PRODUCT SPOTLIGHT NIKON SEECOAT BRIGHT
Functional AR, More Than Just Clear
By Mark Mattison-Shupnick, ABOM
Release Date: August 1, 2017
Expiration Date: August 23, 2019
Upon completion of this program, the participant should be able to:
- Understand the changes that naturally occur to the way we see colors and brightness. This is especially true when there is the reduced illumination of shadows, in different geographies or from the effects of aging on the clear media of the eye.
- Learn the technology and benefits of a new functional AR called Nikon SeeCoat Bright that can improve and brighten colors and vision.
- Know how to incorporate and communicate the benefits of Nikon SeeCoat Bright into your practice.
Mark Mattison-Shupnick, ABOM, is currently director of education for Jobson Medical Information LLC, has more than 40 years of experience as an optician, was senior staff member of SOLA International and is a frequent lecturer and trainer.
This course is approved for one (1) hour of CE credit by the American Board of Opticianry (ABO). Technical Level 1 Course STWJH670-2
This course is supported by an educational grant from NIKON OPTICAL USA, INC.
Patients have an expectation that their lenses will deliver crisp and clear vision. As professionals we recommend AR lenses to ensure that the technology of the lens material and design are delivered with maximum effect. AR lenses improve clarity but as we’ve learned, the functionality of AR can be improved with increasing the number of layers from three to five to seven, using double hard coats for super scratch resistance, adding hydro and oleophobic top layers or as we’ve learned more recently augmented to attenuate blue light.
However, the eye changes with age, there is less light sensitivity, the lens becomes yellow, the color balance shifts, the media can become cloudy, and ultimately, the pupil does not dilate as it did in youth. As a result, seeing bright, crisp and clearly defined objects is also reduced, especially in dim light. That affects the way that we see and the way that we see color. New Nikon SeeCoat Bright is a specially designed clear AR lens for everyday use. It rebalances colors delivered to the eye so that reds become brighter, contrast is improved, and the color-balancing shift that occurs with age is normalized. This course describes the technology, testing and way that an ECP can easily add the Nikon SeeCoat Bright opportunity to any office.
REDUCED COLOR PERCEPTION
As light dims, it becomes harder to distinguish color and the shades of color. In fact, as you know, color disappears when there is little light. The cones require lots of light energy to convert their chemistry to electrical signals to be interpreted by the brain.
In bright light, the peak sensitivity of the eye is 555 nm. However, the peak wavelength of the color perception curve shifts toward the blue-green spectrum (to 507 nm) as light dims. This leads to a dulling of color perception. This phenomenon is referred to as the Purkinje effect. In the older eye, this is exacerbated since the eye may be receiving less light overall.
REDUCED LIGHT SENSITIVITY
After about age 10, the crystalline lens gradually yellows as you age; a successful result of absorbing UV to protect the retina from UV radiation’s accumulated effects. This increasing yellowness reduces illumination. This effect is also combined with a reduced sensitivity of the photoreceptors in the older adult’s eye. As a result, your eye’s ability to perceive color can also change dramatically.
At age 60, the amount of light reaching the photoreceptor cells of the retina is only one-third of the amount seen at age 20. This can affect a person’s ability to do everyday tasks. It might become more difficult to see the difference between blue, green and red clearly.
THE HUMAN REACTION
The brain tries to adjust to the diminished sensitivity to light. But, it also means that we require more light to see well. LED lamps are popular because of their improved illumination, brilliant white color, pinpoint focusing and affordable cost.
We also become more sensitive to glare because for many, light entering the eye is more scattered rather than being focused precisely on the retina. In the aged eye, opacities in the lens, a pre-cataractous lens and cloudy media can further scatter light rather than allowing the production of a sharp image.
Combining these factors, some individuals have a harder time seeing clearly in every light condition and/or distinguishing between certain color shades. Then, in presbyopia, the lens becomes less flexible, may have some opacities and the pupil constricts to increase the depth of focus of the eye by blocking the light scattered by the periphery of the cornea. What in the past may have been just the right amount of light is no longer enough. All of the previous results in less illumination for the photoreceptor cells. You might ask, “Do patients notice the dimming of their world?”
The brain and the way that it creates “vision” are quite amazing. In dim light and/or as the lens yellows, the brain will correct for the reduced illumination by rebalancing color. But, without all the light it needs, some of the objects in the field will be too dark to distinguish details clearly. Look at Fig. 3. The brain corrects for dim light but the definition of the leaves in the background is lost.
