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Tints for Low Vision

Explore how tints or filters can improve vision for someone with low vision, understand different tint types, and learn to choose the right one with our optometrist's comprehensive guide.

 

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There are so many ways to improve the vision of our patients with low vision, one such approach is the use of various tints or colored filters in lenses for low vision. These tints can significantly improve the visual experience for people suffering from conditions like macular degeneration, glaucoma, diabetic retinopathy, and other low vision impairments.

While the exact reason why some people find different lenses improve their ability to reduce glare, improve contrast, or create a calming effect, is not entirely clear, the impact of color on the visual system is gaining traction in the world of specialty eyecare.  As the main organization in this field, the College of Syntonic Optometry states "Syntonics, or optometric phototherapy, is the branch of ocular science dealing with the application of selected light frequencies through the eyes. It has been used clinically for over 80 years in the field of optometry with continued success."

Let's delve deeper into how these tints work and their potential benefits.

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Understanding Low Vision

Before discussing the role of tints, it's crucial to comprehend what low vision signifies. Low vision is a term used to describe significant visual impairment that can't be fully corrected with standard eyeglasses, contact lenses, medication, or even surgery. The World Health Organization classifies low vision based on visual acuity and field of view. The condition can significantly impact a person's quality of life, hindering their ability to perform daily tasks such as reading, driving, or recognizing faces.

Low vision may result in some of the following vision problems:

  • How much of the world we see (field of view/peripheral vision loss)
  • The sharpness of what we see (blurry or hazy vision)
  • Missing parts of the vision (for example a dark spot in the center of vision)
  • Color contrast sensitivity (difficulty discerning one color from another)
  • Night vision impairment
  • Glare

A low vision optometrists goal is to help the patient understand the tools and options available to maximize visual function and improve the quality of life.

Role of Tints or filters in Low Vision

Role of Tints or filters in Low Vision

A tinted or filtered lens works by filtering out specific wavelengths of color, one example that is familiar to most are sunglasses, which filter out light that is in the Ultra Violet (UV) range, 100-400nm. However light as we see it is a combination of the colors along the spectrum, filters or tints, are used to specifically filter out wavelengths along that spectrum. Filter lenses have a color to them, although in many cases the color of the lens is something that the patient enjoys.  While there are generally recommended lenses for different conditions and symptoms, each patient will have a different experience, and part of the process of fitting tinted lenses on a patient with low vision is to assess the effect of a particular filter on the patient.

Tinted or filter lenses, when applied to eyeglasses, can assist in managing light sensitivity, improving contrast sensitivity, reducing glare, and enhancing depth perception. The primary role of tints in the context of low vision is to manipulate light entering the eyes, aiming to optimize the remaining vision. Perhaps the clearest benefit of tinted lenses is the impact on improved color contrast, which, for someone with vision loss from conditions such as Age Related Macular Degeneration, can make a major difference in visual function.

Tints can effectively filter out harmful high-energy visible (HEV) light or blue light, reducing strain and discomfort. They can also enhance specific colors in the visual field, improving contrast and making it easier to discern objects and details. By decreasing glare, tints can help low vision individuals function better in brightly lit environments.

In this article, the authors presented a thorough study on the impact of tinted lenses on a variety of neurological conditions including migraines, autism, photosensitivity epilepsy, cluster headaches, visual snow, stroke, multiple sclerosis, and head injury's. (https://touchneurology.com/headache-disorders/journal-articles/potential-uses-for-precision-tinted-lenses-in-a-neurology-clinic/)

 

 

Types of Tints for Low Vision

Types of Tints for Low Vision

There are numerous types of tints available for individuals with low vision. The choice of tint largely depends on the individual's specific visual needs and lifestyle, and should be chosen under the direction of a low vision optometrist or neuro optometrist.

