Documenta Ophthalmologica

, Volume 88, Issue 3–4, pp 307–325 | Cite as

Cataract and latitude

  • Jonathan C. Javitt
  • Hugh R. Taylor
Article

Abstract

For many years, it has been suggested that exposure to sunlight, particularly its ultraviolet component, may be associated with an increased risk of senile cataract. This paper adresses 1) the physical and geographic variables that affect the entry of ultraviolet light in the eye; 2) the epidemiologic evidence that associates cataract with ultraviolet light exposure; and 3) the effectiveness of personal barrier protection (i.e. sunglasses and hats) in reducing ocular exposure to ultraviolet light. The epidemiologic evidence is drawn from studies in Australia, China, Tibet, and the United States. The U.S evidence consists of data from the Maryland Watermen study and analyses of cataract surgery under the Medicare program which provides health insurance for nearly all Americans age 65 and over (30 million) and pays for 85% of the 1.3 million cataract extractions performed annually in the U.S. Analysis of the Medicard data shown that, after controlling for age, sex, and race, and income of the population and also controlling for supply of ophthalmologists, optometrists, price of surgery and local practice costs, the strongest predictor of cataract surgery likelihood in a Medicare benificiary is the person's latitude of residence. Latitude correlates directly with the UV-B content of sunlight, because the incident angle of the sun determines the atmospheric penetration of ultraviolet radiation. Data suggest that the probability of cataract surgery in the U.S. increases by 3% for each 1 degree decrease (i.e. more Southerly) in latitude.

Key words

Cataract Latitude Sunlight Epidemiological analysis Ultraviolet Risk factors 
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References

