WILL YOUR SUN­GLASSES PRO­TECT YOU FROM EYE­LID CANCER?

Sun­glasses aren’t just a fash­ion state­ment, they could save your sight They pro­tect against sun­burnt eyeballs, cataracts and even EYE­LID cancer . . .

Daily Mail - - Front Page - By JO WA­TERS

Most of us know the dan­gers the sun poses to our skin, and will make an ef­fort with sPF. But chances are we’ll miss a key area on our faces: the skin around our eyes.

In the UK, skin cancer rates are ris­ing, with a sig­nif­i­cant pro­por­tion of them be­ing can­cers of the eye­lid. Eye­lids and the sur­round­ing area are a hot spot for cancer be­cause the skin is thin­ner, and it of­ten goes un­pro­tected from the sun.

It’s not just that we’re fail­ing to put on enough sun­cream: we’re also not choos­ing the right sun­glasses. the sun’s ul­tra­vi­o­let (UV) rays can dam­age the eyes, caus­ing sun­burn to the eye’s sur­face as well as con­tribut­ing to cataracts (where the lens clouds over) in the long term.

tri­cia Grif­fin hadn’t ap­pre­ci­ated the risks un­til she de­vel­oped a skin cancer on her eye­lid. she first no­ticed a tiny white lump on her eye­lid as she was putting on her make-up two years ago.

‘I as­sumed it was con­nected to get­ting older — a bit like a skin tag,’ says tri­cia, 65, a re­tired teacher from Bar­net, North Lon­don, who has a daugh­ter, Ruby, 28. ‘I vaguely thought I must get it checked, but didn’t get around to it. It never got big­ger or ob­scured my vi­sion.’

then, four months later, tri­cia vis­ited her cousin Mary who’d just had an eye op­er­a­tion. ‘she told me she’d had skin cancer in her eye­lid and when she de­scribed the lump I re­alised to my hor­ror that I had the same,’ says tri­cia.

‘I was shocked. I’d al­ways looked out for changes in moles and hadn’t re­alised this area could be prone to cancer.’

she went straight to her GP and was re­ferred through her med­i­cal in­surance to a pri­vate spe­cial­ist, who di­ag­nosed a basal cell car­ci­noma on her eye­lid.

Basal cell car­ci­no­mas are the most com­mon type of skin cancer on the eye­lids and af­fect the deeper layer of the skin. Al­though they rarely spread to other parts of the body, they can dam­age sur­round­ing struc­tures such as the tear duct and the eye’s open­ing mech­a­nism.

Around 13,600 cases of eye­lid can­cers are di­ag­nosed each year, mak­ing up around 10 per cent of non­ma­lig­nant skin can­cers di­ag­nosed in the UK.

the sec­ond most com­mon form of eye­lid skin cancer is squa­mous cell car­ci­noma, which af­fects the outer lay­ers of the skin.

to­gether, basal cell and squa­mous cell car­ci­no­mas ac­count for 95 per cent of all eye­lid can­cers (ma­lig­nant melanoma, an ag­gres­sive skin cancer that spreads to other or­gans, is rarer in the eye­lids).

Basal cell and squa­mous cell car­ci­no­mas may start off as small pim­ples or fleshy bumps, but can grow, bleed and crust over, ex­plains Raj Das-Bhau­mik, a consultant oph­thalmic sur­geon at Moor­fields Eye Hospi­tal in Lon­don. ‘skin may thicken and de­velop into ul­cers that don’t heal,’ he adds.

other changes to look out for in­clude red­ness and in­flam­ma­tion of the eye­lids, un­ex­plained eye­lash loss and the eye­lashes turn­ing white, caused by pig­ment cells be­ing af­fected by the cancer.

You should see your GP if you no­tice any of these changes.

RISK OF SUN­BURN OF THE EYEBALLS

‘AL­tHoUGH genes play a role, sun ex­po­sure is a huge risk fac­tor for de­vel­op­ing these can­cers,’ says Mr Das-Bhau­mik.

Cancer Re­search UK fig­ures for 2015 sug­gest the num­ber of non­melanoma skin can­cers has risen by 61 per cent in the past ten years.

Dr Howard stevens, a consultant der­ma­tol­o­gist at the Royal Free Hospi­tal and skin Care Net­work in Lon­don, where tri­cia was treated, says spe­cial­ists are see­ing a surge in cases of skin cancer, in­clud­ing those on the eye­lid, as the gen­er­a­tion who had the first span­ish pack­age hol­i­days in the sev­en­ties hit re­tire­ment age.

‘the sun pro­tec­tion mes­sage didn’t re­ally get go­ing un­til the Nineties — so we’re now see­ing the ef­fects of the sun on peo­ple who had decades of sun ex­po­sure with­out pro­tec­tion,’ he says.

As well as cancer, UV dam­age can lead to pho­tok­er­ati­tis, a type of sun­burn of the cornea, the clear part at the front of the eye. this is more com­mon in ar­eas where light re­flects off sur­faces such as wa­ter, or snow up a moun­tain.

