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Eye Fatigue and Glare

Glare is the single most common complaint from readers. They want to know what causes it and why such sensitivity to sunlight (photophobia) impacts them. Then, they want to know what can be done to minimize or resolve this stressful phenomenon. Note: Glare is not confined to bright sunlight in the heat of summer. Snow glare and computer glare also rank high in causing vision problems.

According to the National Institute for Ocupational Safelty and Health (NIOSH), glare constitutes 50% of users' complaints. Symptoms given by people using video display terminals are: burning eyes, irritated eyes, and blurred vision. Many persons with RP (who seem to suffer more from glare) use light tinted sunshields for indoor tasks including computer work.

The following information on tinted sunshields is derived from Sunglasses", an article by Jeanette Berry, M.A., and Jeffrey Barnett, and which was kindly submitted by Linda Cline, customer representative for NoIR Medical Technologies. It is condensed here for the sake of brevity.

"Eye fatigue is a common problem noted by visually challenged persons. Though it has been associated with infrared radiation, it is more commonly a glare response. Glare is the sensation produced by the reflection of, or over-abundance of visible light within the field of vision. Glare can cause discomfort or a reduction in visual performance. Glare can impact vision by veiling, dazzling or temporarily blinding.

"When the eye is exposed to sunlight, the natural response is for the pupil to contract its opening and the eyelids squint, thus decreasing the amount of light that enters the eye. If glare is present, the eye strains to see objects through the glare. All of this involves a physical reaction of the eye and its surrounding muscles. Over a period of time, eye fatigue induced by this response, also becomes a problem, thus furthering to diminish visual functioning at that time.

"The appropriate selection of sunwear can effectively address the problems caused by the sun's damaging rays and glare- related eye fatigue. ...While all sunglasses filter varying amounts of visible light, many do not protect against the damaging rays that are also present. Paradoxically, dark lenses may allow more UV rays to reach the eye than no lenses at all. By reducing the visible light (shading the eye,) the pupil may enlarge rather than allowing the natural aversion reflexes to constrict it. This then allows a greater quantity of all rays into the eye. The net effect--more damaging rays enter the eye. Unfortunately, the only way to know if a sunglass has protective qualities is to carefully read the promotional literature provided by the manufacturer.

"The important factors involved in accurately selecting sun- wear can be broken down into categories: 1) protection needs; 2) lens type; and 3) lens color and transmission.

"Protection needs would take into consideration any ocular pathology present, the need to protect from UV, or blue light, and the location that the protection needs to be placed (in front or to the side of the eye, etc.,) based on the task needing to be accomplished.

"There are many types of lens materials that can be used in the manufacturing of sunglasses. Some, such as glass, CR-39, and polycarbonate, have inherent protective qualities which, by the use of coating or absorbing additives, can enhance these capabilities. The most common of these is UV protection. It is possible to find some manufacturers who do add IR protection as well, though it is much less common.

"Several types of lenses are available in both prescription and non-prescription sunwear:

"The constant density lens has its color and transmission fixed and is even across the lens. It is best if tinted during the original manufacturing or in the finishing stages of frame assembly. This allows the edges to have the same color as the rest of the lens.

"The photochromatic lens is sensitive to UV rays and is able to adapt to light and dark environments as necessary.

"The mirror lens adds and extra buffer which reflects unneeded light.

"The polarized lens reduces reflected surface glare (such as that of light off of water) by only allowing light to pass through which strikes the lens at a certain prescribed angle.

"Certain ocular pathologies may demand higher or lower transmissions levels. Visual functioning reacts to color, so the correct selection of lens color can enhance residual vision, while a color that is not optimal can significantly decrease visual functioning.

"There is no short and easy answer to appropriate sunwear selection. The determination is ultimately made on the subjective level and is almost unavoidably a trial and error process at the onset. Being an educated consumer is the best way to start. In essence, the key to choosing the correct sun- wear is exploration. Be ready to try new colors or frame features. When narrowing down the possibilities, it may be helpful to remember this equation and its meaning:

PHYSIOLOGY + TASK + ENVIRONMENT = LENS

"Physiology: What type of problems are present at this point in time. What protection is needed.

"Task: What needs to be accomplished while wearing the sunglasses (small detail or general picture.)

"Environment: Type of lighting available (clear, sunny, haze, rain. etc.,) is the lighting direct or indirect (shade trees, high noon, etc.)

"By taking into account these three variables and through careful examination of the available types of lenses, selection of sunwear which not only looks good but works well can be made."

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