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J.–L. Ooi, N. Sharma, M. Oakey, P. Dawes, D. Papalkar, S. Sharma, M.T. Coroneo; Ultraviolet Photography to Detect Early Sun Damage in the Eyes of School–Aged Children . Invest. Ophthalmol. Vis. Sci. 2005;46(13):949.
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Purpose: Ophthalmohelioses, or sun–related eye conditions, pose a significant problem to the eye health of the Australian community. It is not currently possible to detect early changes of disease due to chronic ocular sun exposure before they are clinically evident on slit–lamp examination. We aimed to develop a method to detect preclinical changes of ocular sun damage using ultraviolet fluorescence photography (UVFP) and to investigate the sensitivity of our system compared to standard photography. We also aimed to determine the age at which changes become detectable and the prevalence in children. Methods: We developed a photographic system using UVF to detect evidence of early ocular sun damage. This concept is based on the established technique of UVF in the detection of dermatological diseases resulting from UV exposure. Significant advances were made including refining the UV light source, ensuring portability and utilising digital technology to allow a greater depth of field compared to film. The UVF system was initially tested on established pingueculae. We then screened 71 children aged 3 to 15 from schools in Sydney, Australia. UV and standard (control) photographs were taken of the nasal and temporal interpalpebral regions of each eye. Results: Established pinguecula consistently fluoresced using UVFP, demonstrating the ability of our method to detect ocular UV damage. High quality, reproducible images were obtained. Of the 71 children studied, 23 (32%) had changes on UVFP. Importantly, of these, 16/23 (70%) had changes seen only on UVFP; 7/23 (30%) had changes that were also detected on control. Also, no changes visible on control photographs were undetected by UVFP. Thus UVFP was considerably more sensitive than control. Changes became detectable on UVFP from 9 years of age. Prevalence increased with chronological age, such that the presence of changes was 0/27 (0%) for children aged 3–8, 6/23 (26%) for those aged 9–11 and 17/21 (81%) of those aged 12–15. Conclusions: We hypothesise that the areas seen to fluoresce on UVFP but not detectable on control photographs represent precursors for clinical conditions such as pinguecula and pterygium. We have developed the first UVF photographic system to be used successfully to detect such changes, which may occur years before the development of clinical manifestations.
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