  1. 1.
    Javitt JC, Taylor HR. Ocular protection from solar radiation. In: Tasman WS, Jaegar EA, eds. Duane's Clinical Ophthalmology. Philadelphia: JB Lippincott Company, Inc., 1991: 5; 55: 1–13.Google Scholar
  2. 2.
    American Academy of Ophthalmology. Eye and visual system abnormalities. In: Eye Care for the American People, Supplement to Ophthalmology. San Francisco: American Academy of Ophthalmology, 1987: Chapter 2.Google Scholar
  3. 3.
    Hausser KW, Vahle W (as translated by Urbach F). Sunburn and suntanning. In: Urbach F, ed. Biologic effects of ultraviolet radiation. Oxford: Pergamon Press, 1969: 3–21.Google Scholar
  4. 4.
    Jones RR. Ozone depletion and cancer risk. Radiat Res 1987; 2: 443–6.Google Scholar
  5. 5.
    Duke-Elder S, MacFaul PA. Radiational injuries: action on the lens. In: Duke-Elder S, ed. System of Ophthalmology, Volume XIV, Part 2. St. Louis: C.V. Mosby Company, 1972: 928–33.Google Scholar
  6. 6.
    Phillips M. Electromagnetic radiation. In: Encyclopaedia Brittanica, Volume 6. Chicago: Encyclopaedia Brittanica, Inc., 1980: 644–65.Google Scholar
  7. 7.
    Parrish JA, Anderson RR, Urbach F, Pitts D. UV-A: Biological effects of ultraviolet radiation with emphasis on human responses to longwave ultraviolet. New York: Plenum Press, 1978: Chapter 1.Google Scholar
  8. 8.
    Robertson DF. Solar ultraviolet radiation in relation to sunburn and skin cancer. Med J Aust 1968; 2: 1123–32.PubMedGoogle Scholar
  9. 9.
    Fishman GA. Ocular phototoxicity: guidelines for selecting sunglasses. Surv Ophthalmol 1986; 31: 119–24.PubMedCrossRefGoogle Scholar
  10. 10.
    Sliney DH. Physical factors in cataractogenesis: ambient ultraviolet radiation and temperature. Invest Ophthalmol Vis Sci 1986; 27: 781–90.PubMedGoogle Scholar
  11. 11.
    Rosenthal RS, Safran M, Taylor HR. The ocular dose of ultraviolet radiation from sunlight exposure. Photochem Photobiol 1985; 42: 163–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Rosenthal FS, Bakalian AE, Taylor HR. The effect of prescription eyewear on ocular exposure to ultraviolet radiation. Am J Public Health 1986; 76: 1216–20.PubMedGoogle Scholar
  13. 13.
    Sliney DH. Eye protective techniques for bright light. Ophthalmol 1983; 90: 937–44.Google Scholar
  14. 14.
    Coroneo MT. Albedo concentration in the anterior eye and the location of some solar diseases. M.S. thesis. Sydney: University of Sydney, 1988.Google Scholar
  15. 15.
    Kinsey VE. Spectral transmission of the eye to ultraviolet radiations. Arch Ophthalmol 1948; 39: 508–13.Google Scholar
  16. 16.
    Bachem A. Ophthalmic ultraviolet action spectrum. Am J Ophthalmol 1956; 41: 969–75.PubMedGoogle Scholar
  17. 17.
    Boettner EA, Wolter JR. Transmission of the ocular media. Invest Ophthalmol Vis Sci 1962; 1: 776–83.Google Scholar
  18. 18.
    Cooper G, Robson J. The yellow colour of the lens of man and other primates. J Physiol (London) 1969; 203: 411–17.Google Scholar
  19. 19.
    Lerman S. Human ultraviolet radiation cataracts. Ophthalmic Res 1980; 12: 303–14.CrossRefGoogle Scholar
  20. 20.
    Rosen ES. Filtration of non-ionizing radiation by the ocular media. In: Cronly-Dillon J, Rosen ES, Marshall J, eds. Hazards of light: myths and realities of eye and skin. Oxford: Pergamon Press, 1986: 145–52.Google Scholar
  21. 21.
    Zigman S. Photobiology of the lens. In: Maisel H, ed. The ocular lens: structure, function, and pathobiology. New York: Marcel Dekker, Inc., 1985: 301–47.Google Scholar
  22. 22.
    Verhoeff FH, Bell L, Walker CB. The pathological effects of radiant energy on the eye; an experimental investigation with a systematic review on the literature. Proc Am Acad Arts Sci 1916; 51: 630–818.Google Scholar
  23. 23.
    Pitts DG. The human ultraviolet action spectrum. Am J Optom Physiol Optics 1974; 51: 946–60.Google Scholar
  24. 24.
    Pitts DG, Cullen AP, Parr WH. Ocular ultraviolet effects from 295 nm to 335 nm in the rabbit eye. Washington, D.C.: U. S. Department of Health, Education, Welfare (NIOSH), 1976: 1–55.Google Scholar
  25. 25.
    Parrish JA, Anderson RR, Urbach F, Pitts, D. UV-A: biological effects of ultraviolet radiation with emphasis on human responses to longwave ultraviolet. New York: Plenum Press, 1978: Chapter 9.Google Scholar
  26. 26.
    Ham WT, Mueller HA, Rufflo JJ, Guerry D, Guerry RK. Action spectrum for retinal injury from near-ultraviolet radiation in aphakic monkey. Am J Ophthalmol 1982; 93: 299–306.PubMedGoogle Scholar
  27. 27.
    Rohrschneider W. Linsenschadigung durch ultraviolette Strahlen im Tierversuch. Arch Ophthalmol 1936; 135: 282–92.Google Scholar
  28. 28.
    Zigman S, Yulo T, Schultz J. Cataract induction. In: mice exposed to near UV light. Ophthalmic Res 1974; 6: 259–70.Google Scholar
  29. 29.
    Keeney AH, Rampton DV. Solar irradiation and ocular concerns. Ophthalmology 1986; 93(suppl): 109.Google Scholar
  30. 30.
    Wilson J. The six main causes of blindness. In: International Agency for the Prevention of Blindness, Wilson J, eds. World blindness and its prevention. Volume 1. Oxford: Oxford University Press, 1980: 1–13.Google Scholar
  31. 31.
    Pacurariu I, Marin C. Changes in the incidence of ocular disease in children and old people. Oftalmologica 1973; 17: 289–308.Google Scholar
  32. 32.
    van Heyningen R. The human lens. I. A comparison of cataracts extracted in Oxford (England) and Shikarpur (W. Pakistan). Exp Eye Res 1972; 13: 136–47.PubMedCrossRefGoogle Scholar
  33. 33.
