title: Prevention of the adverse photic effects of peripheral light-focusing using UV-blocking contact lenses.
abstract: OBJECTIVE
  Peripheral light-focusing (PLF) is an occult form of ultraviolet radiation (UVR) hazardous to the human eye. In PLF, obliquely incident light is refracted from the peripheral cornea to concentrated sites inside the anterior segment. In the current study, the directionality of this phenomenon for UVR and whether PLF is established in outdoor settings exposed to sunlight were investigated. The protection provided by a UV-blocking contact lens was also evaluated.
  
  
  METHODS
  UVA and UVB sensors were placed on the nasal limbus of an anatomically based model eye. The temporal limbus was exposed to a UV light source placed at various angles behind the frontal plane. PLF was quantified with the sensor output. The ensemble was mounted in the orbit of a mannequin head and exposed to sunlight in three insolation environments within the region of Sydney, Australia. PLF for UVA and UVB was determined with no eyewear or with sunglasses and commercially available soft contact lenses, with and without UV-blocking capability.
  
  
  RESULTS
  The intensity of UVA peaked at approximately 120 degrees incidence, the level at which the UVB response was also at its maximum. The intensification of UVA was up to x18.3. The intensity of PLF for UVA and UVB was reduced by an order of magnitude by a UV-blocking contact lens, whereas a clear contact lenses had a much lesser effect. Only the UV-blocking contact lens achieved a significant effect on UVA and UVB irradiance in the urban, beach, and mountain locales (P < 0.056).
  
  
  CONCLUSIONS
  The results identify another type of sunlight hazard: the peripheral focusing of obliquely incident light. UVR from albedo (reflected ambient light) is capable of establishing PLF in the anterior segment, but this can be shielded by UV-blocking soft contact lenses. Sunglasses may be unable to shield oblique rays, unless side protection is incorporated. Contact lenses can offer UVR protection against all angles of incidence, including the peak-response angle. They can also protect the eye in settings in which the wearing of sunglasses is not feasible or convenient.
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: L Stephen
authors.initials: LS
authors.lastname: Kwok
authors.forename: Valerian A
authors.initials: VA
authors.lastname: Kuznetsov
authors.forename: Arthur
authors.initials: A
authors.lastname: Ho
authors.forename: Minas T
authors.initials: MT
authors.lastname: Coroneo
mesh_terms: D003261:Contact Lenses; D005123:Eye / Q000528:radiation effects*; D006801:Humans; D008348:Manikins; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D012542:Scattering, Radiation; D013472:Sunlight; D014466:Ultraviolet Rays / Q000009:adverse effects*