title: Conjunctival UV autofluorescence--prevalence and risk factors.
abstract: OBJECTIVE
  Autofluorescence of ultraviolet (UV) light has been shown to occur in localised areas of the bulbar conjunctiva, which map to active cellular changes due to UV and environmental exposure. This study examined the presence of conjunctival UV autofluorescence in eye care practitioners (ECPs) across Europe and the Middle East and its associated risk factors.
  
  
  METHODS
  Images were captured of 307 ECPs right eyes in the Czech Republic, Germany, Greece, Kuwait, Netherlands, Sweden, Switzerland, United Arab Emirates and the United Kingdom using a Nikon D100 camera and dual flash units through UV filters. UV autofluorescence was outlined using ImageJ software and the nasal and temporal area quantified. Subjects were required to complete a questionnaire on their demographics and lifestyle including general exposure to UV and refractive correction.
  
  
  RESULTS
  Average age of the subjects was 38.5±12.2 years (range 19-68) and 39.7% were male. Sixty-two percent of eyes had some conjunctival damage as indicated by UV autofluorescence. The average area of damage was higher (p=0.005) nasally (2.95±4.52mm(2)) than temporally (2.19±4.17mm(2)). The area of UV damage was not related to age (r=0.03, p=0.674), gender (p=0.194), self-reported sun exposure lifestyle (p>0.05), geographical location (p=0174), sunglasses use (p>0.05) or UV-blocking contact lens use (p>0.05), although it was higher in those wearing contact lenses with minimal UV-blocking and no spectacles (p=0.015). The area of UV damage was also less nasally in those who wore contact lenses and spectacles compared to those with no refractive correction use (p=0.011 nasal; p=0.958 temporal).
  
  
  CONCLUSIONS
  UV conjunctival damage is common even in Europe, Kuwait and UAE, and among ECPs. The area of damage appears to be linked with the use of refractive correction, with greater damage nasally than temporally which may be explained by the peripheral light focusing effect.
authors.affiliation: Ophthalmic Research Group, Aston University, Birmingham, UK. Electronic address: j.s.w.wolffsohn@aston.ac.uk.
authors.forename: James S
authors.initials: JS
authors.lastname: Wolffsohn
authors.affiliation: Ophthalmic Research Group, Aston University, Birmingham, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Drew
authors.affiliation: Johnson & Johnson Vision Care, Wokingham, Berkshire, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Sulley
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003228:Conjunctiva / Q000293:injuries* / Q000473:pathology; D003261:Contact Lenses / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005131:Eye Injuries / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D005135:Eye Protective Devices / Q000706:statistics & numerical data*; D005139:Eyeglasses / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D061848:Optical Imaging / Q000379:methods; D015995:Prevalence; D011832:Radiation Injuries / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D012307:Risk Factors; D017678:Sex Distribution
keywords: Autofluorescence; Bulbar conjunctival damage; Contact lenses; Peripheral light focusing effect; Ultraviolet light