Now that summer has mostly arrived, I think that it’s important that we talk about how to protect our eyes from ultraviolet (UV) damage. For many of us, summer time is when we spend the most time outside as children, adults, and seniors. It is important that at all ages we protect our eyes from UV to preserve and protect ocular structures from damage that can result from UV exposure.
There are different types of UV rays and different ways to protect our eyes. The sun emits mostly UVA and UVB (more UVA than UVB). UVA (long wave) is the portion that contributes most to tanning, but also aging of the skin and skin cancer. UVB has shorter wavelengths and can cause sun burn (usually the more harmful of the two due to higher energy levels) – mostly absorbed by the ozone. We need to remember that it is not only the structures inside the eye that need protecting, but the skin around the eyes that needs protecting as well – unless you like wrinkles. Naturally, the cornea (front surface of the eye) absorbs UVB and protects the retina (back sensory structure of the eye) from damage. However, this does not mean that UVB does not damage the cornea and can still damage the retina if it manages to penetrate that far. UVA penetrates deeper into the eye and can cause injury. Neither UVA or UVB has been shown to be beneficial to the eye. UVC also exists but is completely absorbed by the ozone layer and atmosphere so we need not worry about this sub-type.
UV radiation plays a role in various ocular disorders including:
- age-related cataracts
- skin cancer (around the eye)
- age-related macular degeneration (ARMD)
Cataracts are the natural clouding of the lens inside the eyes that occurs over time. We all eventually get cataracts and need to have them removed surgically so we can restore our vision but the rate at which cataracts grow is where the variation occurs. Those of us who spend more time outdoors without UV protection are more likely to require surgery sooner since the cataracts grow faster. In North America, it is common to require the surgery later in life (around 65+); however, when I was providing eye care to small villages in Africa, I was finding that there were people that required the surgery at age 40. Protecting their eyes from the sun was such a foreign concept over there and they had no idea that they were slowly losing their vision because of it.
Pterygium and pingueculae are benign growths that occur on the surface of the eyes (white part). For the most part they are harmless and don’t cause problems. When they grow large enough however, pterygium can grow on to the cornea and into the visual axis to block our vision and pingueculae can grow large enough to cause surface irregularities. When they become problems, they can be removed but the eye is not returned to the state it was prior to the growths; there will be scar tissue and surface abnormalities. These are commonly found in people that work outdoors. I purposely did not include pictures of these since they are not the prettiest things to look at – especially up close but feel free to Google away!
Skin cancers can occur anywhere, including the eye lid. Because the skin surrounding the eyes is extra sensitive, it is important that we protect this area from UV damage. As I mentioned before, UVA is responsible for skin aging as well so for those of us who don’t want wrinkles here, I would highly advise the use of a moisturizer with sun screen, sunglasses, and the use of eye creams before bed.
Photokeratitis is pretty much sunburn to the cornea that is reversible resulting from excessive UVB exposure. This usually happens to people that spend long hours on the beach or snow without eye protection. You will definitely know if you have this because it is extremely painful for 1-2 days and can result in a temporary loss of vision (the cornea is very sensitive).
Age-related macular degeneration is a disease that is enhanced by UV radiation. Those of us who have it or are predisposed due to genetic factors should definitely have UV protection on when outdoors since there is no cure for ARMD. The damage that results from ARMD is often not reversible. I won’t go into details about it as it can be a blog post all on it’s own.
How can we protect our eyes from UV? Follow these rules and you should be set:
- wear sunglasses labelled 100% UV protection or UV400– these will block both UVA and UVB
- wrap styles provide better coverage than other styles since the sun can still sneak in from the sides and top/bottom of glasses
- if you wear contact lenses, switch to UV blocking contacts (ask your eye care provider for which brands do and don’t block UV) – sunglasses still required though but layers of UV protection is always better
- wear a hat – broad-brimmed work best
- clouds don’t block UV light – sun damage can occur ANYTIME there is sunlight (not only in the summer)
- the sun is most intense mid-day to early afternoon, at higher altitudes, and when reflected off water, ice or snow
- REMEMBER THE KIDS!!!!! If you’re wearing sunglasses your kids should also be wearing sunglasses (as humans, most of our time spent outside is when we are kids – 70% of lifetime exposure is when we’re young). Also, the lens inside the eyes is more vulnerable when we’re young so more UV rays are penetrating deeper!
Thank you to my best friend Kelsey for this week’s topic! Comment if there’s anything you would like to learn about.