By René Rodriguez-Sains, MD
René Rodriguez-Sains, MD is an ophthalmic plastic and reconstructive surgeon, ophthalmic oncologist, and ophthalmologist. He is a clinical assistant professor at NYU-Langone Medical Center.
Q: I stay in the shade, use sunscreen, and wear sun-protective clothing when I’m outside, to help prevent skin cancer. But are my eyes also at risk? What dangers does the sun expose them to, and how do I protect myself and my family?
A: Sun exposure can cause both short-term and long-term damage to the eyes, eyelids and surrounding (periocular)areas. Solar ultraviolet A (UVA), UVB, and HEV (high energy visible, aka blue) rays have been linked to conditions from corneal sunburns to melanomas. Notable sun-related eye maladies include:
• Eyelid Cancers (basal and squamous cell carcinomas and melanomas)
• Cataracts and macular degeneration
• Conjunctival (eye surface) benign growths and cancers (squamous cell carcinomas and melanomas)
• Photokeratitis, or sunburned cornea, which afflicts skiers and tanning bed users without UV protection.
The eyelids and surrounding areas can also be cosmetically damaged by sun exposure, leading to premature aging effects such as crow’s feet, seborrheic keratoses (raised benign lesions), freckles and other pigmented spots.
The more you expose your eyes to the sun, the more you increase your odds of developing these conditions, because sun damage is cumulative. Start protecting the eyes as early as possible, making this a lifelong daily habit.
Apply a broad spectrum SPF 15+ sunscreen to all facial areas before heading outside. Applying sunscreen to the upper eyelids is problematic, since it may irritate the eye, but for the lower eyelid, several cosmetic companies make eyelid moisturizers that include UV protection, as well as sunscreens formulated for the skin of the eyelid and sensitive surrounding areas. Read labels carefully, and look for The Skin Cancer Foundation’s Seal of Recommendation.
In my opinion, however, UV-blocking glasses are the best form of sun protection for the eyes, eyelids and periocular areas. Note that I did not specify “sunglasses,” since for people with prescription eyeglasses, clear lenses can be made to block almost 100 percent of UV and blue light (the latter may involve a tint), eliminating the need to switch to sunglasses outdoors. In addition, “transition lenses” that darken in response to brighter light also usually come pre-manufactured with UV protection. For added comfort, especially while driving, everyday glasses can be “polarized,” significantly reducing glare. I recommend 99-100 percent UV-and blue light-blocking polarized transition lenses so that you don’t have to worry if you forget sunglasses.
While we often associate sunglasses with outdoor sports or the beach, they’re good protection outdoors year-round. The lenses should be large enough to cover your eyes and the skin around your eyes. A close-fitting wraparound style is ideal.Lenses should be impact-resistant and polarized to reduce glare, especially from light reflected off water, snow and road surfaces. Neutral grey, green or brown lenses offer the most comfortable vision. Many golfers prefer brown lenses because they enhance contrast, while neutral grey produces the least color distortion.
Another important way to sun-protect your eyes and periocular areas is wearing a hat, ideally with a three-inch or wider brim all around, or at least a cap or tinted visor. Also seek the shade whenever you’re outside, and avoid direct sunlight from 10 AM to 4 PM.
Published on November 3, 2014