Sun damage to the eye has long been known and the recommendation to add sunglasses to the Australian SunSmart campaign (Slip, Slop, Slap + Seek & Slide) reflected this.
We found that since the SunSmart campaign the number of surgical procedures for Pterygium has declined in Australia.
On the flip slide, the world is seeing an epidemic of myopia particularly in the cities of East Asia. The main risk factors for myopia is lack of time spent outdoors.
With our Australian cohorts (Twins Eye Study in Tasmania & Brisbane, Norfolk Island Eye Study, The Raine Study, Kidskin Study and Busselton Healthy Aging Study) we have been comparing markers of excess sun exposure with Myopia and Pterygium. We have validated Conjunctival UV Autofluorescence area as a biomarker of ocular sun exposure with high levels of CUVAF associated with Pterygium and low levels with Myopia. In Busselton we showed that adults who had skin cancer had half the rate of Myopia (11%) compared to those without skin cancer (22%).
Post COVID-19 data suggests the lack of time outdoors is most important in primary school aged children. Data from the Sydney Myopia Study and trials from China and Taiwan suggest 2 hours outdoors per day is recommended. The challenge is balancing adequate time outdoors with UV protection to minimise Skin Cancer, Pterygium and Myopia.