As Southern Californians, we know that exposure to the sun’s ultraviolet (UV) rays can do considerable damage to our skin. But did you know that UV exposure may result in skin cancer on delicate eyelid tissue as well as within the eye, itself?
Cumulative exposure to UV rays also can cause other damage to the eyes, which makes shielding them every bit as important as protecting our skin, says UCI Health ophthalmologist Dr. Mohammad Riazi Esfahani of the Gavin Herbert Eye Institute.
Damage to the eyes results from long-term exposure to UV rays, Riazi says. People with light skin and eye colors are more susceptible; pigment in darker skin and eyes tends to absorb the UV rays, acting as a protectant.
UV effects on the eye
There are three types of UV radiation:
- UVC, which has the highest energy but is mostly absorbed by the ozone layer in the Earth’s atmosphere
- UVB, which reaches the outer layer of the skin
- UVA, which affects the middle layer of skin, called the dermis
Both UVA and UVB waves can causes a host of conditions, such as:
They also suppress the immune system, reducing your ability to fight off these and other maladies.
UV-related vision problems
Riazi, who is also a UCI School of Medicine professor of Ophthalmology, cites some of the most common vision problems related to UV exposure:
Eyelid cancers
Basal cell (the most common) or squamous cell carcino mas appear most frequently on the lower eyelid in people over age 50 who have had repeated, long-term, exposure to the sun. People with weakened immune systems and those who become more sensitive to UV radiation also may be affected. Melanomas, though far less common, can result from intense sun exposure.
Ocular melanoma
Ocular melanoma occurs in the melanocytes within the uvea, the middle part of the eye. It is the most common primary eye cancer and it affects more than 2,500 U.S. adults each year. It can develop in the colored part of the iris and in the choroid, the blood vessel layers at the back of the eye. UV radiation as the cause of this type of cancer is speculative.
Pterygium
This pinkish, benign growth usually appears in the part of the eye nearest the nose and can extend over the cornea. Known as “surfer’s eye,” this condition can affect anyone who spends a lot of time outdoors. Its symptoms can be annoying, but usually it is not serious. Surgical removal may be considered for those that affect the cornea.
Photo keratitis
This is a painful inflammation of the cornea and conjunctiva that results in impaired eyesight, light sensitivity, excessive tearing, red eye and a sensation of grit in the eye. It can be caused by the sun’s reflection from water, ice and snow. It may also result from a work-related injury (welder’s eye). While most cases rarely result in permanent damage, people should see an ophthalmologist who can help ease the painful symptoms with medication and patching.
Cataracts
This progressive clouding and yellowing of the natural eye lens is caused by long-term UV exposure. It is the most treatable cause of vision loss, with more than a U.S. million surgeries performed each year in to remove them.
Macular degeneration
Macular degeneration is the leading cause of blindness in people over age 50. It affects the central vision and makes it difficult for people to perform many daily activities, including reading and recognizing faces. There are two types:
Guarding against UV damage
“Protecting your vision is every bit as important as protecting the skin of your body,” says Riazi.
He recommends taking the following precautions:
- Wear sunglasses: Sunglasses aren’t just for sunny days. Wear them in the shade and on cloudy days when light reflected off shiny surfaces, especially water and snow, can affect you. Wear sunglasses even if your contact lenses have UV protection, since they cover only a small part of the eye.
- Use sunscreen: Apply sunscreen around the eyes and eyelids to shield against skin cancers, skin discoloration and premature aging of the delicate skin. Generously apply broad spectrum sunscreen with an SPF factor of 30 or higher every two hours, even on cloudy days, and after swimming or sweating.
- Wear a hat: The brim should extend at least 3 inches over the face maximum protection.
- Reduce time in the sun: Minimize time in the sun, particularly during high UV times from 10 a.m. to 4 p.m. Pay attention to the UV index in your location. In high-UV locations, use more protective measures. When the UV index is low, just wearing sunglasses or using sunscreen may be sufficient.
- Use extra care when taking certain medications: Sulfa drugs and other medications, such as some tranquilizers and tetracycline, can heighten sensitivity to sunlight, so you will need to take additional precautions.
- Pay special attention to children: Children are more sensitive to sunlight and tend to spend more time in the sun. It has been shown that 80% of UV exposure happens to us before age 18. Children should use sunglasses with medium tint and good protection for UV to reduce the light, but not too dark to dilate the pupils. Impact resistant sunglasses with elastic bands are recommended for children.
Choosing the right sunglasses
You needn’t spend a lot of money to get the right protection from your sunglasses, Riazi says.
Here’s what to look for:
- Check the label and choose lenses that block 99% to 100% of UV rays and screen out 75% to 90% of visible light.
- Lens color isn’t important, except that it should be comfortable for you and allow you to see accurate colors, such as the red and green of traffic lights. Polarizing lens may help protect against glare.
- Wraparound sunglasses or goggles are a must at high elevations, where the UV ray exposure is intense, as well as around snow and water, which can reflect 80% of UV light, even on cloudy days. There also are sunglasses that have been designed surfing and water sports.
- People who work outdoors or engage in activities that could result in eye damage should be careful to buy sunglasses whose lenses are made from polycarbonate or other impact-resistant materials.
“Southern California has among the best weather in the world, with an abundance of beaches, mountains and other locales to enjoy outdoor activities year round,” Riazi says. “Protecting our eyes from UV light allows us to fully enjoy Mother Nature’s gifts.”
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