The Medical Minute: Protecting kids' eyes from the sun

The Medical Minute: Protecting kids' eyes from the sun

Tuesday, August 2, 2011

By Marianne E. Boltz

It’s summer vacation time! Moms and Dads everywhere are busily shopping for that highly anticipated week at the beach or campground. What one item is on most everyone’s list? Sunscreen. We all know the importance protecting children’s delicate skin from the sun’s harmful ultraviolet rays. But what many parents forget are the short- and long-term effects of the sun on children’s developing eyes. Even the most diligent mom or dad who may remember to pack sunglasses for the kids at the beach all too often forget about the other 51 weeks of the year when their kids are outside playing. A staggering statistic: the World Health Organization reports that about 80 percent of exposure to UV light occurs before age 18.

Long-term exposure to UV radiation can be serious. Research has shown that exposure to small amounts of UV radiation over a period of many years increases the chance of developing cataracts and may cause damage to the retina, the nerve-rich lining of the eye that is responsible for our sharp vision. Long-term exposure to the blue and violet portion of the solar spectrum has been implicated as a risk factor for macular degeneration, especially for individuals who are “sun sensitive” with pale complexions. Chronic UV exposure can also cause skin cancer of the eyelids and skin around the eyes. A more immediate type of sun damage to the eye is photokeratitis, a painful burn of the eye's surface causing symptoms such as red eyes, a foreign body sensation or gritty feeling in the eyes, extreme sensitivity to light and excessive tearing.

In addition to having children wear a hat or cap with a wide brim while outdoors, there are several things to keep in mind when discussing sun protection for children. Polycarbonate lens material always is a good idea for prescription or nonprescription sunglasses, as it is considered a “safety” material, particularly important for active children. Photochromic or Transitions lenses, those that darken when outdoors, can be an especially convenient and effective option for children who normally wear glasses on a full-time basis. Lastly, it is never too soon to start having children wear sun protection: infants and toddlers are particularly sensitive to bright light and the damaging rays of the sun. In general, parents of infants 6 months and younger should not expose them to direct sunlight. Children age 6 to 36 months should wear infant or toddler-sized sunglasses such as Baby Banz, which are available in specialty optical shops or online. These have a comfortable, wrap-around neoprene band attached to the front frame and lenses which provides a secure fit for an infant’s small facial features and head.

The American Optometric Association offers the following recommendations when purchasing sunglasses for children or adults:

-- Don’t be misled by faulty UV claims or labeling. Buy sunglasses where there is equipment available to check the lenses’ UV protection capabilities. Price alone cannot guarantee quality UV protection.

-- Check lenses to be sure the tint is uniform, not darker in one area than another and free of distortions.

-- Be sure the lenses block enough light. If you can see your eyes easily through the lenses, they probably are not dark enough.

-- At a minimum, look for sunglasses that block at least 99 percent of both UV-A and UV-B radiation, screen out 75 percent to 90 percent of visible light, and are gray for proper color recognition.

-- If possible, choose a wrap-around sunglass frame -- these provide added side protection from bright light and UV radiation.

The old saying holds true: “an ounce of prevention is worth a pound of cure.” Your children will thank you in years to come for protecting such an amazing gift as their eyes and vision. And, really, what’s one more thing to add to your shopping list? Enjoy your summer vacation!

Marianne E. Boltz, O.D., FAAO, is a pediatric optometrist and assistant professor of ophthalmology at Penn State Hershey Eye Center.

What should I look for in sunglasses?

What do I need to know about sunglasses?

