Eyes and the Periorbital Area Are Vulnerable to Damage From the Sun, Need Special Protection

June 1, 1995

NEW YORK--If the face is the area of the body most vulnerable to sun damage, the eyes are in need of special protection, Rene S. Rodriguez-Sains, MD, said at a media conference sponsored by the Skin Cancer Foundation. Malignancies of the eyes and periocular area are particularly serious because of their proximity to the brain and other vital structures, he said.

NEW YORK--If the face is the area of the body most vulnerableto sun damage, the eyes are in need of special protection, ReneS. Rodriguez-Sains, MD, said at a media conference sponsored bythe Skin Cancer Foundation. Malignancies of the eyes and perioculararea are particularly serious because of their proximity to thebrain and other vital structures, he said.

Disfigurement and loss of sight are among the consequences whensuch cancers spread beyond the very thin skin of the eyelids andperiorbital area (see figure), said Dr. Rodriguez-Sains, chief,Ocular Tumor and Orbital Clinic, Manhattan Eye, Ear, and ThroatHospital.

He urged physicians to be on the alert for sun damage and skincancers in and around the eyes. "Function and cosmesis areimportant issues for cancers around the eyes, so early diagnosisis essential," he said.

In addition to the standard warning signs of skin cancer, signsthat warrant further investigation include persistent red eyeor inflammation of the eyelids that does not respond to medication,the unexplained loss of eyelashes, and any pigmented lesion (flator raised) on the lids, he said.

Ultraviolet (UV) radiation can also cause cataracts, benign andmalignant growths of the conjunctiva, and other ocular disorders."About 10% of cataract cases are directly attributable toUV exposure," Dr. Rodriguez-Sains said.

UV from the sun, as well as from artificial tanning devices ,contributes to macular degeneration and the development of pterygia.Although benign, these growths tug on the cornea, causing refractivechanges. Scarring typically follows surgical removal, and recurrencesare common.

Those at highest risk for UV damage to the eyes and eye area arepatients whose cataracts have been removed but who have not hadintraocular lens implantation or whose implants are not UV blocking;PUVA therapy patients; individuals with atypical mole syndrome;and outdoor workers.

The best defense, Dr. Rodriguez-Sains said, is a properly designedpair of sunglasses with UV-filtering lenses (see box below left).A broad-brimmed hat is also a good idea, though sunlight reflectedupward can still be damaging. He further warned that eye protectionis a year-round matter: Snow and water reflect up to 85% of thesun's radiation.

How to Chose Sunglasses

The Skin Cancer Foundation has introduced a new Seal of Recommendationto guide consumers in the purchase of sunglasses, and sunglasseswith the seal are expected to be available this summer. In themeantime, consumers should look for the following in sunglasses:

1. Lenses that block 99% to 100% of UV rays. Labeling of lensesis not monitored, and street vendors may falsely claim that theirglasses provide this protection. Consumers

are advised to purchase sunglasses from reputable drug, variety,and department stores, or from opticians.

2. Frames large enough to protect the area around the eyes. Awraparound style that hugs the forehead provides optimal sun protection.

3. Frames and lenses that are durable and impact resistant.

4. A tint that permits color discrimination, especially betweenred and green. Lens color does not affect UV filtration.