Question: I was just diagnosed with the very early stages of age-related macular degeneration (just turned 58). My optometrist recommended BluTech for my blue blocking prescription eyeglasses as well as MacuHealth supplements. Wouldn’t I be able to use my current prescription glasses with blue blocking over-glasses to protect my eyes from blue light? Or do I really need to get special glasses for macular degeneration? I want to make sure that I understand the data on this site so that I can discuss the best approaches and products for my newly diagnosed early AMD with my doctor.
Answer: Sorry to hear about your AMD. Your question about the inevitability of special glasses for macular degeneration is very relevant. Below you should find important things to consider in your decision between special glasses for macular degeneration and over-glasses (fit-overs, flip-ups, and clip-ons). The focus of this answer will be on blue light filtering properties and effectiveness of the two options. After all, that is the principal goal you’d be pursuing either with special glasses for AMD and/or over-glasses.
– Macular degeneration glasses & blue blocking products guide
– What is the best blue light filter for macular degeneration glasses
– 46 Sunglasses for macular degeneration & Easy decision rules
Like the above-mentioned articles, this post is principally intended for those diagnosed with early AMD who seek blue light filters to protect their retinas from blue light (and to improve contrast sensitivity, ease the adjusting to a dark room when coming inside on a bright day, improve color sensitivity).
Blue-blocking glasses as prevention. If you are reading this because you are concerned about prevention from AMD and no-one in your family has it (parents, siblings, grandparents), you may be OK with weaker blue light filters than those proposed below.
Disclaimer: My interest in blue light and blue light filters is due to my problems with light sensitivity (photophobia), discomfort glare, and computer eye strain. I am not a vision scientist nor a medical doctor. Moreover, I don’t have macular degeneration and AMD is not the primary focus of GLARminŸ.
Disclosure: GLARminŸ earns a small commission (at no additional cost to you) if you use the links labeled (commission link) and purchase a product. Thanks for your support!
Eye supplements: Just briefly about MacuHealth supplements you were recommended. Its formula contains all three macular pigment carotenoids, including meso-zeaxanthin. Your doctor’s advice is in line with the advice given in the above-mentioned article. See also my review of MacuHealth/MacuShield (not specific to AMD) and this article for other macular pigment eye supplements with and without meso-zeaxanthin.
Special glasses for macular degeneration
Special glasses for macular degeneration may be a deceiving term. In reality, they are normal glasses that filter some proportion of blue light to protect the macula from blue-light-induced cell death, i.e. our central vision. Such glasses may also be used for other purposes such as to improve visual comfort when doing computer work or when working under harsh energy-saving lighting, against insomnia, etc…
(For those, with advanced AMD who have lost all or most of their central vision there are several other product options that are also termed special glasses for macular degeneration. Their options appear to include advanced electronics AMD glasses such as these, these, or these. I am not qualified to say anything about those.)
Problem: Prescription blue blockers and low blue light blocking capacity
The biggest problem of glasses for macular degeneration with prescription is that they don’t block significant proportions of blue light. More so special (less common) prescriptions.
You can find spectral transmissions of all major brands (Zeiss DuraVision BlueProtect, Nikon SeeCoat Blue Premium, PFO Global iBlu Coat, BluTech, and Essilor Crizal Prevencia or/and Smart Blue Filter) of blue-blocking lenses for prescription glasses in this article (section 3). Note that, with minor variations, they tend to transmit over 80% of light by about 420nm. This is quite a lot. Remember from section 1 in the a.m. article that the whole range of blue light (400-500nm) appears more dangerous to your retina than the rest of visible light wavelengths. Within blue light, wavelengths 410-460nm are thought to be particularly dangerous (see image below – source).
Therefore, glasses with above-mentioned lenses might be a reasonable option for those concerned about prevention, but since you were already diagnosed with AMD, you should probably consider something more effective at filtering blue light (at least up to 460nm if not all the way up to 500nm).
Problem: Prescription blue blockers and high cost
Another problem with special prescription glasses that block blue light is that they tend to be relatively expensive.
Advantages of special glasses for AMD
The appearance. These lenses tend to be almost indistinguishable from regular, clear lenses. Hence, you won’t get strange looks and questions about the special tint.
Moreover, this type of lenses can be fitted to just about any style of frame – so you can be sure the glasses will be to your liking. (With over-glasses the style options tends to be fewer).
Glasses for all occasions. These can be legally worn in all lighting conditions, including for driving at night*. Driving at night is illegal/discouraged in many countries with stronger blue blockers because our low light conditions vision depends principally on blue light. The above-mentioned lenses tend to be Category 0 ophthalmic lenses meaning that they transmit at least 80% of visible light. (This puts a fairly low limit to how much blue light they can block, which may be one of the reasons why it is hard to get stronger blue blocking lenses for prescription glasses).
* May not apply to all of the lenses mentioned above. Check with the vendor before ordering, if you plan on driving at night with your blue blocking glasses/over-glasses.
How to improve blue light protection on (special) prescription glasses for AMD
Also suggested in the preceding post -sections 3 and 4– as well as in this video from Essilor is that combining various blue blocking technologies (including transitions) in the same lens, you can increase their blue blocking effectiveness considerably.
Unfortunately, such “combination” lenses tend to be more expensive. But, if you want to get this type of lenses you are likely to get good prices and service from ReadingGlassesETC – single vision lenses (commission link), or MojoOptical – multifocal and progressive lenses.