  • NoIR Ambers: Light #48, Medium #40, Dark #43
    • Significantly increases contrast and reduces glare.
  • NoIR Infrared-blocking Ambers: Light #11, Medium #01, Dark #07
    • Infrared filter
    • Significantly increases contrast and reduces glare.
  • NoIR Orange #68
    • Significantly increases contrast while moderately reducing glare.
  • NoIR Grays: Lightest #20, Light #22, Medium #22, Dark #23
    • Equal reduction of all wavelengths; good for patients who are sensitive to any small distortion of color perception.
  • NoIR Gray Greens: Light #12, Medium #02, Dark #08
    • Infrared filters; good for highly photophobic patients
    • #08 has the lowest possible level of light transmission (transmits only 1% of visible light). Has been favored by highly symptomatic TBI and glaucoma patients.
  • NoIR Plums: Light #88, Medium #81, Dark #80
    • Increases contrast and reduces glare with very little disruption of color perception; very soothing to many patients with glare sensitivity due to a wide variety of etiologies
  • NoIR Topazes: Light #41, Dark #47
    • Increases contrast and reduces glare with minimal/moderate disruption to color perception. Often favored by patients who are averse to blue/purple.
  • Chadwick Roses (true FL-41 filters): Light Rose, Medium Rose, Dark Rose
    • Increases contrast and reduces glare with minimal/moderate disruption to color perception. Often favored by patients who are averse to blue/purple.
  • NoIR Purple #72
    • Yellow blocker; patients often “love or hate” this color. Significant contrast enhancement and glare reduction. Migraine sufferers seem to make up the highest percentage of cases who benefit from this color.
  • Chadwick Blues: Light E-15, Medium E-30, Dark E-50
    • Increases contrast and reduces glare with minimal/moderate disruption to color perception. Often favored by patients who are averse to topaz/rose.
  • NoIR Yellow #58 and NoIR Yellow #465
    • Typically recommended for night driving.
  • NoIR Reds: Light #90, Dark #93, Dark #99 and NoIR Pink #70
    • Typically recommended for Achromatopsia
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Selecting the Right Tint for Your Needs

Selecting the Right Tint for Your Needs

Choosing the correct tint isn't a one-size-fits-all situation. The choice depends heavily on the specific needs and preferences of the individual. For example, someone with a high degree of light sensitivity might benefit most from a gray tint, while a person with macular degeneration might find a yellow or amber tint more beneficial.

In a low vision or neuro optometry practice, we recommend tints based on a comprehensive eye examination and detailed discussions about the patient's needs and lifestyle. Furthermore the patient will try on different filtered lenses to give a subjective evaluation of the impact of the tint.

Evaluating Glare When Selecting Filtered Lenses

During a low vision evaluation for filtered lenses the low vision therapist or doctor may ask some of the following question's:

  1. Do you ever feel that your sunglasses are too dark or not dark enough? 
  2. Do you have difficulty seeing for several minutes when going from outdoors to indoors or vice versa?
  3. Do you feel that your vision is hazy or foggy in some environments more than others?
  4. Do you avoid stores with bright fluorescent or LED lights, or do such stores cause eye pain, headaches, or other symptoms?
  5. Do you tend to prefer much dimmer or much brighter lighting than your friends and family?
  6. Are you bothered by lights that flicker? 
  7. Do you ever wear a hat or visor to keep overhead light from bothering you?
Role of Tints or filters in Low Vision
Low Vision optometry and eye care
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Common Questions

For light-sensitive eyes, a tint that blocks specific wavelengths of light can be beneficial. Amber or yellow tints are commonly recommended by a low vision optometrist, as they can filter out harsh blue light and glare, reducing eye strain and sensitivity. A low vision exam may help determine the exact tint that best suits an individual's needs.
The best tint for eyes varies depending on personal preference and specific visual needs. Some find relief with yellow or amber tints for computer work, while others may prefer a gray tint for general daily use, as it minimizes color distortion. A low vision eye doctor can guide you to the most suitable choice.
Yes, tint can significantly affect vision by enhancing contrast, reducing glare, or altering color perception. Different tints serve various purposes, such as improving clarity in low-light conditions or reducing eye fatigue from bright lights.
While both terms are often used interchangeably, a tint generally refers to the coloration added to a lens, affecting the appearance and sometimes the function of the lens. A filter, on the other hand, specifically alters the wavelengths of light that pass through, providing targeted benefits such as blocking harmful UV rays or reducing glare.
Tinted glasses can be worn while driving, but the legality and suitability depend on the tint's color and density. Light tints that enhance vision and don't significantly alter color perception are typically acceptable. However, consulting with a low vision optometrist or reviewing local regulations is advisable to ensure that your tinted glasses comply with legal requirements for driving.
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Summary

Tints are a powerful tool in a low vision or neuro optometrist's arsenal for helping patients with low vision. The right tint can significantly enhance a patient's ability to navigate their world more comfortably and effectively. While they do not cure the underlying condition, they can in many situations improve the quality of life for individuals struggling with these impairments.

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