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The Salisbury Eye Evaluation Project

Sheila K. West, PhD; Donald D. Duncan, PhD; Beatriz Muñoz, MSc; Gary S. Rubin, PhD; Linda P. Fried, MD, MPH; Karen Bandeen-Roche, PhD; Oliver D. Schein, MD, MPH

JAMA. 1998;280:714-718.

Context.— Exposure to UV-B radiation in sunlight has been shown to increase the risk of cataract formation in high-risk occupational groups, but risk to the population has not been quantified.

Objectives.— To determine the ocular exposure to UV-B radiation in sunlight for a population of older persons and to determine the association between UV-B and lens opacities.

Design.— The Salisbury Eye Evaluation project, a population-based cohort of older adults.

Setting.— Salisbury, Md.

Participants.— A total of 2520 community-dwelling 65-year-old to 84-year- old adults in Salisbury, Md, from 1993 to 1995, of whom 26.4% were African Americans.

Main Outcome Measure.— Association of photographically documented cortical opacity 3/16 or greater in at least 1 eye with ocular UV-B exposure, reported in Maryland sun-years of exposure.

Results.— The odds of cortical opacity increased with increasing ocular exposure to UV-B (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02- 1.20). The relationship was similar for women (OR, 1.14; 95% CI, 1.00- 1.30) and for African Americans (OR, 1.18; 95% CI, 1.04-1.33). Analyses of the ocular dose by each age group after the age of 30 years showed no vulnerable age group, suggesting damage is based on cumulative exposure.

Conclusions.— Although this population of older Americans has relatively low ocular exposure to UV-B in sunlight, there is still an association between ocular exposure and increasing odds of cortical opacity. Our study found an association among African Americans, which, to our knowledge, has not been reported previously. All sex and racial groups would benefit from simple methods to avoid ocular sun exposure.

From the Wilmer Eye Institute, Johns Hopkins University, Baltimore, Md.

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