Pho­tok­er­ati­tis causes in­flam­ma­tion of the cornea and can be treated with mild steroid drops.

‘It is ex­tremely painful and can re­sult in tem­po­rary sight loss,’ says Mr Das-Bhau­mik.

sun­light can also cause a con­di­tion called ptery­gium, a pink fleshy growth on the con­junc­tiva, the clear thin mem­brane that lines the eye­lid and front of the eye, which can be­come in­flamed, he adds. these growths are not can­cer­ous and usu­ally don’t need treat­ment, but if they blur vi­sion then they’re re­moved sur­gi­cally.

Cataracts, a com­mon eye con­di­tion where the lens in the eye be­comes cloudy and vi­sion is blurred, is also thought to be ac­cel­er­ated by UV dam­age from the sun.

In­deed a study by Case Western Univer­sity in Cleve­land, ohio, in 2014 sug­gested that UV light can trig­ger dam­age by free rad­i­cals in the eye.

sun­light en­cour­ages pro­teins in the lens to clump to­gether, which makes it cloud over, ex­plains Mr DasBhau­mik. ‘ the dam­age builds up over time. Dam­age in child­hood can re­sult in cataracts de­vel­op­ing pre­ma­turely.’

Cataract surgery is the most com­mon elec­tive pro­ce­dure done in the UK. Most peo­ple over 65 have cataract-re­lated sight prob­lems, and 300,000 op­er­a­tions are per­formed ev­ery year to re­move the cloudy lens and re­place it with an ar­ti­fi­cial clear one.

HOW TO CHOOSE THE RIGHT SHADES

to PRo­tECt your­self from sun dam­age, the ad­vice is to sit in the shade and wear a wide-brimmed hat. And — cru­cially — to wear sun­glasses when it is sunny (all year round) even in the UK.

‘Wear­ing sun­glasses isn’t about fash­ion or see­ing in bright light, but about pro­tect­ing the eyes and the skin around them,’ says Mr Das-Bhau­mik.

Ide­ally, they should be large, wrap­around sun­glasses that fit tightly, to block out sun from all sides, he says. ‘It’s im­por­tant they fit your face and sit prop­erly on the nose and don’t let any sun in.’

While wrap­around glasses are best, an­other op­tion is glasses that cover your eye­brows and the bone be­low your eye, and cover as much of the edge of your nose as pos­si­ble. Emma shields, from Cancer Re­search UK, adds: ‘ the sun­glasses should also have a CE mark, which sig­ni­fies they meet Euro­pean safety stan­dards and block all UV rays from the sun.

‘If you fol­low this rule you shouldn’t need to ap­ply sun­cream around the eyes, which can cause ir­ri­ta­tion.’ sun­glasses with no UV pro­tec­tion could be worse than wear­ing no sun­glasses as the dark lenses make the pupils of your eye di­late and let in more harm­ful rays, warns Mr Das-Bhau­mik, who him­self wears avi­a­tor or wrap­around sun­glasses with po­larised lenses that block out hor­i­zon­tal and ver­ti­cal light, pre­vent glare and im­prove con­trast.

‘My cheap­est pair of these cost £6 and have a CE mark and do the job fine,’ he says.

In ret­ro­spect, tri­cia Grif­fin blames her choice of sun­glasses for her cancer. ‘I thought I’d been care­ful,’ she says. ‘I’d never put sun­cream on my eye­lids as it caused ir­ri­ta­tion, but I as­sumed my sun­glasses would pro­tect me, though I ad­mit they were a fash­ion­able style rather than wrap­around.’

Eye­lid cancer is di­ag­nosed by a biopsy, and the tu­mour is usu­ally re­moved with surgery. the most ef­fec­tive op­er­a­tion for basal cell and squa­mous cell car­ci­no­mas is Mohs mi­cro­graphic surgery.

‘ this is a pre­cise tech­nique where the cancer is re­moved in lay­ers, a bit like peel­ing an onion,’ ex­plains Dr stevens. ‘It’s ex­am­ined un­der a mi­cro­scope dur­ing the pro­ce­dure to check we have clear mar­gins around the tu­mour. It has a cure rate of around 98 per cent.’

Af­ter surgery the eye­lid usu­ally heals it­self, or it can be re­paired or re­con­structed so the pa­tient can still open and close their eye.

tri­cia had a tu­mour the size of her thumb re­moved un­der lo­cal anaes­thetic. ‘Al­though it looked small on the sur­face, it was like an ice­berg with about 75 per cent be­low the sur­face,’ says tri­cia. ‘I’m lucky I went to the doc­tor be­fore it in­vaded more tis­sue.

‘I now wear high fac­tor sun­cream ev­ery day and wrap­around sun­glasses when­ever the sun is out — in win­ter and sum­mer.’

Pic­ture: GETTY IMAGES

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