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Thread: Sunglasses after Cataract Surgery

  1. #1
    Rising Star Lori's Avatar
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    Sunglasses after Cataract Surgery

    Hey Everybody!

    I want to boost our Plano Sun sales and intend to market the Post Op Surgery Crowd, and the doc's going to help by recommending in the room!

    I'm curious about the 'buzz' words ya'll use and whether it includes polarized or not. I don't sell polarized lenses to everyone; kind of depends on their needs.

    Thanks!

  2. #2
    What's up? drk's Avatar
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    I think it's a good idea to wear sunglasses when you have new, clear IOLs.

    I don't think this group would particulary benefit from polar any more or less than anyone else. I would offer it to anyone, if you stock it.

    I think tint color would be a factor, too. Gray or brown.

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    You should be aware of this recent paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511652/

    Most IOL already have UV protection. So, don't pitch UV too hard for this group.
    Vitor Pamplona
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    Quote Originally Posted by vfpamp View Post

    Most IOL already have UV protection. So, don't pitch UV too hard for this group.

    Most ECPs recommend UV protection for the entire eye area, not just passing through the lens/IOL.

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    Quote Originally Posted by Kwill212 View Post
    Most ECPs recommend UV protection for the entire eye area, not just passing through the lens/IOL.
    Yep. That's why I said don't pitch it too hard. Most of the prevalence of UV issues are related to Cataracts and Macula Degeneration, which are not a problem anymore after the IOL insert. The patient will be protected against photokeratitis and other less known/prevalent conditions. And in the case of photokeratitis, a UV protection against the patient's activity (welding, snowboarding, etc) is more important than a general sun light UV protection.
    Vitor Pamplona
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    Quote Originally Posted by vfpamp View Post
    Yep. That's why I said don't pitch it too hard. Most of the prevalence of UV issues are related to Cataracts and Macula Degeneration, which are not a problem anymore after the IOL insert. The patient will be protected against photokeratitis and other less known/prevalent conditions. And in the case of photokeratitis, a UV protection against the patient's activity (welding, snowboarding, etc) is more important than a general sun light UV protection.
    You misunderstand. I mean outside of the eye and the surround facial area.

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    Quote Originally Posted by Kwill212 View Post
    You misunderstand. I mean outside of the eye and the surround facial area.
    Isn't UV blocking makeup/skin filter better for those areas? Being applied every day is better than wearing off over time.
    Vitor Pamplona
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    Quote Originally Posted by vfpamp View Post
    Isn't UV blocking makeup/skin filter better for those areas? Being applied every day is better than wearing off over time.
    What's wearing off? You have lost me.

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    Quote Originally Posted by Kwill212 View Post
    What's wearing off? You have lost me.
    Eyeglasses UV coatings wear off on average in about 1 year for a 4hr/day use, faster in the tropics.
    Vitor Pamplona
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    Quote Originally Posted by vfpamp View Post
    Eyeglasses UV coatings wear off on average in about 1 year for a 4hr/day use, faster in the tropics.
    I assume you have a source for that?

    Also who is using UV coatings?

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    Well, there are several papers testing the quality of the UV protection in the market. I remember this one because I was one of the reviewers https://biomedical-engineering-onlin...938-016-0209-7

    I also did test glasses sold in the US myself a few years ago using a similar procedure with similar results. We ended up not publishing because there wasn't anything new we could say...
    Vitor Pamplona
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    Quote Originally Posted by vfpamp View Post
    Well, there are several papers testing the quality of the UV protection in the market. I remember this one because I was one of the reviewers https://biomedical-engineering-onlin...938-016-0209-7

    I also did test glasses sold in the US myself a few years ago using a similar procedure with similar results. We ended up not publishing because there wasn't anything new we could say...

    So it is entirely possible I missed something in this paper, but I don't see anything to back up "Eyeglasses UV coatings wear off on average in about 1 year for a 4hr/day use, faster in the tropics." This paper seems to be aimed at the tests themselves being inadequate in their current state. Both in duration and intensity. It does say this


    "The exposure of sunglasses to the sun may deteriorate their UV protection and alter the category under which they are classified (lenses may become lighter when overexposed to the sun) over time."

    It doesn't cite a source for how much UV deterioration or how long it takes to deteriorate. The other papers I found also said similar things but no cited source for the previous studies. ANSI Z80.3-2015 RESISTANCE TO RADIATION TEST only references change in luminous transmittance after irradiation, not UV degradation. ISO 12312-1:2013 limits to the amount of relative change to luminous transmission, but then stats "the UV requirements for the initial τv shall continue to be satisfied. I don't know what the Brazilian standards say.


