Shades not child's play

Sunglasses at a young age can head off eye problems in later years

THERE IS more to donning a great pair of shades than conveying instant chic. Over time, the glasses' shielding effect can prevent the formation of cataracts and pterygiums on the surface of the eye, plus internal damage that health experts are just beginning to learn about.

Just as with the skin, sun damage to the eyes begins at a young age and is cumulative, so that its effects don't become noticeable until long after the damage is done.

It's for that reason that pediatric ophthalmologists such as Dr. Malcolm Ing, chief of ophthalmology at Kapiolani Medical Center for Women and professor and chairman of ophthalmology at the University of Hawaii at Manoa, recommend putting sunglasses on children as young as 1, "or at least put a bonnet on them if they're going to be out in the sun," he said.

He cites Australia as being a leader in mandating sun-protective habits. "The Caucasians who settled there had no innate protection from the sun, so the rate of skin cancer there was the highest in the world."

There, children are not allowed outside during school recess breaks unless they are wearing a hat or sunglasses, and the government-run Australian Radiation Protection and Nuclear Safety Agency monitors and posts via Internet daily ultraviolet radiation levels for six cities, to help people determine just how much protection they'll need outdoors.

Such measures have already led to a decrease in incidences of skin cancer in that country, although Ing said it's too early to tell what effect such measures will have on the eyes.

"Dermatologists tell us that we experience 80 percent of sun exposure in the first 18 years of life, and we know about the damaging effect on skin. What's less obvious is the damaging effect on eyes, but to me, it's only logical that we should start children on sun protection early, when they're more susceptible to damage."

Ing tried to get eye-safety measures adopted in a few private schools here, but administrators were reluctant to impose sunglasses on every student, even though Hawaii is in the danger zone, close to the equatorial belt, where cases of skin cancer and cataracts are most prevalent.

IT DOESN'T HELP that most parents are still unaware of the hazards that await an unprotected eye. To many parents, sunglasses for children are considered cute novelty items, although a few manufacturers, such as Bab's Optics by Deanna Lee and Eyes Cream Shades, offer serious sunwear for ages 10 and under.

Eyes Cream Shades, at about $20 per pair, are made of shatterproof polarized polycarbonate, the same material that goes into making protective eyewear for American soldiers in Iraq. Experts recommend shatterproof lenses for children in case of injury while playing. Eyes Cream Shades also provide the 100 percent UVA and UVB protection required of all sunglasses sold in the United States.

Unfortunately, according to Eyes Cream Shades owner Faith Smith, many sunglasses sold by street vendors do not comply with federal law, and that is how most children's glasses are still sold, on the street, on a whim.

"Using a tinted lens without UV protection can be extremely dangerous," Smith said. "Lens tint has the effect of increasing the wearer's pupil size and admitting more ultraviolet light to the intraocular lens, which can cause premature cataracts and/or permanent damage to your eyes."

Her company has been getting a lot of attention lately because of the Hollywood baby boom, and with such high-profile moms as Courtney Cox, Sarah Jessica Parker and Teri Hatcher adopting Eyes Cream Shades for their precious million-dollar progeny, according to Smith.

FOR ING, 1985 was an eye-opening year. For his own family, he said, "After 1985 it was, 'Sunglasses for everybody, let's do it.' "

That was the year that Johns Hopkins University published a landmark study showing that crab fishermen working on Maryland's Chesapeake Bay had more cortical cataracts compared to people with less sunlight exposure. Cataracts are the opacification of the lens, while pterygiums are a thickening of the eye's outer coating (conjunctiva) that grows onto the cornea, possibly blocking vision.

Ing said that 50 percent of people between ages 70 and 80 have cataracts and that "cataract surgery happens to be the most common surgical procedure paid for by Medicare benefits." This amounted to $2.4 billion in medical costs in 2004, according to researchers from Johns Hopkins University.

The researchers concluded that the Chesapeake study results are especially important for children because they have many years of exposure ahead.

"The problem is, kids don't become happy with the idea of wearing sunglasses until high school, and by then, damage may have already been done," Ing said.

And even then, the reason teens start to wear sunglasses is because they like the look. They may not have a clue the glasses are helping them.

"A group of high school students here did a survey of people wearing sunglasses on the beach, and they were amazed to learn that less than one-third knew that their sunglasses where preventing their eyes from being damaged," said Ing, who understands the phenomenon firsthand. Long before he started his ophthalmological studies, he remembers picking up his first pair of aviators in high school.

"I thought they were cool. I really like the shape. I still use that style," he said.

---

--