RED AND COLOR DIFFERENCES CAN BECOME A PROBLEM
I think the effects that presbyopes and older individuals experience indoors and out, in shadows and in sun, during different time periods of the day are quickly summarized in Fig. 3. As we learned, the Purkinje effect reduces the transmission of red in the human eye. The yellowing of the lens can dull the vibrancy of color and make distinguishing the differences of the shades of blues, greens and reds more difficult. Aging reduces the eye’s effectiveness, and lenses can further complicate the effects.
INTRODUCING SEECOAT BRIGHT BY NIKON
Nikon SeeCoat Bright is a new type of functional anti-reflective (AR) lens that causes a brightening of the red end of the spectrum by increased reds and somewhat diminished greens and yellows. This results in brightened color perception even in dim light conditions. It is an augmented AR, i.e., has been enhanced to do what the best of premium AR lenses do, plus it adds a specific advantage for a large part of the patient population. That means that it can be a more global change to the way that you order and dispense AR especially to a major portion of your patient base.
Nikon SeeCoat Bright is targeted at the over 40 population when the crystalline lens’ yellowing can reduce color sensitivity or when patients complain about poorer vision in dim light. Considering that the majority of presbyopes are older—the Baby Boomer generation are on average approaching 70—that teaches us that the average presbyope in the U.S. is about 63 and has an add that is +2.25 or +2.50. From the U.S. Census from 2011 projected to 2016, 31 percent of the U.S. population is 44 to 64 years of age, 15 percent is 65 or older. That means this product is a large business opportunity since there are many in the patient base that can benefit from it.
This new coating technology brightens and improves contrast for wearers, for those who experience reduced light transmission. This unique transmission works with the cones’ sensitivity to reduce certain wavelengths while not affecting others so that the interpretation of color by the brain is changed. What is the effect on vision? Reds become more vibrant, backgrounds appear brighter. When the glasses are tried on, there is an immediate observation of some brightening. But since vision occurs in the brain, it is expected that the full effect of the lens would be apparent after a short wearing period. Its positive effects can be more noticed when the eyewear is removed.
Look at the transmission curve of a SeeCoat Bright lens in Fig. 4. This change to the resulting transmission curve changes the wavelengths received by photoreceptor cells in the retina. Since the interpretation of color is a product of the mix of wavelengths delivered to the brain, those colors can affect the brightness of red. The result alters the Purkinje Shift so that the peak of sensitivity again shifts back toward the red and therefore allows a more vibrant red.
In addition, as we learned, color transmission changes according to the intensity of light. Under dim lighting, the eye’s perception of color spectrum is diminished; colors can appear dull. This loss of color sensitivity in dim lighting becomes even more notable after the age of 40 as the crystalline lens yellows. Older adults’ eyes may have other clouding of the media. The effect of the SeeCoat Bright color shift “brightens” the world seen, as a result of the lens’ technology, shifting color sensitivity toward the red (Fig. 5). This color supporting technology is recommended for patients who experience difficulty reading or conducting visually demanding activities in dim light. The result is a more natural color perception and increased contrast.
Your experience with lenses that brighten may be yellow tinted lenses. However, yellow lenses have poor cosmetics, the dazzle of the yellow color and its color shift can be annoying and the fact that yellow lenses are typically too dense a tint (too dark) to be safe at night (reduces transmission 20 to 25 percent or more). SeeCoat Bright has only a slight pinkish hue, unnoticeable to the wearer. These new premium AR lenses further enhance any lens’ design attributes.
All SeeCoat Bright lenses are 100 percent UVA and UVB absorbing (except hard resin which is 90 percent absorbing) and include an anti-reflective (AR) back surface that reduces back surface UV reflection into the eye. In addition, the hard coat and AR properties make the lenses significantly scratch and abrasion resistant while the hydro and oleophobic surface makes them easy to clean and stay clean. This significantly improves the life of the lens for the best in patient satisfaction.
SeeCoat Bright lenses were tested on 45 wearers aged 40 to 69 at Queensland University of Technology (Brisbane, Australia) in April 2017. Wearers were asked to describe the lens’ performance for glare contrast sensitivity, distance visual acuity and overall contrast sensitivity plus near vision acuity.
Forty-one of the 45 found improvement with glare contrast sensitivity. As such, the key benefits would translate to improved vision in dim and dark lighting and improved comfort. An improvement in distance visual acuity results in sharper perception of contours as well as better vision under mesopic conditions.
