Sun exposure and pterygium of the eye: A dose-response curve

PURPOSE: To present a quantitative analysis of pterygium and ocular sun exposure, a dose-response curve, and a discussion of the health-promotion implications of the findings, METHODS: A hospital-based, case-control study was conducted in Perth, Western Australia. Case subjects had surgical removal of a pterygrum; control subjects had an ear, nose, or throat procedure. A lifetime history of residence, sun exposure patterns, and use of hats, spectacles, and sunglasses was obtained at interview. Measures of potential sun exposure included latitude, daily sunshine hours, and daily global solar radiant energy. The most complex estimate of actual sun exposure was the daily ocular solar radiation dose, calculated from climatic data, time spent outdoors not under shade, and the use of hats and spectacles. RESULTS: There were strong positive associations between pterygium and measures of potential and actual sun exposure. Associations were as strong for whole-life measures as for those in any specific age range. Pterygium odds ratios increased with exposure level; the odds ratio was 4.0 (95% confidence interval, 1.6 to 10.9) for the highest quarter of the daily sun exposure.. The strongest associations were seen for the estimated daily ocular solar radiation dose, with an odds ratio of 6.8 (95% confidence interval, 2.6 to 19.1) for the highest quarter of exposure. CONCLUSIONS: Pterygium is strongly related to ocular sun exposure, with little evidence that exposure during any particular period of life is more important than in other periods; the implication for prevention of pterygium is that ocular protection is beneficial at all ages. (Am J Ophthalmol 1999; 128:280-287 (C) 1999 by Elsevier Science Inc. All rights reserved.)