How can we protect our eyes from the sun?

DEAR DOCTOR K:

Does spending time in the sun pose a threat to our eyes? What can we do to protect ourselves?

DEAR READER:

Yes, it does. And to a large extent, the damage may already be done. I spoke to Dr. Louis Pasquale, an ophthalmologist at Harvard-affiliated Massachusetts Eye and Ear Infirmary. He noted that spending a lot of time in the sun without sunglasses when you’re young may put you at risk for developing eye problems when you’re older. The damage would probably be done in your 20s and 30s.

We don’t know exactly how the sun’s ultraviolet rays cause eye damage. And we also don’t know for certain whether sunlight directly causes certain common eye conditions like cataracts, glaucoma and age-related macular degeneration (AMD).

But there’s good evidence that sun exposure can cause an eye condition that often leads to other problems. This condition is called “exfoliation syndrome.”

Exfoliation syndrome leaves tiny, dandruff-like flakes in the eye. A buildup of these flakes clogs the eye’s natural drains, which can lead to other problems. Worldwide, it is the most common identifiable cause of two kinds of glaucoma. It is also linked to cataracts and possibly to AMD.

There are no symptoms of exfoliation syndrome until you start to lose your sight from other eye problems. There’s no cure — but there are treatments for the other conditions that may result.

The best way to stop exfoliation syndrome, glaucoma, AMD and cataracts from robbing you of your vision is to discover these conditions before they progress. You can do that with a comprehensive eye exam, done by an ophthalmologist. The American Academy of Ophthalmology recommends comprehensive eye exams:

  • every two to four years for people ages 40 to 55;
  • every one to three years for people ages 55 to 65;
  • every one to two years for people ages 65 and older.

People with risk factors for eye problems — those with diabetes, for example — may need more frequent eye exams.

Finally, it’s never too late to protect your eyes from further sun damage. You can do that with the right pair of sunglasses. Foremost is to make sure the sunglasses protect against ultraviolet rays, both UVA and UVB. You’ll want 95 to 100 percent blockage. You may also consider buying polarized lenses, which reduce the glare from water, sand and snow.

Having been raised in “sunny” Southern California, I spent a great deal of time in the sun during the first 20 years of my life. I didn’t wear sunglasses for most of those years. In my 60s I developed cataracts in both eyes, one of which was bad enough to require surgery. I also developed damage to the retina of one eye, which my ophthalmologist calls “accelerated aging.”

My ophthalmologist tells me he can’t be sure if these conditions were influenced by my failure to protect my eyes from the sun when I was young. If he can’t be sure, neither can I. But I’ll bet they were.