Photobiological Eyewear in Optometric Practice: A Clinical Decision Framework for Condition-Specific Wavelength-Selective Lens Recommendation in Migraine, Sleep Disorders, and Photic Discomfort

This paper presents a clinical decision framework to assist optometrists in selecting condition-appropriate photobiological lenses based on patient presentation, symptom profile, and time-of-day considerations. Unlike generic blue-light-filtering lenses prescribed uniformly for all light-related complaints, the framework classifies photobiological lenses into three functionally distinct categories: Category A (FL-41, 480-520 nm) for migraine photophobia and light sensitivity, Category B (Amber, 460-560 nm) for circadian disruption and evening sleep protection, and Category C (HEV-selective, 400-450 nm) for daytime screen comfort. We present a structured patient assessment protocol, symptom-to-category mapping guide, light environment questionnaire, prescription lens compatibility table, three representative clinical scenarios, common prescribing errors to avoid, and the dark sunglasses paradox in photophobia management. 6 pages, 5 data tables, 3 clinical scenarios, 20 peer-reviewed references. Authors: Dubey S, Choudhary MAffiliation: Sleepaxa Private Limited, Mumbai, IndiaORCID: 0009-0003-7510-9254