Blue light–blocking intraocular lenses (IOLs) trade off rod-mediated visual function for limited protection against acute retinal phototoxicity.1 Twenty-five years ago, I cautioned ophthalmologists and manufacturers that clear IOLs transmitted potentially harmful 330- to 400-nm UV radiation (UVR) to the retina.2,3 Within a few years, most manufacturers incorporated UVR-blocking chromophores into IOLs.4 Eighteen years ago, I suggested blocking violet light in addition to UVR.4 Violet light has substantial potential retinal phototoxicity but little effect on scotopic (nighttime) or photopic (daytime) vision.5- 7 Nonetheless, visible light–blocking IOLs have been introduced only recently in the United States.
The solid line and dashed lines are the transmittance spectrum of a 20-diopter (D) AcrySof UV only–blocking intraocular lens (IOL) (Alcon Inc, Dallas, Tex) and a 20-D AcrySof Natural IOL (Alcon Inc).11 The area between the curves is amount of violet, blue, and green light transmitted to the retina by an AcrySof UV only–blocking IOL but blocked by an AcrySof Natural IOL. Blocked light theoretically decreases rod-mediated visual function and the risk of acute UV-blue retinal phototoxicity.1
The Purkinje shift is the change in peak spectral sensitivity from longer to shorter wavelengths as illumination decreases.7 Thus, rod-mediated scotopic sensitivity (nighttime vision) is much more dependent on violet and blue light than cone-mediated photopic sensitivity (daytime vision).
Thank you for submitting a comment on this article. It will be reviewed by JAMA Ophthalmology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 56
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.