The most important things to look for when choosing a pair of sunglasses is the amount of UV light that is blocked by the sunglasses and a proper fit. Lenses should be large enough to shield your eyes from most angles. It is important to note that darker lenses in sunglasses do not necessarily offer better UV protection. Sunglasses have many features, not all of which are related to the amount of sun protection they provide:

• Blocks 99% of UV light:
  This is a very important thing to look for when purchasing sunglasses. This claim tells you that the sunglasses block 99 percent of harmful UV rays. The tag may also say "UV absorption up to 400 nm".
• Wrap-around:
  This is another important thing to look for when purchasing sunglasses. These types of sunglasses wrap around the face and protect eyes from all angles.
• Polycarbonate lenses:
  This type of lens is the most impact-resistant lens on the market today. (This type of lens does not necessarily offer better UV protection than other types of lenses.)
• Blocks 90 percent of infrared rays:
  The amount of infrared rays sunglasses block does not effect the UV protectiveness of sunglasses. (Infrared rays are not harmful to eyes.)
• Polarized:
  This type of lens does not help protect your eyes from damaging UV rays. However, this type of lens can improve eyesight by reducing distracting surface glare, most notably from water and snow.

In early 2000, the American Society for Testing and Materials (ASTM) has published new national standards for the preparation and labeling of fabrics and garments intended to protect humans from the sun's UVA and UVB radiation. The American Sun Protection Association (ASPA), a member of the ASTM standard drafting committee, is leading a national effort to encourage the sun protective clothing industry to adopt and promote the new standards in the U.S. marketplace.

The new ASTM standards D6544 and D6603 combine with AATCC 183 to form the most stringent UV-protective clothing standard in the world. "This is the credibility boost the U.S. sun protective clothing industry has been waiting for," said Mary Buller, ASPA Executive Director. "Finally, consumers will know what UPF is and will come to trust that the garment they buy will provide the same level of UV protection during its use-Iife as it did on the day it was purchased."

Classification Category	UPF Range	UPF Values Allowed on Labels	Approximate % UV Blocked
Good UV Protection	15-24	15 and 20	93.3% - 95.8%
Very Good UV Protection	25-39	25, 30 and 35	96.0% - 97.4%
Excellent UV Protection	40-50+	40, 45, 50 and 50+	97.5% - 98.0%

D6544 requires fabrics making a claim of sun protectiveness to (a) undergo 40 simulated launderings, (b) be exposed to 100 fading units of simulated sunlight, and if intended for swimsuits, and (c) be exposed to chlorinated water prior to UV- transmission testing. The standards are currently voluntary, but could become mandatory if not adopted by the industry in a timely manner. Sun protection claims will be monitored by the FTC.

Protecting Children from the Sun

Just a few serious sunburns can increase your child's risk of skin cancer later in life. Kids don't have to be at the pool, beach, or on vacation to get too much sun. Their skin needs protection from the sun's harmful ultraviolet (UV) rays whenever they're outdoors.

• Seek shade. UV rays are strongest and most harmful during midday, so it's best to plan indoor activities then. If this is not possible, seek shade under a tree, an umbrella, or a pop-up tent. Use these options to prevent sunburn, not to seek relief after it's happened.
• Cover up. Clothing that covers your child's skin helps protect against UV rays. Although a long-sleeved shirt and long pants with a tight weave are best, they aren't always practical. A T-shirt, long shorts, or a beach cover-up are good choices, too—but it's wise to double up on protection by applying sunscreen or keeping your child in the shade when possible.
• Get a hat. Hats that shade the face, scalp, ears, and neck are easy to use and give great protection. Baseball caps are popular among kids, but they don't protect their ears and neck. If your child chooses a cap, be sure to protect exposed areas with sunscreen.
• Wear sunglasses. They protect your child's eyes from UV rays, which can lead to cataracts later in life. Look for sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
• Apply sunscreen. Use sunscreen with at least SPF 15 and UVA and UVB protection every time your child goes outside. For the best protection, apply sunscreen generously 30 minutes before going outdoors. Don't forget to protect ears, noses, lips, and the tops of feet.

Take sunscreen with you to reapply during the day, especially after your child swims or exercises. This applies to waterproof and water-resistant products as well.

