Eye damage from UV rays - a timely warning

Ian Smithin Industry News

IanSmithI love this profession, and one of the great joys is being outdoors, whatever the weather, along with the different variety of tasks I carry out though the year. I wouldn't change a thing. I seem to be one of the lucky people who actually enjoys going to work in the morning.

But, I write this as a word of caution to all of you. I'm sure that, by now, you have all been made aware of the damage that the suns UV rays can cause to our skin, so, hopefully, we either stay covered up or we use sunscreen. But, it is not just our skin that we should be protecting.

Back in 2002, I went for a routine eye test and I was diagnosed as having something called pterygium. This is a benign growth to the conjunctiva, growing from the nasal side towards the cornea, and forming a wing-shaped growth. Apart from looking unsightly, by the end of the day my eyes felt sore and gritty.

If I wanted to wear contact lenses, with this condition, it would not have been possible. The optician asked me if I had ever worked in the Middle East or Australia. I said that I hadn't, but that I spent the majority of my time outdoors. I was asked if I wore sunglasses. I explained that I never had, and was told that this was the reason I now had this condition, as it is caused by UV damage.

IanSmith Eye1After the diagnosis, I always wore sunglasses when outside. Unfortunately, this was all too late for me; the damage was done. Whilst wearing sunglasses slowed the growth down, now, ten years on, the pterygium had growth to the edge of my cornea. This meant that, if it was not removed, it would continue to grow, over the cornea, and blind me.

An operation was the only option if I wanted to keep my vision.

The operation is really not very pleasant. The pterygium is cut out and removed, a graft is then taken from under the eye lid and stitched in the hole where the pteryguim had been.

I have had one eye done, and it is not something that I would wish on anybody! In a month or so, I have got to go through it all again for the other eye.

The operation will probably change the shape of my eye, meaning visits to the opticians after both operations to get appropriate new lenses for each eye of my glasses.
IanSmith Eye2
We must learn the lessons from the past. I know people go on about health and safety regulations being a pain but, as we become aware of issues that affect people's health, we must try to avoid the same things happening to the next generation of groundsmen and greenkeepers.

As well as this recent condition, my ears ring at night through not wearing defenders when I first started out, working on the machinery that was much noisier back then. We used to have fertiliser delivered in 50kg bags, which I could hardly move, so my back aches constantly ... and, now, my eyes.

These things can all be prevented through risk assessments, and using the appropriate machinery that falls within EU regulations. We should only be carrying manageable weights, or using lifting equipment where necessary. We should be making sure that we, and our staff, wear the appropriate PPE; not just toetectors, ear defenders and hard hats but, now we are aware of the issues with UV, should also include sun screen and sun glasses for 100% UV protection. All these things your employers should supply to you as part of your terms of contract.

For all my moans and groans, I still feel very lucky to work in this industry. Hopefully, it will be even better for the next generation of both greenkeepers and groundsmen.

It's not a fashion statement wearing sunglasses, it's to stop long term eye damage.

It's not soft carrying only 20kg at a time, it's safer for your long term health.

Let's learn from our past mistakes. As I started by saying; "The Future's So Bright, I Gotta Wear Shades".


Pterygium in the conjunctiva is characterised by elastotic degeneration of collagen (actinic elastosis) and fibrovascular proliferation. It has an advancing portion, called the head of the pterygium, which is connected to the main body of the pterygium by the neck. Sometimes, a line of iron deposition can be seen adjacent to the head of the pterygium called Stocker's line. The location of the line can give an indication of the pattern of growth.

The exact cause is unknown, but it is associated with excessive exposure to wind, sunlight, or sand. In addition, pterygia are twice as likely to occur in men than women. Some research also suggests a genetic predisposition due to an expression of vimentin, which indicates cellular migration by the keratoblasts embryological development, which are the cells that give rise to the layers of the cornea. These cells also exhibit an increased P53 expression likely due to a deficit in the tumor suppressor gene. These indications give the impression of a migrating limbus because the cellular origin of the pterygium is actually initiated by the limbal epithelium.

As it is associated with excessive sun or wind exposure, wearing protective sunglasses with side shields and/or wide brimmed hats and using artificial tears throughout the day may help prevent their formation or stop further growth.

Symptoms

Symptoms of pterygium include persistent redness, inflammation, foreign body sensation, tearing, which can cause bleeding, dry and itchy eyes. In advanced cases the pterygium can affect vision as it invades the cornea with the potential of obscuring the optical center of the cornea and inducing astigmatism and corneal scarring.

Treatment

A variety of options are available for the management of pterygium, from irradiation, to conjunctival auto-grafting or amniotic membrane transplantation, along with glue and suture application. As it is a benign growth, pterygium typically does not require surgery unless it grows to such an extent that it covers the pupil, obstructing vision or presents with acute symptoms. Some of the irritating symptoms can be addressed with artificial tears. However, no reliable medical treatment exists to reduce or even prevent pterygium progression. Definitive treatment is achieved only by surgical removal. Long-term follow up is required as pterygium may recur even after complete surgical correction.

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