By The Eye PracticePublished On: 5 May 20172.5 min read

Age-related macular degeneration (ARMD) accounts for over half of all irreversible vision loss in Australia. Some key risk factors you can’t do anything about.

These include age and family history. But others – such as smoking and exposure to blue light – are more controllable. One such factor is the type of intraocular lens (IOL) that’s placed inside your eye during your cataract surgery.

Macular degeneration and blue light

The macula is the central part of your retina and the most important. It allows us to see small detail such as reading print and facial recognition. But the light-sensitive cells of this vital part of your eye can become damaged over time due to the cumulative effects of exposure to blue light. In an age of digital screens that emit blue light, we are more at risk than ever of toxicity to the eyes.

But the eyes have ways of protecting themselves. Pigment around the macula absorbs blue light and mops up the free radicals that cause oxidative damage in the eye. The crystalline lens of your eye also acts as a natural blue-blocker, effectively absorbing blue light throughout your life. But what happens when your natural lens is removed during cataract surgery?

Intraocular lenses and ARMD

The artificial lens that’s placed in your eye during cataract surgery is called an intraocular lens, or IOL. It’s a small disc of acrylic or silicon material and comes in a range of designs – many of which include a blue-blocking filter as standard. These IOLs block ultraviolet light and short-wave visible blue light. Since their introduction in the 1990’s, debate has occurred over whether this is a good or bad thing, but it is now generally accepted that the protection of the macula from blue light does not come at a cost.
Once your crystalline lens is removed, the role of blue-light filter is carried out by your cornea (front surface of your eye) and the intraocular lens. By choosing to implant a blue-blocking IOL, your surgeon is giving you the best protection against damage from UV and blue light.

Lowering your risk of ARMD

If you’re in a risk category for macular degeneration and are about to undergo cataract surgery, make sure to discuss it with your surgeon. The simple provision of a blue-blocking IOL may offer protection to your macula that you just won’t get with a clear IOL. Blue-blocking IOLs are more expensive than clear ones, and your health fund / Medicare may not fully cover the cost. Increased out of pocket cost may be a barrier to some people getting these IOLs but we believe they are worth the investment.

References

Blue-blocking IOLs: a complete review of the literature
Henderson BA, Grimes KJ.
Surv Ophthalmol 55:284–289, 2010. 201
Recent studies provide an updated clinical perspective on blue light-filtering IOLs
Davison JA, & Patel et al
Graefes Arch Clin Exp Ophthalmol (2011) 249:957–968