Follow the directions on the package for using a sunscreen product on babies less than 6 months old. All products do not have the same ingredients; if your or your child's skin reacts badly to one product, try another one or call a doctor. Your baby's best defense against sunburn is avoiding the sun or staying in the shade.

Keep in mind, sunscreen is not meant to allow kids to spend more time in the sun than they would otherwise. Try combining sunscreen with other options to prevent UV damage.

Too Much Sun Hurts

Turning pink? Unprotected skin can be damaged by the sun's UV rays in as little as 15 minutes. Yet it can take up to 12 hours for skin to show the full effect of sun exposure. So, if your child's skin looks "a little pink" today, it may be burned tomorrow morning. To prevent further burning, get your child out of the sun.

Tan? There's no other way to say it—tanned skin is damaged skin. Any change in the color of your child's skin after time outside—whether sunburn or suntan—indicates damage from UV rays.

Cool and cloudy? Children still need protection. UV rays, not the temperature, do the damage. Clouds do not block UV rays, they filter them—and sometimes only slightly.

Oops! Kids often get sunburned when they are outdoors unprotected for longer than expected. Remember to plan ahead, and keep sun protection handy—in your car, bag, or child's backpack.

Sun Safety at School

The brochure Sun Safety at Schools: What You Can Do (PDF-245KB) explains how school administrators and staff, parents, and community healthcare service providers can promote sun safety.

View page in

• Español (Spanish)

Contact Us:

• Centers for Disease Control and Prevention
  Division of Cancer Prevention and Control
  
• cdcinfo@cdc.gov

• Content source: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion

Lack of Eye Protection From UV Rays May Cause Damage Now and Later in Life

Lack of Eye Protection From UV Rays May Cause Damage Now and Later in Life

Prevent Blindness America Warns Public on Possible Immediate and Lasting Effects of UV Damage

CHICAGO (April 29, 2009) – Ultraviolet (UV) rays are well known for their damaging effects on the skin. One area of the body that sunscreen cannot protect is the eyes. Prolonged exposure to UV rays can cause “sunburns” to the eye, also known as photokeratitis. The painful condition may result in temporary loss of vision for 1-2 days. In addition, the presence of pterygium, a growth of tissue that forms on the white of the eye, is in direct correlation to the amount of UV exposure that the person has been subjected to. Without treatment, this condition may require surgical treatment.

The damaging effects of UV rays may not develop until years later. In fact, UV damage is cumulative and has been linked to cataracts and macular degeneration later in life. The delicate skin around the eye and the eyelids is also susceptible to UV damage. According to the Office of Air and Radiation at the Environmental Protection Agency, basal cell carcinoma is the most common type of skin cancer to affect the eyelids and may appear on the lower lid, in the corners of the eye and under eyebrows.

Prevent Blindness America, the nation’s oldest volunteer eye health and safety organization, has declared May as UV Awareness Month to help educate the public on how to protect their eyes. Fortunately, protecting the eyes and vision is easy and does not have to be expensive. No matter what time of year it is or what the weather forecast is, sunglasses that block 100 percent of UV-A and UV-B rays should always be worn in conjunction with a brimmed hat. While UV-A has lower energy, it penetrates deep into the eye and may injure the macula, the part of the retina responsible for sight in the center field of vision. UV-B radiation is presumably more dangerous and is mainly absorbed by the cornea and lens of the eye and can damage those tissues.

Wrap-around sunglasses are best as they protect the eyes and the skin around the eyes. Some contact lenses may offer UV protection but they can’t protect the entire eye and the skin around it.

“When we head outside to enjoy the great outdoors, we all need to remember to protect one of our greatest gifts—our sight,” said Hugh R. Parry, president and CEO of Prevent Blindness America. “We adults need to be good examples for our children and encourage them to get in the habit of protecting their vision for years to come.”

According to the American Optometric Association, children are at a greater risk of UV damage because the lenses of their eyes are more transparent, which allows more short wavelength light to reach the retina. Parents looking to purchase sunglasses for their children should remember to buy sunglasses with the proper UV protection. Sunglasses without UV protection may shade the eyes but actually cause the pupils to dilate, allowing in even more harmful rays.