    From the paper:

    "In our previous investigations on sunglasses standards, limits and insertion of missing requirements have been suggested for ocular safety. In this paper, we evaluate the degradation of the lenses (category and ultraviolet protection) as sunglasses are exposed to solar radiation for periods considered still within its lifetime. Our study includes 44 unbranded sunglasses: 12 were submitted to a solar simulator (0.46 suns) for 2500 h and spectroscopy was performed every 25 h. The remaining 32 were submitted to a 10-sun solar simulator for 962 h of exposure, and transmittance spectroscopy and UV protection evaluation have been done. These exposure conditions are equivalent to wearing sunglasses for a period over 2 years, for 2 h daily. Standards require 50 h exposure as the aging test. Under this condition, only one lens failed the requirement. However, our longer-term irradiation (sunglasses desired lifetime period exposure) experiment in solar simulator shows that the majority of lenses will eventually fail the standard requirement, suggesting the revision of such aging test.(emphasis mine) Additionally, there has not been any significant alteration on UV protection. Summarizing, current parameters, for the resistance to radiation test for sunglasses on standards, is ineffective for ocular safety within its lifetime. In summary, current parameters for the resistance to radiation test for sunglasses, required by ISO 12312-1 standard, are ineffective for sunglasses average lifetime required by population."

    Also:

    It is also important to understand the lifetime of the optical properties of sunglasses. The exposure of sunglasses to the sun may deteriorate their UV protection...(emphasis mine)


    Where is the data for the above statements in bold? Maybe there was a table or paragraph I missed somewhere, or didn't understand, a reference I didn't read. The other thing about this particular paper that doesn't really jive is that I saw no mention of what type of sunglasses they are referring to, other than plano. Polarized, tinted, material, etc. There are some 20 -30 year old sunglasses I brought out from my basement and tested with two different simple UV meters, that all still showed 0-1% UV transmittance, and show no degradation after years of wearing, plano and Rx. How can this be if they should be unsafe after 2 years for 2 hours per day? I would also like to reiterate my question of, who is using UV coatings? Is there a mass market of cheap UV coated sunglasses I am unaware of that degrades over time, or do all sunglasses lose their ability to safely block UV with prolonged sun exposure? That would necessarily imply that all clear glasses are unsafe to wear in a much shorter time span since they are worn outside much longer than sunglasses for the average glasses wearer, I would assume. Does the average Joe need to replace their Rx lenses every 6 months do to loss of UV protection?

    There has to be something I am missing here. It's probably simple and staring me in the face and I am going to look like an idiot, but it won't be the first time.

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    The study (even though there isn't table to reference the results and the raw data is not available to mere mortals like us) did show that the lenses degraded over time. What they were trying to assess was by how much.

    As you might imagine, this is a fairly complicated subject with the manufacturers heavily influencing the findings of such research. The group that published that paper is working on a new testing procedure: https://www.researchgate.net/publica...g_test_display but with no results yet.

    When we were sourcing injection-molding lens manufacturers for our Phoropter, we were advised by all manufacturers to cover the lenses as much as possible to avoid the degradation of the multiple coatings they apply, including UV. In some cases, the degradation would be 3x faster if the lenses were exposed. So, I do believe such benefits wear off quite quickly when they are not protected by their cases. Material designers for product label makers have a similar behavior.

    Bringing it out of the lab and back to the real life, what will freak you out is that there are huge variations in UV exposure per sex https://www.ncbi.nlm.nih.gov/pubmed/14967793 and other social economic factors. So, if we can agree that UV will degrade, the question of by how much has a bigger correlation with their lifestyles than with their locations, but it will certainly include a factor of both.

    Our internal data shows that patients that came in with 2+ year old sunglasses and said in a survey that they wear them for "extended periods of time (+2hrs)", had a significant degradation of UV protection to the point we would offer the advice to replace them. We did not separate brands for this study.
    Vitor Pamplona
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    Master OptiBoarder optical24/7's Avatar
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    Quote Originally Posted by vfpamp View Post



    When we were sourcing injection-molding lens manufacturers for our Phoropter, we were advised by all manufacturers to cover the lenses as much as possible to avoid the degradation of the multiple coatings they apply, including UV. In some cases, the degradation would be 3x faster if the lenses were exposed. So, I do believe such benefits wear off quite quickly when they are not protected by their cases. Material designers for product label makers have a similar behavior.

