Every morning, ophthalmologist Dr. Susan Sarangapani does two things without fail: She applies SPF50 sunscreen to her face, arms, and hands, then puts on sunglasses.
While the sunscreen isn’t too surprising, the glasses, perhaps, are.
However, she wears them for the same reason: to protect herself, but specifically her eyes, from the sun’s ultraviolet (UV) rays.
What’s more, he says, he’ll wear them outdoors all year round, whether it’s sunny or cloudy.
“What people don’t realize is that the eyes are ten times more sensitive to the sun’s harmful UV rays than the skin,” says Dr Sarangapani, consultant surgeon at Luton and Dunstable Hospital NHS Foundation Trust and clinic OCL private ophthalmologist in London. “And failing to protect them can lead to problems, from excessive blinking due to light sensitivity to serious long-term conditions that can cause vision loss.”
“What people don’t know is that the eyes are ten times more sensitive than the skin to the sun’s harmful ultraviolet rays,” says Dr. Sarangapani.
These include age-related macular degeneration (AMD), where the cumulative effects of UV exposure contribute to the deterioration of the middle part of vision, and cataracts, where the lens of the eye becomes cloudy.
“Rays can also increase the risk of cancer both in the delicate skin of the eyelid and in the eyeball itself,” adds Dr. Sarangapani.
While we all know the risk of skin cancer, “people are still surprised when I tell them to wear sunglasses with UV protection, whether it’s a hot, sunny day or not,” he says.
Much of what we know about all of this comes from Australia which, due to its high levels of year-round ultraviolet radiation, has invested years of research into the effects of sun damage and is decades ahead of us in terms of the impact on eye health. .
In 2007, the Australian Cancer Council added the words “seek” and “slide” to its famous “slip, slop, slap” campaign, launched in the 1980s to address Australia’s unfortunate situation of having the highest rates of skin cancer in the world. The decision arose after research carried out in the 1990s by renowned Australian ophthalmologists, Professors Hugh Taylor and Paul Mitchell.
‘They worked with the Melbourne Visual Impairment project and the Blue Mountains Eye study – population-based studies looking at the prevalence, severity and progression of common eye disorders. [such as cataracts, glaucoma and AMD]’ says David Mackey, professor of ophthalmology at the University of Western Australia.
Professor Taylor had also carried out work on sunlight and eye diseases in Australia which showed that indigenous Australians who lived closer to the equator had higher rates of cataracts and pterygium, when lesions appear on the white part of the eye. , and that is also related to increased risk. of skin cancer.
Another study, published in 1989, which looked at the effect of sun exposure on Chesapeake Bay fishermen in the US over time, found a link between their UV exposure and the development of cataracts, pterygium and skin cancer.
This understanding is particularly important for children, whose eyes are at higher risk of UV damage. With larger pupils and clearer lenses, due to younger, healthier eyes, up to 70 percent more UV reaches the retina than in an adult eye.
This has led to eye protection being considered as important as skin protection in Australia; Their impact can be seen in 2021 research published by Professor Mackey and his team into the effectiveness of the sun protection campaign since sunglasses were added. This showed that surgery for pterygium is declining, with a 47 per cent decline nationally, Professor Mackey says.
Every morning, ophthalmologist Dr. Susan Sarangapani does two things without fail: She applies SPF50 sunscreen to her face, arms, and hands, then puts on sunglasses.
“For my part, I certainly practice what I preach and for eight months of the year, when the ultraviolet rays are strongest, I wear a hat and sunglasses.”
Yet in the UK we still seem worryingly ignorant about these risks, experts say.
Dr Paramdeep Bilkhu, clinical advisor at the College of Optometrists, says: “Some people still think that it needs to be hot to have high levels of UV radiation – this is not strictly true, as the levels you are exposed to are also “depend on altitude and reflection.” surfaces, such as water, that rays bounce off.