Blue-blocking over-glasses* for AMD
Fit-overs, flip-ups, or clip-ons may be a good option for prescription glasses wearers with AMD. There are several issues to consider when deciding between special glasses for macular degeneration that also block blue light vs. wearing regular prescriptions with over-glasses.
*Reminder: the term over-glasses is used here not only for fit-overs but also for flip-ups and clip-ons.
Advantages of over-glasses
When compared to special prescription glasses for macular degeneration, over-glasses (when combined with your existing prescription glasses) offer several advantages:
More choices in blue blocking profile. Having your prescription taken care of by regular glasses with clear lenses, over-glasses afford you more options in choosing how much blue light you want to filter. In fact, you can find over-glasses that block near 100% of light up to 460nm, 480nm, 520nm, etc. You can also find over-glasses that filter 90% (or less) of blue light up to 470nm and a lot less beyond that wavelength…
Lower cost. The more expensive over-glasses, for example, Cocoons, might cost you up to US$60 (or 70 at most). This is considerably cheaper than a special pair of blue-blocking prescription glasses.
Also, if/when your prescription changes you only need to get a new pair of regular/clear prescription glasses and with your old pair of over-glasses you are protected from blue light. (Normally, blue blocking prescription lenses are more expensive than regular/clear ones).
Another cost issue is if, for any reason, you decide you need more (or less) protection from blue light. Another pair of over-glasses cost far less than special prescription blue blocking glasses (provided that you manage to find prescription lenses that block more blue light).
No blue blocking option. Perhaps this is obvious, but nevertheless. There are situations/environments that are blue-light-safer (when driving at night, or when at home if you have incandescent/halogen lamps, or on cloudy days). In those cases, you might prefer all the light you can get. With over-glasses, you just take them off and go on doing your things.
(Transitions also provide this option because in those environments they tend not to be in the unactivated state or somewhere in between depending on the intensity of UV light – which tends to be correlated with the intensity of blue light).
The decision between over glasses and special prescription glasses for macular degeneration would be too easy if there weren’t also some inherent disadvantages to over-glasses:
Less comfort. Some people find over-glasses, particularly fit-overs, less comfortable to wear. Also, you always need to have with you two pieces of eyewear.
Aesthetics. Fit-overs, in particular, may not satisfy one’s aesthetic standards. Although, if the image of over-glasses you have in your mind is really bad, you might want to make research your options a bit – you might be surprised because some brands (e.g. Cocoons) do have good looking over-glasses.
Image quality. Light passing through two lenses will normally be more distorted than that passing through just one. Hence, using over-glasses one has to live with a slightly lower image quality, although most people notice no difference at all.
If you still can’t decide
With so many variables to consider, it might be very difficult for you to decide. More so, if this is your first experience with blue light filters.
One way to lower the risk of your decision is to go to a near low vision agency. Hopefully, they can lend you blue blocking glasses and over-glasses with different spectral transmission profiles. Take your time for testing (a few days if possible): there are issues that you might notice right away, others require longer testing periods in different environments, lighting conditions and performing different tasks.
Alternatively, you can order GLARminŸ blue light filter Tester kit. It was designed to fit over your regular prescription glasses (if you happen to have particularly large glasses, check Tester’s dimensions before ordering anyhow). The Tester will enable you to test 8 blue light filters with different spectral transmission profiles. Moreover, you may use this table to find glasses or over-glasses with a similar profile to the Tester Filter that works best for you.
Over-glasses that appear most suitable for AMD
If you’ve decided that over-glasses might be your best choice of blue light protection for AMD you can view the full range of your options in this table. If you’d like full protection from blue light, up to about 500nm, as recommended in this guide (section 1), you might focus on the following products:
Cocoons lemon (yellow) non-polarized lens fit-overs, clip-ons, and flip-ups – according to Cocoons it blocks 100% of blue light up to 470nm – hence this lens completely blocks the most critical wavelengths for AMD – moreover, at 86% its overall visible light transmission it is very high, which is interesting for those who need more light to see well;
– Order from Cocoons or you can try to find them in Cocoons Amazon store (commission link).
Spektrum PROSPEK ELITE, amber lens clip-ons (spectrogram) – block 100% blue light up to 480nm and about 90% at 500nm which seems very reasonable to fight your AMD;
– Order from Amazon (commission link) or Spektrum
NoIR #60UV 49% Orange lens clip-ons, flip-ups, and fit-overs (spectrogram) – block 100% blue light up to about 530nm; NoIR has the greatest selection of tints and models – you can view their suggestions for macular degeneration filters here (click on each lens to view spectrograms and available models of glasses and over-glasses);
– Order from NoIR or Amazon (commission link)
LowBlueLights orange lens fit-overs (spectrogram) – block 100% blue light up to about 520nm; Very high overall light transmission (nearly 70% according to fluxometer) for a lens that blocks all light up to 520nm
– Order from LowBlueLights
Cocoons orange (non-polarized) lens fit-overs and flip-ups – according to Cocoons it blocks 100% of light up to 520nm – at 34% overall visual light transmission it might be a bit dark for indoor use – better suited for outdoors;
– Order from Cocoons directly or their Amazon store (commission link).
All of the options above block 100% of blue light up to the cutoff wavelength. If you’d rather use a filter that lets in some blue light you can move further down the above-mentioned table.
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