And, children’s glasses should be made of unbreakable polycarbonate to fit their active lifestyle. The frames should be bendable and the lenses should not pop out. The child should try the sunglasses on and make sure they shield enough of the eye above, below and on the sides.

For more information on the dangers of UV exposure and more information on how to choose the best sunglasses for adults and children, please visit preventblindness.org/uv or call (800) 331-2020.

About Prevent Blindness America

Founded in 1908, Prevent Blindness America is the nation's leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Focused on promoting a continuum of vision care, Prevent Blindness America touches the lives of millions of people each year through public and professional education, advocacy, certified vision screening and training, community and patient service programs and research. These services are made possible through the generous support of the American public. Together with a network of affiliates, divisions and chapters, it's committed to eliminating preventable blindness in America. For more information, or to make a contribution to the sight-saving fund, call 1-800-331-2020.

Choosing Children's Sunglasses

Choosing sunglasses for your kids

Did you ever notice how cute kids are in sunglasses? Like those "fashion statement" sunglasses with a cool super-hero look or trimmed in teddy bear faces?

More importantly, sunglasses may save their skin and eyes later in life by blocking the sun's powerful ultraviolet rays (UVR).

Children under age 10 are at a high risk for skin and eye damage from UVR. The skin on their eyelids and around their eyes is more delicate and vulnerable than adult skin. "And until about age 10, the lens of a child's eye is clear, allowing greater solar penetration and thus greater UVR-induced ocular changes," explains Adelaide A. Hebert, MD, professor and vice chair of dermatology, University of Houston. "After that, the lens starts to become more opaque, providing better protection."

UVR exposure causes 90 percent of all skin cancers. In addition, retinal exposure to UVR is associated with cataracts and macular degeneration, both causes of vision impairment. UVR damage builds over time, so the sooner you start protecting your children's eyes from the sun, the lower their risk will be of ever developing future eye problems.

Fortunately, good sunglasses protect both the skin around the eye and the eye itself. While children under 6 months old should never be exposed to the sun, once they reach 6 months, they should wear sunglasses outside. If they require prescription glasses, they should also wear prescription sunglasses.

Keep these rules in mind when buying sunglasses for children:

* Find glasses that block 99-100 percent of both UVA and UVB rays. Buy ones that indicate the percentage of UVR protection they provide. The more skin covered, the better, so look for large, wraparound styles.
* Use playground-proof lenses. Kids run, trip, fall, and bounce off objects at alarming speed. Their sunglasses should match this active lifestyle. Find impact-resistant, scratch-proof lenses that don't pop out of the frames. Avoid glass lenses, unless recommended by a doctor; plastic is safer. Frames should be bendable but unbreakable. Make sure the glasses fit snugly, close to the face.
* Let them choose. You're not the one who has to wear the glasses or hear other kids' comments on them. Children – especially older kids and teens – are likelier to actually wear them if they select them themselves.
* Eyeball the glasses. Check to see that lenses are not scratched or warped and have no other flaws that distort vision. Very young children may not know to complain if the glasses are flawed, so it's up to you to check before buying.
* Double Up. Sunglasses block only rays that come directly through the lenses. The skin around the eyes remains vulnerable to rays entering though the sides or from the top, or reflected upwards off snow, sand, water, etc. Wearing a wide-brimmed hat is a good backup, blocking out many rays from above and even from the sides, while also shielding the face and neck. Seeking shade during the sun's most intense hours, 10 a.m. to 4 p.m., provides another level of protection.

"We need to teach children early the importance of wearing sunglasses – just as we teach them to brush their teeth and wear a seatbelt, so that they develop good habits that last for life," concludes Dr. Hebert.

source: Skin Cancer Foundation http://www.skincancer.org/choosing-sunglasses-for-your-kids.html