    Zigman S, Datiles M, Torczynski E. Sunlight and human cataracts. Invest Ophthalmol Vis Sci 1979; 18: 462–67.PubMedGoogle Scholar
  34. 34.
    Hiller R, Giacometti L, Yuen K. Sunlight and cataract: an epidemiologic investigation. Am J Epidemiol 1977; 105: 450–59.PubMedGoogle Scholar
  35. 35.
    Hiller R, Sperduto RD, Ederer F. Epidemiologic associations with cataract in the 1971–72 National Health and Nutrition Examination Survey. Am J Epidemiol 1983; 118: 239–49.PubMedGoogle Scholar
  36. 36.
    Hiller R, Sperduto RD, Ederer F. Epidemiologic associations with nuclear, cortical, and posterior subcapsular cataracts. Am J Epidemiol 1986; 124: 916–25.PubMedGoogle Scholar
  37. 37.
    Taylor HR. The environment and the lens. Br J Ophthalmol 1980; 64: 303–10.PubMedCrossRefGoogle Scholar
  38. 38.
    Hollows F, Moran D. Cataract — the ultraviolet risk factor. Lancet 1981; 2: 1249–50.PubMedCrossRefGoogle Scholar
  39. 39.
    Mao WS, Hu TS. An epidemiologic survey of senile cataract in China. Chin Med J 1982; 95: 813–18.PubMedGoogle Scholar
  40. 40.
    Xu J, Mao W, Zhu S, Kupfer C. A case-control study of senile cataract in Lhasa, Tibet, China. Invest Ophthalmol Vis Sci 1987; 28(suppl): 396.Google Scholar
  41. 41.
    Brilliant LB, Grasset NC, Pokhrel RP, Kolstad A, Lepkowski JM, Brilliant GE, Hawks WN, Pararajasegaram R. Associations among cataract prevalence, sunlight hours, and altitude in the Himalayas. Am J Epidemiol 1983; 118: 250–64.PubMedGoogle Scholar
  42. 42.
    Cameron LL, Auer CL, McCormick PA, Owens SL, Fine SL, Taylor HR. Association of sunlight with senile macular and lens changes. Invest Ophthalmol Vis Sci 1983; 24(suppl): 202.Google Scholar
  43. 43.
    Cameron LL. Association of senile lens and dermal changes with cumulative ultraviolet exposure. Ph.D. dissertation. Baltimore: The Johns Hopkins University, 1985.Google Scholar
  44. 44.
    Cameron LL, Emmett EA, Abbey H, Patel A, Newland H, Taylor HR. Association of senile lens opacities with UV and other factors. Invest Ophthalmol Vis Sci 1986; 27(suppl): 45.Google Scholar
  45. 45.
    Taylor HR, West SK, Rosenthal FS, Muñoz B, Newland HS, Abbey H, Emmett EA. Effect of ultraviolet radiation on cataract formation. New Engl J Med 1988; 319: 1429–33.PubMedCrossRefGoogle Scholar
  46. 46.
    Steinberg EP, Javitt JC, Sharkey P, Zuckerman A. Legro MW, Anderson GF, Bass EB, O'Day D. The content and cost of cataract surgery. Arch Ophthalmol 1993; 111: 1041–9.PubMedGoogle Scholar
  47. 47.
    Javitt JC, Kendix M, Tielsch JM, Steinwachs DM, Schein OD, Kolb MM, Steinberg EP. Geographic variation in utilization of cataract surgery. Medical Care, 1994, in press.Google Scholar
  48. 48.
    Javitt JC, Canner JK, Kolb MM, Steinberg EP and the National Cataract Outcomes Study. National outcomes of cataract extraction: association of posterior capsulotomy with increased risk of pseudophakic retinal detachment. Ophthalmology 1992; 99: 1487–98.PubMedGoogle Scholar
  49. 49.
    Leibowitz HM, Krueger DE, Maunder LR, Milton RC, Kini MM, Kahn HA, Nickerson RJ, Pool J, Colton TL, Ganley JP, Lowenstein JI, Dawber TR. The Framingham Eye Study monograph: an ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration, and visual acuity in a general population of 2631 adults, 1973–1975. Surv Ophthalmol 1980; 24: 335–610.PubMedCrossRefGoogle Scholar
  50. 50.
    Javitt JC, McBean AM, Nicholson GA, Babish D, Warren JL, Krankauer H. Undertreatment of glaucoma among black Americans. N Engl J Med 1990; 325: 1418.Google Scholar
  51. 51.
    Javitt JC, Vitale S, Canner JK, Krakauer H, McBean AM, Sommer A. National outcomes of cataract extraction: retinal detachment following inpatient surgery. Ophthalmology 1991; 98: 896–902.Google Scholar
  52. 52.
    Robinson WS. Ecological correlations and the behavior of individuals. Am Sociol Rev 1950; 15: 351–57.CrossRefGoogle Scholar
  53. 53.
    Morgenstern H. Uses of ecologic analysis in epidemiologic research. Am J Public Health 1982; 72: 1336–44.PubMedCrossRefGoogle Scholar
  54. 54.
    Rosenthal FS, Phoon C, Bakalian AE, Taylor HR. The ocular dose of ultraviolet radiation in outdoor workers. Invest Ophthalmol Vis Sci 1988; 29: 649–56.PubMedGoogle Scholar
  55. 55.
    U.S. Bureau of the Census. Geographical mobility: March 1987–March 1990. Current Population Reports, Series P-20 ♯456, Table 20.Google Scholar
  56. 56.
    Pizarello LD. The dimensions of the problem of eye disease among the elderly. Ophthalmology 1987; 94: 1191–5.Google Scholar
  57. 57.
    Kupfer C. Six main causes of blindness. In: Internatonal Agency for the Prevention of Blindness, Wilson J, eds. World blindness and its prevention. Volume 2. Oxford: Oxford University Press, 1984: 4–14.Google Scholar
  58. 58.
    Maddox J. The great ozone controversy. Nature 1987; 329: 101.CrossRefGoogle Scholar
  59. 59.
    Garelik G. A breath of fresh air. Time 1987; September 28: 35.Google Scholar
  60. 60.
    Bowie L. The politics of ozone: balancing interests. The Sun Paper, September 27, 1987.Google Scholar
  61. 61.
    Farmer CB, Toon GC, Schaper PW, Blavier JF, Lowes LL. Stratospheric trace gases in the spring 1986 Antarctic atmosphere. Nature 1987; 329: 126–30.CrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1995

Authors and Affiliations

  • Jonathan C. Javitt
    • 2
  • Hugh R. Taylor
    • 2
    • 1
  1. 1.Department of OphthalmologyThe University of MelbourneEast MelbourneAustralia
  2. 2.Worthen Center for Eye Care ResearchGeorgetown University Center for SightWashington, DCUSA

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