Precision Optical Filters in Managing Light Sensitivity and Migraine Symptoms

Precision Optical Filters in Managing Light Sensitivity and Migraine Symptomsms

The Role of Eye Care Professionals in Managing Light Sensitivity

By Dr. Harbir Sian , BSc, OD

As eyecare professionals, we play a crucial role in recognizing and managing many systemic diseases and chronic conditions. In recent years, research on light sensitivity has shown that it can be an indicator of various underlying ocular or neurological conditions. And now we have the opportunity to be the first line of defense in identifying, treating, and managing light sensitivity and the related condition.

Understanding Light Sensitivity and Migraine

Photophobia is remarkably common, potentially affecting as much as 20% of the average population, and it can be extremely debilitating. Though there are many causes of light sensitivity, it’s highest prevalence is amongst people with migraine. Research has shown that as many as 90% of migraine sufferers experience light sensitivity either continuously or during a migraine attack.

Commonly, migraine is misunderstood as a simple headache. However, migraine is a genetic, neurological disease that affects almost 15% of the population -- over 1 billion people globally. Migraine’s prevalence and severity has established it as the 3rd most prevalent disease in the world and the 6th most disabling, according to the World Health Organization. Migraine can be so disabling that those suffering a migraine episode are often incapable of pursuing activities of daily living.

While a throbbing headache is common, a combination of various symptoms can debilitate someone during a migraine attack. Symptoms often include light sensitivity, nausea, and brain fog, to name a few. Migraine pain is generally experienced as a severe headache, typically isolated to one side of the head. Migraine episodes can be triggered by various external and internal factors, and while research into migraine continues to expand, there is still no known cure for this disease. The only option for people with migraine is to control for migraine attack triggers or to manage symptoms.

What is the Relationship Between Light Sensitivity and Migraine?

It’s important to understand the relationship between light sensitivity and migraine to provide a comprehensive therapeutic approach. Light sensitivity is seen in almost 90% of people with migraine and 40% of these patients experience constant light sensitivity. Light sensitivity can be a predictor of an oncoming migraine attack as well as a predictor of how well one would respond to treatment. When light sensitivity is present, people with migraine tend to respond better to treatment than those without it.

In the Migraine in America Symptom and Treatment Study 2018 (MAST), researchers identified light sensitivity to be “the most bothersome migraine symptom”. This substantiates how important it is to control light sensitivity as well as how potentially effective light mitigation can be.

The Link Between Light and Pain

Light is known to precipitate migraine attacks in up to 60% of people. Light exposure can also prolong and worsen the intensity of an attack.

In the last decade, there has been an increase in light sensitivity research on migraine subjects. What we know today: • Specific wavelengths of light can either worsen light sensitivity and light-triggered migraine headache pain or soothe it. • The painful wavelengths of light are found in the blue (480nm), amber (590nm), and red (627nm) range of the light spectrum. • The soothing wavelengths are found in the green range (520-540nm). • The painful light specifically triggers certain cells in the retina, known as Intrinsically Photosensitive Retinal Ganglion Cells (ipRGC), which contain the photopigment melanopsin. When released, melanopsin acts through pain pathways in the thalamus, creating light related pain. A narrow band of green light has been shown to soothe migraine headache pain.

The science proves that preventing melanopsin secretion with light mitigation can improve light related pain. By filtering blue, amber and red wavelengths of light, while allowing in the soothing green wavelengths of light, light related pain will improve.

Lack of Proven Options

Historically, options available to those experiencing photophobia were scarce. Available options included dark sunglasses (which can cause chronic dark adaption), tinted or blue light blocking lenses, and FL-41 lenses (originally created to reduce the impact of flickering fluorescent light).

What these options have is common is they lack an objective study proving clinical and statistical significance around managing light sensitivity and its associated pain. The knowledge gap around the mechanism of action also contributed to ECPs potentially recommending options that didn’t meet a strict level of clinical significance.

A Confused Market

For years, the ECP and consumer markets have had an increase in interest around blue light filters. A simple web search will result in numerous vendors selling these filters.

Unfortunately, for the average self-service migraine and light sensitivity consumer, they may believe that these blue light filters are the solution to their photophobia. In fact, simple blue light filters alone haven’t proven clinical and statistical significance in reducing light-triggered pain and/or managing overall light sensitivity. Thankfully, there is now a clear, proven option for us to recommend to our migraine and photophobia patients.

The World’s First Clinically Proven Lens for Migraine & Light Sensitivity

The Avulux lens is a unique, patented, multi-band, precision optical filter. The lens absorbs up to 97% of the most painful blue, amber, and red light while allowing beneficial green light through.

Through an independently run clinical trial, Avulux achieved the highest scientific standard – demonstrating clinical and statistical significance in reducing light sensitivity and light-triggered migraine pain. Over all reported migraine episodes, at 2 hours, 72% of Avulux users experienced no light sensitivity vs 52% for placebo and Avulux wearers reported an average headache pain reduction of 2.29, on a 0-10 pain scale, vs 1.13 for placebo. Furthermore, 36% fewer migraine attacks required the use of medication while subjects wore Avulux compared to placebo, making Avulux an effective non-pharmacological option for our patients.

Avulux is a proven, safe, and effective option for managing photophobia and light-triggered migraine pain. The lens has no known side effects, no adverse events, and it does not distort the wearer’s color perception.

Finally, we have a legitimate, clinically-backed lens that we can confidently recommend to our patients.