    .
    Would that be necessary if your phoropter lenses were made of glass? What material do you use?

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    Quote Originally Posted by optical24/7 View Post
    Would that be necessary if your phoropter lenses were made of glass? What material do you use?
    I think glass cannot block 100% of UV, similar to CR-39. It requires coating to comply with current safety standards.

    Poly is 100% UV blocking by default.

    Triacetate (cheap sunglasses) block about 40 percent UV
    Vitor Pamplona
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    You’re worried about uv blocking lenses in phoropters? I would think pristine optics would be a bigger priority in a phoropter, unless it’s designed for performing refractions outdoors.

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    Quote Originally Posted by vfpamp View Post
    I think glass cannot block 100% of UV, similar to CR-39. It requires coating to comply with current safety standards.

    Poly is 100% UV blocking by default.

    Triacetate (cheap sunglasses) block about 40 percent UV
    I would like to see the "safety standard" that requires UV protection?

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    Quote Originally Posted by optical24/7 View Post
    You’re worried about uv blocking lenses in phoropters? I would think pristine optics would be a bigger priority in a phoropter, unless it’s designed for performing refractions outdoors.
    About 30% of our customers use the device outdoors even though we do not recommend such use. UV is a minor discussion point, but still there.
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    Quote Originally Posted by Don Gilman View Post
    I would like to see the "safety standard" that requires UV protection?
    ANSI Z80.3:2010 Non-prescription sunglasses and fashion eyewear (up to 380nm)
    ISO 12312.1 Eye and face protection – Sunglasses and related eyewear (up to 380nm)

    AUSTRALIA: AS/NZS1067:2003 (required up to 400nm)
    EUROPEAN UNION: EN1836:2005 + A12007 Sunglasses and fashion spectacles (380nm)
    China (PRC) GB xxxx-1-20xx1 Eye and face protection - Sunglasses and related eyeware -Part 1 Sunglasses for general use (required up to 400nm)
    Brazil: NBR ISO 12312-1; 2015 (required up to 380nm, but with 400nm in a new draft)

    The ANSI and ISO texts are base for extended regulations in virtually every country. Generally speaking, the UV requirements for country-specific regulations are tougher than the ISO/ANSI standards.
    Attached Thumbnails Attached Thumbnails tab_1_oconnor.jpg   tab_2_oconnor.jpg  
    Last edited by vfpamp; 01-28-2020 at 09:52 AM.
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    Vitor, I hope this doesn't fall on dead ears.

    I know ODs that purchased your devices as inexpensive autorefractors, and I find that perfectly wonderful.

    However, please do not market it as a Do-It-Yourself vision exam.

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    Quote Originally Posted by drk View Post
    Vitor, I hope this doesn't fall on dead ears.

    I know ODs that purchased your devices as inexpensive autorefractors, and I find that perfectly wonderful.

    However, please do not market it as a Do-It-Yourself vision exam.
    Thank you!

    We try to be careful on the use of the words. We know the US convention of "vision exam" is much more than a refraction and we do not intend to confuse such definitions.

    However, keep in mind that we operate in 135 countries at the moment and marketing materials for those countries reflect the local regulations, not the US regulations. For instance, certain Canadian states allow Opticians to refract (vision test as they call). In Mexico, Optometry is grossly underdeveloped (6-month course) to the point that we frequently have to teach the basics of Visual Acuity to Optometrists. In Brazil, Optometry is technically forbidden (also underdeveloped), so most of the materials are for MDs. Pharmacists can refract and sell glasses in the Netherlands. And in Japan, there's no eyeglasses prescription (only measurements from auto-refractors). Cyprus, Denmark, France, Slovakia, Spain and United Kingdom as well as Iceland, Liechtenstein and Switzerland consider the profession of ‘optician (dispensing optician)’ a healthcare profession, Austria, Croatia, Germany, Luxembourg, Netherlands - a craft profession and Czech Republic and Lithuania - a trade profession; which mostly defines what they can and cannot do including how to call what they do. Estonia, Lithuania, Poland, Portugal and Romania don't regulate either opticians and optometrists.

    So, it's hard to make everybody happy when there are so many different cultures using the same words as we do in the US. But we try our best.

    On the Do-it-Yourself part, many of our OD clients offer our devices to patients as a way to do it themselves when needed. We see more of this behavior in professions and conditions that require constant assessment of refraction, like athletes, the military and treatments or drug trials that require measuring refraction constantly by the patient.
    Last edited by vfpamp; 01-28-2020 at 11:41 AM.
    Vitor Pamplona
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