Relationship between practices of eye protection against solar ultraviolet radiation and cataract in a rural area.

Li-Ju Chen,Ming-Chin Yang,Chun-Fu Shieh,Jy-Haw Yu,Yun-Jau Chang,James Fielding Hejtmancik

doi:10.1371/journal.pone.0255136

Abstract

BackgroundCataract is a public health concern worldwide that differentially affects rural residents of outlying islands where ultraviolet radiation (UVR) may have greater penetration because of less shading.ObjectivesTo assess the relationships between attitudes and practices of eye protection and eye diseases for residents of an offshore island of Taiwan.MethodsQuestionnaire survey was administered to local residents (age > 50 years) regarding socio-demographic information, attitudes/practices of eye protection under sun exposure and eye diseases.ResultsA total of 816 participants (response rate 90.7%, 816/900) completed the questionnaires. Mean age was 63.7 (+ 10.8) years. Among these participants, 44.4%, 15.1% and 8.3% had cataract, dry eye and glaucoma, respectively. Although 86.3% and 88.2% of participants agreed that they should avoid outdoor activities and wear glasses/broad-brimmed hats in harsh daylight, 69.4% and 48.3% of participants never/rarely used glasses or hats/umbrellas in harsh daylight, respectively. Predictors of less practices of eye protection against solar UVR included residents who were male, with lower education level, with longer residence and lack of commercial health insurance. Multivariate logistic regression revealed that practices of eye protection under sun exposure were significantly associated with less cataract, but not glaucoma or dry eye. Participants who did not wear glasses, broad-brimmed hats/use umbrellas or both in harsh sunlight (almost) every time were respectively associated with a 57% (P = 0.028), 45% (P = 0.027) or 70% (P = 0.026) increase of cataract than those who did in harsh sunlight (almost) every time.ConclusionsPractices of eye protection under sun exposure is associated with lower risk of cataract.

Highlights

Cataract, primarily an age-related disorder, is the leading cause of visual impairment all over the world [1, 2]
Questionnaire survey was administered to local residents regarding sociodemographic information, attitudes/practices of eye protection under sun exposure and eye diseases
Multivariate logistic regression revealed that practices of eye protection under sun exposure were significantly associated with less cataract, but not glaucoma or dry eye

Summary

Introduction

Primarily an age-related disorder, is the leading cause of visual impairment all over the world (except developed countries) [1, 2]. Studies have supported the role of high cumulative ultraviolet radiation (UVR) exposure in development of cortical [3, 4], nuclear and posterior subcapsular cataracts [5]. Appropriate clothing, shade use (wearing hats or using umbrellas), and use of UVR blocking spectacles, sunglasses or contact lenses are effective measures for ocular protection against UVR [9, 10]. The effectiveness depends upon the percentage of transmission blockage of diffuse direction of UVR and its reflection of the irradiance over eyes. Sunglasses, clear lenses (plano and prescription) and some contact lenses reduce UVR markedly, back reflectance property of the lens and frame characteristics vary and influence the effect of UVR protection [12]. Cataract is a public health concern worldwide that differentially affects rural residents of outlying islands where ultraviolet radiation (UVR) may have greater penetration because of less shading

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