ASSOCIATION OF SENILE LENS AND DERMAL CHANGES WITH CUMULATIVE ULTRAVIOLET EXPOSURE

A cross-sectional prevalence survey of senile lens opacities was conducted, using as subjects white men between the ages of 40 and 70 years who had a biopsy of their facial skin within the previous 18 months. The subjects were identified through the records of the Dermatopathology Department of Johns Hopkins Hospital, which also supplied the biopsy specimens for staining and examination. These specimens were graded by the extent of dermal elastosis seen histologically; this ordinal grading acted as a measure of cumulative solar UV exposure in this population.; The men attended a clinic where they received an ophthalmic examination, including grading of the type and severity of senile lens opacity seen in each eye after mydriasis. A history of exposure to sun and other potential cataract risk factors was obtained by interview. The visual appearance of actinic damage to their facial skin was graded and recorded. The history of sun exposure was used to calculate a cumulative UVB exposure index; this index and the visual grading were tested as measures of solar UV damage against the histological elastosis grade.; The three exposure measures were not found to be equivalent. The UVB exposure index was not a good predictor of either measure of skin damage after adjustment by age and susceptibility to sun damage, and may be confounded by behavioral practices which were not recorded. The visual assessment of actinic skin damage was a significant predictor of severe actinic elastosis, but also appears to be confounded by age, which was incompletely controlled by adjustment. In both cases, the best predictor of severe actinic elastosis was poor ability to tan, a measure of susceptibility to sun damage.; Cortical opacity prevalence was weakly associated with actinic elastosis (RO = 2.0, p = .11); the association was primarily in those under age 55. Small numbers and a lack of dose-response weakened the evidence of association. Other associations with cortical opacities include age, diabetes, and history of welding flashburns.; Nuclear sclerosis prevalence was associated with age and use of thiazide-based drugs. Posterior subcapsular opacity prevalence was associated with use of oral steroids, prescription eyedrops, and thiazide based drugs. Weak negative associations were seen for all three opacity types with the use of aspirin to treat arthritis.