gms | German Medical Science

The eye while dependent on visible light energy can be damaged by these and the contiguous ultraviolet (UV) and infrared wavelengths. Diseases of the eye in which sunlight has been implicated have been termed the ophthalmohelioses, and these conditions pose a significant problem to the eye health of many communities. The ophthalmohelioses have a large impact on patients’ quality of life and have significant implications in relation the cost of health care. The pathophysiology of three slowly progressive, sun-related diseases of the anterior eye, cataract, pterygium and climatic keratopathy will be reviewed in the light of recent research. Although cataract is not entirely caused by insolation, it now seems certain that sunlight plays a contributory role – cataract extraction is one of the, if not the most, commonly performed surgical procedures in many societies. Pterygium, typically afflicting a younger population, adds a tremendous burden, both human and financial, in many countries. Evidence that peripheral light focusing by the anterior eye to the sites of usual locations of pterygium and cataract plays a role in the pathogenesis of these conditions. Recognition of the light pathways involved with foci at stem cell niches has directed our investigations into inflammatory and matrix metalloproteinase-related pathophysiologic mechanisms. An understanding of the intracellular mechanisms involved has provided some insight into how medical treatments have been developed for the effective management of ocular surface squamous neoplasia. The concept of peripheral light focusing has also provided direction in the prevention of these diseases. This has resulted in improved sunglass design and the further development of UV-blocking contact lenses. UV-blocking contact lenses may offer protection to at risk groups where other protective measures are impractical and are a valuable addition to the limited protective measures we have available. With the recent development of ocular UV fluorescence photographic techniques, we have been able to demonstrate preclinical ocular surface evidence of solar damage – this has implications for improving our ability to effectively impart the protection message to young people who are particularly at risk. The conundrum of the public health message about solar exposure will also reviewed, and in this context, the potential role of vitamin D deficiency is summarized. While the role of ultraviolet light in retinal pathology is less certain, evidence for its involvement will be discussed. The eye may play a role in the development of individualized assessment techniques of solar damage, perhaps allowing us to provide better advice to both individuals and populations.