Cumulative UV on the Eye UV Eye Damage may Effects be invisible, but itof is there!
Chronic UV light exposure may contribute to aging processes in the eye An Australian group of researchers, led by Professor Minas Coroneo have developed a method to detect precursors of ocular sun damage, using ultraviolet fluorescence photography (UVFP). Presence of areas of increased fluorescence was detected by UVFP, or presence of pinguecula was detected by standard photography.
Percentage of subjects with ocular changes consistent with pinguecula
Pinguecula
Raised, yellow-white fibrous growth; usually found nasally. While changes visible to the naked eye are seen using UV fluorescence photography 1 Established on standard photography, as early as thepingueculae, mid-teens, early signs maywere be seen in children as3x young as nine 32 years % of age. More common in areas and activities with high UV seen in 10% of the children; on UVFP, all of these pinguecuexposure, and with environmental lae demonstrated fluorescence (Figure 1). elements In total, 32% (wind, dust). Symptoms include dryness and discomfort – ocular lubricants can help with these. have increased fluorescence detected on UVFP, including the 30% with pingueculae. Of the remaining 70%, the changes were only detectable using UVFP (Figures 2, 3).
0 – Normal
1 – Trace
Fluorescence on UVFP was seen in children aged 9 years and above, with prevalence increasing with age. The presence of fluorescence was 0% for children aged 3 to 8 years, 26% for those aged 9 to 11 years, and 81% of those aged 12 to 15 years.
10 %
2 – Mild
Standard (Control) Photography
4 – Severe
Ultraviolet Fluorescence Photography (UVFP)
UV Fluorescence photography reveals early sun damage not seen in standard photography*
Early Detection Technique – UV fluorescence photography Control photograph demonstrates an established pinguecula
13 year old – early signs of pinguecula visible Left nasal interpalpebral region of a 13-year-old boy with an established pinguecula. withFigure slit1:lamp
Corresponding UV-fluorescence photograph illustrates fluorescence at the side of the pinguecula
Same 13 year old – UV fluorescence photography
Corresponding UV-fluorescence photograph demonstrates an area of fluorescence in the right temporal interpalpebral region
Same 11 year old – UV fluorescence photography shows early signs
photograph 11 year old –Control no signs is apparently normal visible with slit lamp
courtesy of Prof. Minas Coroneo. Figure 2: Right temporal interpalpebral regionPictures of an 11-year-old girl without pinguecula.
Pterygium
3 – Moderate
Detection of early signs of pinguecula in children1 Age group (years)
White light image (visible signs)
UV Fluorescence image ( visible signs)
3-8 (n=27)
0%
0%
9-11 (n=23)
0%
29%
12-15 (n=21)
33%
81%
Corresponding UV-fluorescence photograph demonstrates an area of fluorescence in the left nasal interpalpebral region
Control photograph is apparently normal
Triangular-shaped, vascularised growth onto cornea; more common nasally. Seen from 20’s & 30’s in high UV-environments or activities (e.g. surfers, sailors, fishermen) and related to high UV exposure in youth and dry, windy climates.2 Ocular lubricants will help the symptoms of dryness and theregirlare also cosmetic concerns. Vision can be affected. Figure 3: Left nasal discomfort, interpalpebral region ofbut an 11-year-old without pinguecula.
0 – Normal
1 – Trace
2 – Mild
3 – Moderate
4 – Severe
Photos provided courtesy of: Professor Minas T. Coroneo Department of Ophthalmology, 2nd Floor, South Wing, Edmund Blacket Building, Prince of Wales Hospital, Randwick NSW 2031 AUSTRALIA. * Ooi J, Sharma N, Papalkar D, Sharma S, Oakey M, Dawes P, and Coroneo M. Ultraviolet Fluorescence Photography to Detect Early Sun Damage in the Eyes of School-Aged Children. American Journal of Ophthalmology, 2006 Feb; 141(2): 294 -298.
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Cortical cataract Spoke-shaped cloudiness of internal lens; begins in 40s’ – 50’s and highly related to UV exposure.3 Other key risk factors include age, smoking, diet, medication and general health. Symptoms include blurred vision, haloes and glare with night driving.
0 – Normal
1 – Trace
2 – Mild
3 – Moderate
4 – Severe
Macular Pigment Density A higher level of macular pigment appears to have a protective effect against age-related macular degeneration, a major cause of reduced vision for people over age 55. Chronic UV light exposure contributes to the aging processes in the eye, including macular changes.4 Young children are more at risk from ocular UV exposure when the crystalline lens has little ability to block UV light.5 Other key risk factors include age, hereditary, health, smoking and diet. Symptoms include blurred central vision and can lead to blindness.
Early Detection Techniques Patient Symptoms Low Contrast Visual Acuity
Slit Lamp Examination Retinal Imaging
UV Fluorescence Photography Macular Pigment Optical Density
This is offered as an educational tool that you may choose to use as part of your patiients’ evaluations. These materials are not intended as, and do not constitute medical or optometric advice.