Improvement on overall contrast sensitivity testing provides a patient the benefit of easier reading under low light conditions and an easier ability to distinguish colors. At near, the improvement in acuity translates to a benefit of easier reading under low light conditions and color distinction. Look at the chart in Fig. 7. In all tests, more than half of the wearers found improvement.
FITTING AND DISPENSING
Obviously, there are two ways that one might adopt this new product into your practice. First, the easiest is to replace your current AR with this one especially for those over 40. However, as we know, not all products are the first choice of all patients, all the time. That means that your experience will help determine for which patient SeeCoat Bright is recommended.
Given the unfortunate occurrence of digital eyestrain, blue light attenuating lens properties are a successful opportunity for a patient’s lenses. However, a choice is required since the SeeCoat Bright design cannot also be combined with blue light attenuating lenses. Look at Fig. 4 again. If the blue wavelengths were reduced, the effective change to the various wavelengths transmitted, as interpreted by the brain, would be different.
That means that knowing the questions to ask up front helps refine the decision with the patient. There are some key deciders. Since the majority of patients that would benefit are over 40, it suggests that you consider SeeCoat Bright first unless the patient spends significant time at a computer. It also suggests that the presbyope, with an add of +1.75D and over, seriously considers a pair of computer glasses for near and mid-range. And on that pair of lenses, blue light attenuating lenses would be used. The other patient answer that we are looking for is the patient that says, “I have problems seeing clearly in dim light,” when asked if vision is good both during the day and in the evening.
Ask the patient to answer the following questions; they’ll help you decide whether SeeCoat Bright makes sense. Ask, “Do you feel that colors are not as bright as they used to be, especially in dim light or when it gets dark?” and “Is it easy or difficult to read small letters in dim light conditions?” Problems of dimness suggest that the patient would prefer a brightened world.
Let me digress a bit about color through lenses. As you know, seeing and in fact color recognition takes place in the brain. The cones are sensitive to overlapping ranges of the visible spectrum. If the colors are pre-processed with a filter, a different reaction to the colors “seen” is possible. Think of the new color-enhancing lens opportunities provided by sun lens products like Costa 580, Smith ChromaPop, Oakley Prizm and Enchroma for the color blind. Like those products, recognition takes place in the brain, so if using a demonstrator, be sure the patient takes enough time so they can experience the effect of the lenses. How can you know? I suggest that you wear them yourself for experience since they are available in both single vision and progressive. That ensures that you can talk from firsthand experience.
As the crystalline lens ages, the lens yellows. That means that overall light and blue wavelengths transmission decreases. Therefore, everyone, depending on the lens’ yellowness, becomes less sensitive to blue light. These patients should react positively to SeeCoat Bright and experience a vision improvement. Presenting this positive result helps the patient understand the benefit, and it creates value in the patient’s mind. SeeCoat Bright can be recommended regardless of patient’s working hours in front of a screen. However, it’s a balance. Like many of the lens enhancements we have in our toolbox, we can’t load them all into one pair of glasses. If eye protection is more of value than vision improvement, a blue light-reducing lens can be recommended to satisfy your customer’s preference.
Communicating the message and getting agreement to purchase is like other lens enhancements. You have to ask the right questions. That starts the dialogue to convert a need, issue or concern into a valuable solution. Once there’s value, there’s a reason to spend and patients will want that product. That creates success, word of mouth and increased business.
Ask, “Do you feel that colors are not as bright as they used to be, especially when it gets dark?” or “How do you feel when you read small letters in dim light?” Then answer knowledgeably, “As the crystalline lens ages, the light transmission is decreasing… SeeCoat Bright improves vision and in a wearer test, most participants reported that their sensitivity to red, as well as distance and near vision improved.”
Collateral marketing materials like patient brochures and sales aids are available; in fact, they’re essential. In this way, the patient receives the right sound bites and sees a variety of images supporting the vision experience. Using brochures provides a continuity of message critical for a patient to make a justified decision. Order and use the dispensing mat, consumer leaflet, sales manual, technical manual, and the various visuals and images to make your point.
Patients have an expectation that their lenses will deliver crisp and clear vision. However, the eye changes with age, there is less light sensitivity, the lens becomes yellow, the color balance shifts, the media can become cloudy and ultimately, the pupil does not dilate as it did in youth. As a result, seeing bright, crisp and clearly defined objects is also reduced, especially in dim light. New Nikon SeeCoat Bright is a specially designed clear AR lens for everyday use. It rebalances colors delivered to the eye so that reds become brighter, contrast is improved, and the color-balancing shift that occurs with age is normalized. Nikon SeeCoat Bright is an opportunity for any office.