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Welcome to question of the day #336

Eyetools question of the day #336

I work in community practice. The manager has encouraged me to recommend an anti-reflection coating to all patients including those who only need single-vision reading glasses for home-based near-visual tasks. I understand the benefits of an anti-reflection coating for moderate to high prescriptions, high index lenses, for nighttime driving, and for office use, but I can’t see any benefit for a person who needs a low prescription only for home-based near tasks. What’s your opinion on this?

I too can see the benefit of an anti-reflection coating for moderate to high prescriptions, high-index lenses, for nighttime driving, and for office use. An anti-reflection coating will moderate to high-powered lenses look better, cut down on nighttime glare, and reduce glare from office lighting.

I often read that anti-reflection coatings can reduce glare and visual and physical discomfort associated with using computers and other devices with a screen. I haven’t seen any research evidence to back up these claims. If glare from a screen causes visual and/or physical discomfort it is simple to reduce the brightness of the screen through the device’s settings.

When I’m considering whether to recommend an anti-reflection coating for single-vision reading glasses I think about whether the patient has any lens opacities. Lens opacities reduce the amount of light entering the eye reducing visual acuity. Lenses without an anti-reflection coating reflect around 8% of the light incident on the lens. So, the patient loses light through lens reflection and also by absorption and scattering by the lens opacity. Light reflected off the rear surface of the lens into the eye can also cause more glare. I would recommend an anti-reflection coating for home-based reading glasses for people with lens opacities to get that extra 8% of light into the eye to help get the optimum visual acuity and contrast sensitivity.

I also think about whether the patient has early to moderate dry age-related macular degeneration in one or both eyes, and has some useful functional vision. If they do then I recommend an anti-reflection to get that extra 8% of light into the eye to help get the optimum visual acuity and contrast sensitivity.