Most parents are careful to spread sunscreen on their children. One risk from the sun that often gets overlooked: damage to young eyes.
Vision-care experts are stepping up efforts to raise awareness of the danger of overexposure to the sun’s ultraviolet rays, which is cumulative and irreversible. Children and adolescents are especially vulnerable to the sun’s rays because their ocular lenses aren’t yet mature and can’t filter UV light as effectively as adults, causing damage to the retina. The average child takes in about three times the annual UV exposure of the average adult, and an estimated 25% of a person’s lifetime exposure occurs before age 18.
Less than half of parents enforce sunglass use for their children, according to recent surveys by the Vision Council, a trade group, and the American Academy of Ophthalmology. Years of overexposure can lead to cancer of the eye or eyelid. It has also been linked to an increased risk later in life for cataracts, a clouding of the lens of the eye, and macular degeneration, the leading cause of blindness in adults. About half of Americans have lighter colored eyes that make them more susceptible to UV-related damage.
“Everyone buys in to what happens to your skin when it comes to sun damage, but many parents are really surprised to learn about the cumulative UV damage to the eyes,” says Dawn Hartman, an optometrist at Columbus Ophthalmology Associates in Columbus, Ohio, who reviews UV-protection issues with parents at children’s visits. Her own 7-year-old son, Andrew, wears impact-resistant prescription sports glasses with UV protection lenses that get darker in bright sunlight.
Vision-care experts are stepping up efforts to raise awareness of the danger of overexposure to the sun’s ultraviolet rays, especially to children. Danielle Crans
Danielle Crans, a spokeswoman for the Columbus group, purchased special sunglasses designed for infants and toddlers for her son Benjamin, who is 1 year old, that are made of a softer, more flexible material easy for them to tolerate. She always makes sure he wears his sunglasses and sunscreen outside. Working for a group of eye doctors, she says, has made her “well aware of the damage that can be caused by sun exposure and the importance of protecting his eyes.”
Parents can’t always enforce sunglass-wearing when children are playing outside or participating in sports and other physical activities that are important for health. “I’d much rather have kids running around outdoors if they’ve forgotten their sunglasses than inside watching TV and eating ice cream,” says Sean Donahue, chief of pediatric ophthalmology at Vanderbilt University, in Nashville, Tenn. Still, he says, “If kids are going to be near the water, sand, beach or snow, it is prudent to have sunglasses, especially if they are complaining that it is too bright.” A hat or visor that shields the eyes can add protection, especially if glare is bothersome, Dr. Donahue says.
For kids, bright summer days at the beach, surfing and sailing, pose the highest risk, as sand and water reflect UV light. In extreme cases, exposure can cause sunburn of the eye known as photokeratitis, which can lead to temporary vision loss. In winter, snow can reflect up to 85% of UV rays, leading to the same affliction, often called snow blindness.
One concern for teens is the use of tanning beds, since many take off the goggles provided to avoid getting “raccoon eyes” and end up with sunburn of the eye. Teen’s eyes, like their skin, may be more light-sensitive if they are taking certain medications like antibiotics for acne.
Researchers are starting to better understand how UV exposure contributes to cataracts. A study by researchers at Case Western Reserve University in Ohio, published in May in the Journal of Biological Chemistry, found that chemical changes induced by years of chronic sunlight exposure interfere with the neatly ordered proteins in the lens of the eye. UV light causes oxidation of vitamin C in the lens, and the products of that oxidation chemically react with lens proteins to cause cataracts, says Ram Nagaraj, an author of the study and ophthalmology professor at Case. The finding “reiterates the importance of wearing sunglasses to protect your eyes from the sun’s harmful rays.”
“It can definitely be hard to put sunglasses on a baby or get toddlers and preschoolers to put them on,” says Anne Sumers, an ophthalmologist in Ridgewood, N.J., and clinical spokesperson for the American Academy of Ophthalmology. But, she says, there are better glasses available nowadays for younger children with straps that keep them on, and help protect their eyes from irritants like sand and wind.
Vision experts recommend sunglasses that block close to 100% of the entire UV spectrum, including UVA rays, which penetrate deep into the eye, and UVB rays, which are mostly absorbed by the cornea and lens. Sunglass UV absorption is improved by adding certain chemicals to the lens during manufacturing or by applying special lens coatings. Also recommended: wraparound styles that fit tight to the face and can screen out radiation that comes from above or around the sides of sunglasses.
Diane Bailey of the Columbus area, whose family sees Dr. Hartman for vision care, says after her own father got cataracts in his 60s, she began focusing on the importance of “any protection you can give kids at younger ages.” She is always slapping a baseball hat on her 5-year-old son, Liam, and got him a pair of cool wraparound sunglasses with a Lightning McQueen theme from the movie “Cars.” Her 14-year-old daughter, Audrey, who has worn prescription glasses since early childhood, recently got contacts with UV protection, since she spends hours by the pool on summer days and runs cross-country. Audrey says she sees her sunglasses more as fashion statements but she understands sun protection is important. “The sunglasses have really good coverage so I’ m not bugged by light at all.”
A leading lens maker, Paris-based Essilor International, is promoting use of an index it developed for eyewear, E-SPF, modeled on the sun-protection factor used for sunscreen. The designation isn’t in wide use by other eyewear makers. Higher values are awarded to lenses where no-glare or antireflective treatments are added to both the front and back of lenses to prevent UV light from bouncing off the inside of glasses. Among their products, which are sold through independent eye-care professionals and vision-care retailers, are regular glasses with ratings of E-SPF 25 and sunglasses with E-SPF 50+ ratings.
Contact lenses with UV blockers provide extra protection as measured by two classes of standards set by the Food and Drug Administration. Johnson & Johnson’s Oasys and 1-Day Acuvue TruEye lenses offer the highest level available, blocking more than 90% of UVA and 99% of UVB radiation. Cristina Schnider, an optometrist in the professional affairs group at the company’s vision-care unit, says children as young as 8 do well with contacts.
The company’s Vision Care Institute, which provides educational programs for eye-care professionals around the world, is launching an app for consultations to explain risks and steps patients can take to protect their eyes, including graphic illustrations that show how eyes are particularly vulnerable to the sun at different times of the day.
For example, while the skin’s risk for sunburn is greatest from 10 a.m. to 2 p.m., the risk is greatest to the eyes is from 8 a.m. to 10 a.m. and from 2 p.m. to 4 p.m. At those times, UV rays come from different angles and eyes receive nearly double the amount of UV than during midday hours.
Printed in the Wall Street Journal July 7, 2014