Blue-Tinted Glasses in Photosensitive Epilepsy in Road Traffic: Protection or Risk?

A patient in his 20s with juvenile myoclonic epilepsy who was receiving anti-seizure medication experienced epileptic reflex seizures triggered exclusively by flickering light. Blue lenses can prevent seizures in up to 90% of cases in patients with photosensitive epilepsy. Consistent with this, wearing blue polarized glasses during EEG photostimulation in this patient resulted in complete suppression of epileptic activity (“photoparoxysmal response”). As a result, blue Z1 lenses were prescribed. This raises the question: Is this patient permitted to resume driving if he remains seizure-free? This is due to the fact that blue lenses reduce the red spectral component of light by 80–90%, thereby impairing the recognition of red traffic signals (Figure). Therefore, international and German guidelines for glasses (DIN EN ISO 12312–1:2022–08) do not permit lenses that reduce the red spectral component by more than 80% or have a light transmittance of less than 92% in road traffic. According to the regulations of the German Federal Highway Research Institute (Bundesanstalt für Straßenwesen), fitness to drive a motor vehicle can only be certified after 1 year of freedom from spontaneous seizures. The risk of reflex seizures must be assessed by a neurologist. Irrespective of whether seizure freedom is achieved, patients who wear the tinted glasses discussed here are not permitted to drive a motor vehicle.

Figure

Figure: a) Photo taken without the lens; b) photo taken with the anti-seizure blue-tinted lens in place, Photo: Prof. Schulze-Bonhage

Dr. med. Lena Bender, Prof. Dr. med. Andreas Schulze-Bonhage, Epilepsiezentrum, Medizinische Fakultät, Universitätsklinikum Freiburg, [e-mail]

Prof. Dr. med. Wolf Alexander Lagrèze, Neuroophthalmologie, Klinik für Augenheilkunde, Universitätsklinikum Freiburg

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by Christine Rye.

Cite this as: Bender L, Lagrèze WA, Schulze-Bonhage A: Blue-tinted glasses in photosensitive epilepsy in road traffic: protection or risk?Dtsch Arztebl Int 2026; 123: 446. DOI: 10.3238/arztebl.m2026.0062

Photo: Prof. Schulze-Bonhage