in your lab. We ar them also make sure the tint does not bleach out.
The study was done in Utah and was told to me by a patient who needed relief from new lights installed at the hospital she works. She was hiding in the closet for a few hours at a time until she go the lenses; no more migraines!

Craig

[MikeAurelius]

If it was glass, I'd say go with Rose 1 or Rose 2.

[AngeHamm]

This migraine sufferer has found no tint that helps with fluorescent flicker. Darker lenses help with the extreme light sensitivity when the migraine is in effect, but fluorescents are hell on a migraine. The issue isn't the brightness, it's the flicker. And a 20% tint doesn't reduce 20% of the flicker, it just dims the whole thing.

[fjpod]

http://en.wikipedia.org/wiki/Flicker_fusion_threshold

There is very little published scientific articles other than CFF threshold can be improved by lowering overall illumination by means of a tint. Fluorescent light flicker can also be virtually eliminated with the use of newer electronic ballasts and not using the older magnetic ones. But this alone does not explain migraine headaches or their amelioration.

[finefocus]

This migraine sufferer has found no tint that helps with fluorescent flicker. Darker lenses help with the extreme light sensitivity when the migraine is in effect, but fluorescents are hell on a migraine. The issue isn't the brightness, it's the flicker. And a 20% tint doesn't reduce 20% of the flicker, it just dims the whole thing.

One thing I have found to help in these cases (I've had several) is a visor. The flicker is obviously still there, but is reduced in apparent magnitude when it is indirect (reflected from walls, desks, etc.) rather that direct from the light fixture.

By the way, I contacted Irlen, asking which tints might be useful, and got: no direct answer, a sheaf of tint samples, and a solicitation to buy half-a-thousand paper products in my chosen color. Trial and error seems to be their thing.

[sharpstick777]

Although tints don't reduce the flicker per se, they reduce the varience between stages so the flicker is essentially less noticable. As well, older floresence put out more short wave blue, so a yellow/orange tint will reduce the blue irritation. You have a double whammy with older flouresent lights, and its difficult to determine which is worse, the flicker or the blue saturation.

In an MD practice many years ago we found that tint will reduce migraines in about 60% of patients, but you have to experiment to get the prefect color, there was no one color that worked for every patient. Then there is that 40% who sees no improvement for unknown reasons. The darker the tint the more benefit there was, esp around 30%.

Is the flicker in your patients workspace? They may have legal recourse with a Drs. note, which would require the employer to upgrade to full spectrum electronic ballast flouresence. Heck, our local power company came through and changed all our lights for free many years ago in a power saving move, it was funded by the savings on our power bill.

The other way to reduce flicker is introduce non-flouresent light in the enviroment. So LED and Halogens worked the best, using 2 desk lamps, one on each side of the work enviroment. Again, in some states the employer may be required to provide those lights.

In most cases a combination of elements has the greatest effect.

As well, the Chemistrie magnetic layers could be a great tool to allow your patient to switch "tint" depending on their enviroment, without multiple pairs of eyewear. You may have to have a plano layer custom ground, and then tinted, once you find the color thats best. It would be the most flexible solution.

[Jacqui]

I have always used a black gradient, sometimes also with pink on the bottom. Seems to help most people including me.

[Robert_S]

Vistamesh will help with flicker. At least,it should.

[Chris Ryser]

The Vista Mesh lens has a micromesh filter built into the lens which acts in the same way as a Polarizing filter. Vista Mesh lenses are also available as sunglasses - click here. The micromesh filter elimates flicker, reduces glare and deflects EMI (electromagnetic interference) radiation - all of these things can cause problems for PSE and Visual Dyslexia sufferers

See all of it ---------------> http://www.hdickinson.co.uk/product_page.php?id=240

[SharonB]

Thanks for all of the suggestions - Not sure which approach to take first, but the "kiss" principle tells me to start with a tint rather than Vista Mesh (for expediency). Also, she could try the visor. We can always go to more sophisticated solutions later. I'll report back when I know how things are going with her.

[Robert_S]

Vistamesh is honestly not particularly sophisticated, nor is it expensive. But you're right that a tint would be the easiest approach. The problem is then choosing the correct tint. You mentioned the flicker effect in your opening post... Just be aware that a tint won't truly address that issue. Good luck with your patient!

[fjpod]

Tinting DOES reduce the human eye's ability to see flicker. Whether or not it will help Migraine headaches is anyone's guess.

[Robert_S]

Obviously it does reduce flicker to some extent. I did qualify my statement with the word 'truly'.

[SeaU2020]

I hope you are talking about the "usual" flicker from the lighting. If it is faulty, the FIRST step would be to get it fixed.

[kelanor]

Is she in a mostly stationary position at work?

My thought would be to see if she can get a "reasonable accommodation" from her workplace to get a different overhead lighting. She'd probably need a note from a Dr.; but some work places are pretty good about that kind of thing.

[fjpod]

I hope you are talking about the "usual" flicker from the lighting. If it is faulty, the FIRST step would be to get it fixed.

absolutely.

[Chris Ryser]

So funny that nobody goes back in time to see what the optical world did to cure a problem when it first popped up. Nobody seems to realize that the problem started when gas filled light tubes started to become popular in the 1940s and 1950s with the blueish day light tubes.

American Optical came up with their "Cruxite A/B and C", and Bausch & Lomb with their "SoftLight" 1 / 2 / 3, lenses which became the most sold addition for reading glasses at the time.

These days you can dip the lenses into the dye pot and solve the problem in a couple of minutes and make some money doing it.

[MakeOptics]

If you look at spectral curves of GE's most popular fluorescent tubes you'll find that you have particular peaks that could be messing with your patient. Try filters or tints that eliminate those specific bands that are found to be the issue. BPI does make a lorgnette set to test out their therapeutic tints. Also a 20% tint should be a good choice, you don't want to eliminate the blues which is what most of these dyes effect otherwise you could effect the cues to the circadian rhythm and then you have gotten rid of the migraines to replace them with a grumpy insomniac. Anyway another tint option is BPI's EVA tints they do help with the peaks in fluorescent tubes. I am including their spectral curves here to see if that sheds any "light" on the situation.