“The sky doesn’t have to be clear either,” he adds. ‘Ultraviolet rays can pass through cloud cover. The risk of UV rays to eye health is real, even outside of the summer months.’
The intensity of the sun is measured by the UV index, which is usually provided on weather broadcasts or available on the Met Office website depending on your location. This rating is rated from 1, “low,” to 11+, “very high,” but anything above 3 (rated “moderate”) can cause harm, so that’s when you should wear sunglasses.
“While we protect our skin from these rays with clothing or sunscreen, our eyes are continually exposed,” says Dr. Bilkhu.
“Also, as with skin color, lighter eye colors, such as blue, are more prone to UV damage than browns, because they have less pigment to absorb the rays.”
There are two types of harmful rays: UVA and UVB.
‘UVA rays pass through the front of the eye to the lens, and there is a possible link between UVA exposure and macular and uveal degeneration. [i.e. eye] melanoma,” says Dr. Bilkhu.
‘UVB rays carry more energy and are absorbed by the cornea [the clear part at the front of the eye] and exposure can cause what are effectively sunburns to the eyes.
“This usually occurs several hours after exposure and can be painful, causing redness, sensitivity to light and watery eyes, and can cause blurry vision,” says Dr. Bilkhu.
“Fortunately, it’s usually temporary and anti-inflammatory eye drops can help.”
However, prolonged exposure to UVB rays can damage the DNA of cells, increasing the risk of cancer, adds Dr. Sarangapani.
This can affect the eyelid, where the skin is thinnest and particularly vulnerable, or the eyeball itself, although it is rare (with around 851 cases diagnosed annually in the UK).
Uveal melanoma is the most common form of eyeball cancer, affecting the uvea (the middle layer that includes the iris) and can be fatal. Symptoms include a change in pupil size or shape, blurred vision, or eye pain. “Unfortunately, this can lead to removal of the eyeball,” says Dr. Sarangapani.
“However, a simple way to prevent this is to wear UV-blocking sunglasses,” he adds. ‘I use them all year round, but I advise patients to use them from at least mid-March to mid-October.
‘Also protect children above all: babies under six months should be kept completely away from direct sunlight. From six months onwards, babies can wear glasses-type glasses that are secured with an elastic band so that they cannot be removed. From the age of five they can wear normal sunglasses.
When you wear them during the day is also important.
“To protect the skin, the advice is to avoid the sun between 11 a.m. and 3 p.m., when the intensity of UV rays is strongest,” says Dr. Bilkhu.
‘But in the case of sunglasses, it is important to also wear them early in the morning and late at night. This is when the sun is lowest in the sky and your eyes can be dazzled by the glare, meaning they are being hit by ultraviolet rays.’
But you should also wear the right type of sunglasses.
“The easiest way to get it right is to consult your optician,” suggests Dr. Bilkhu, who wears sunglasses when UV levels are high or if the sun is low in the sky, regardless of the time of year. .
Otherwise, there are easy rules to follow.
First, look for the CE or UKCA European standard mark. This means that the lenses meet health and safety standards that ensure protection against ultraviolet light.
Secondly, don’t assume that a darker lens (or indeed a higher price) offers higher levels of UV protection.
“The darkness of the lens has nothing to do with UV protection; the tint simply reduces the brightness of the visible light reaching the eyes,” says Dr. Bilkhu.
If you wear prescription glasses, you can choose photochromic lenses with UV protection, or wear clip-on or flip-up sunglasses. Contact lens wearers should choose products with UV filters. “However, they only protect the cornea and prevent UV rays from entering the eye through the pupil; they do not protect the exposed areas of the eyeball or the surrounding skin, so it is important to wear additional sunglasses,” says the Dr. Bilkhu.
“Wearing sunglasses regularly is very simple and can prevent avoidable vision loss in the future,” says Dr. Sarangapani.
“If my colleagues in Australia, who have been researching this issue for decades, emphasize its importance, so should we.”
