Welcome to question of the day #260

Eyetools question of the day #260

I know that UV (ultraviolet light) is harmful to the external and internal structures of the eye. Which patients are most at risk?

Eye specialists have known about the harmful effects of UV for many years and have passed this information to their patients. However, I doubt whether many patients follow up this information on UV risk by purchasing and wearing UV protection.

I think a better approach is to target those patients most at risk, with verbal and written information on the damage that UV can cause to external and internal structures and how these can affect the appearance of the eyes and also the person’s long term eye sight.

Overexposure to UV can have short-term effects such as UV keratitis and long-term effects like :

Cancerous growths on the lower lids and skin around the eye



Acceleration of cataract formation

Increased risk of retinal damage.

During the history and symptom taking ask about time spent outdoors. This will help you find those patients most at risk of ocular UV damage.

People who work outdoors are at risk of ocular UV damage. They are exposed to 10% to 20% more UV light than the average indoor worker. UV radiation is usually most intense between the hours of 10 am and 4 pm, typical hours of a dayshift.

Sunglasses are essential even for partly cloudy days. The worst exposure conditions can be with a high sun and light overcast clouds because the clouds further scatter UV radiation to lower elevation angles. It is not widely known that ocular exposure on a partly cloudy day is actually greater than on a clear, sunny day.

Outdoor workers should be advised to use high quality UV protection.

People who don’t work outdoors but are outdoors for recreation even if only at the weekend need UV protection. Walkers, climbers, boaters, swimmers, anglers, runners, cyclists, skiers and beachgoers are at risk

Outdoor recreationists should be advised to use high quality UV protection.

Children often spend more time outdoors than adults, make up another patient population that needs UV-blocking sun protection. Up to 50% of the total UV a person is exposed to by age 60 occurs before the age of 20.

Because the long-term effects of sun damage are cumulative, the longer that people are left unprotected from the sun’s harmful rays over the course of their lifetime, the more likely they will suffer damage to their eyes. Every time a parent applies sunscreen on their child’s face they should also put on their child’s UV blocking sunglasses.

People who wear UV absorbing contact lenses should wear UV protecting sunglasses as the conjunctiva is left vulnerable to UV radiation, as well as the skin of the lids and brow bone. A pair of non-prescription, high quality sunglasses will be of great benefit.

Health-conscious individuals will be interested in protecting themselves from harmful UV radiation, especially those with a family history of age-related macular degeneration and those with other risk factors such as such as fair skin, light eyes and a fair retina. This type of person should be strongly advised to wear sunglasses.

You can go further by showing patients pictures of the diseases caused by exposure to UV radiation. A picture speaks a thousand words.

Personalised prescribed recommendations carry more weight than a blanket statement that UV is bad.

Help patients protect themselves by finding those at most risk and advising them to wear sunglasses when exposed to UV radiation. You will be best serving your patients and ensure the prosperity of the business.