Sunlight Exposure and Childrens’ Eyes

While there are cultural and ethnic variances across different parts of the globe which must be respected, shielding children’s eyes from excessive ambient UV radiation in direct and reflected sunlight is extremely important – based on cumulative evidence from epidemiologic human studies and experimental animal studies. Significant long-term damage to eye-related tissues (the eyelid skin, conjunctiva, cornea, lens and in young children possibly the retina) can be caused by UV radiation, and thus can be prevented. Children who have undergone cataract surgery and some with other ocular diseases may be at even greater risk of retinal damage; protective UVA/B blocking glasses are especially important for these children. The best prevention continues to be avoidance of significant sun exposure during the highest risk time periods during the day (typically ‘9 to 5’) and during the year ( e.g. UV radiation reaches its highest level in the Scandinavian countries in June & July ) whenever possible. When outside look for shaded areas and wear brimmed hats. These recommendations do not mean, and should not be understood as sun or outdoor activity is to be avoided at all times; on the contrary clear evidence exists that sunlight is needed for appropriate Vitamin D metabolism and more recently there is some early evidence that myopia progression may be decreased by time outdoors. The advice of a local Ophthalmologist specializing in child eye health should be sought for specific instructions in your region.

With this in mind whenever outside appropriate UVA/B blocking protective lenses in well fitted, safe spectacle frames are valuable for all; particularly in the younger child, adolescent and those who are geographically or medically at higher risk. The lenses should block at least 99% of UVA/B light and meet local protection standards. The spectacles should (1) provide safety when impacted, (2) leave little room for light to enter around the temporal edges, and (3) be comfortable to wear for any age. Parents may look for lenses made of polycarbonate, CR39 type material or meeting local safety standards, and labels stating that the glasses meet ANSI (American National Standards Institute) requirements or block UV absorption up to 400 nm (nanometers). Polarized lenses often provide greater comfort from glare, especially for light sensitive children.

These recommendations include both prescription (tinted or not) glasses and nonprescription sunglasses. Poorly made spectacles, improper lens material, non UVA/B block material or unreliable labels from unknown manufacturers all place the child at greater risk and should be avoided.

 

Evidence and Basis:

Visible light is a small part of the electromagnetic radiation spectrum. Electromagnetic radiation, however, also consists of ultraviolet light (or radiation – UVR) and infrared light (or radiation -IR). The sun represents the largest single source of optical electromagnetic radiation (UV, Visible light and IR). Additionally the majority of lifetime sun exposure occurs under the age of 21.

 

Several factors must be taken into consideration when evaluating the effect of sunlight on the child’s eye:

 

Selected References :

  1. Sliney, D.H. Physical factors in cataractogenesis: ambient ultraviolet radiation and temperature. Invest. Ophthalmol. Vis. Sci. 1986 27, 781-790.
  2. Söderberg, P.G., Philipson, B.T., Lindström, B. Unscheduled DNA synthesis in lens epithelium after in vivo exposure to UV radiation in the 300 nm wavelength region. Acta Ophthalmol. (Copenh.) 1986. 64, 162-168.
  3. Dong, X., Ayala, M., Löfgren, S., Söderberg, P.G. Ultraviolet radiation-induced cataract: age and maximum acceptable dose. Invest. Ophthalmol. Vis. Sci. 2003 44,1150-1154.
  4. Dong, X., Löfgren, S., Ayala, M., Söderberg, P.G. Maximum tolerable dose for avoidance of cataract induced by ultraviolet radiation-B for 18 to 60 weeks old rats. Exp. Eye Res. 2005.80, 561-566.
  5. Taylor HR, West SK, Rosenthal FS, Munoz B, Newland HS, Abbey H, Emmett EA. Effect of ultraviolet radiation on cataract formation. N. Engl. J. Med. 1988; 319:1429–1433.
  6. Cruickshanks KJ, Klein BE & Klein R (1992): Ultraviolet light exposure and lens opacities: the Beaver Dam Eye Study. Am J Public Health 82: 1658–1662.
  7. Taylor HR (1990): Ultraviolet radiation and the eye: an epidemiological study. Trans Am Ophthalmol Soc 87: 802–853.
  8. Soderberg PG. Optical radiation and the eyes with special emphasis on children. Progress in Biophysics and Molecular Biology 107 (2011) 389e392
  9. WHO, UNEP, IRPA, 1994. WHO Environmental health criteria 160. Ultraviolet radiation Human studies: The eye. WHO, Geneva.

World Society of Paediatric Ophthalmology and Strabismus
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Email:wspos@wspos.org

World Society of Paediatric Ophthalmology and Stabismus is a registered Charity with the U.K. Charities Commission (Charity Registration Number ;1144806) (Registered November 2011)

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