Vol 9 (2024): Continuous Publishing
Review paper
Published online: 2024-07-04

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Conjunctival ultraviolet autofluorescence imaging: an emerging diagnostic tool for monitoring the effects of ocular sun exposure

Maciej Czepita1, Damian Czepita1
Ophthalmol J 2024;9:127-132.


Conjunctival ultraviolet autofluorescence is a relatively new diagnostic method that is utilized to diagnose and quantify the amount of ocular ultraviolet exposure. It has also been used to monitor the progression of myopia. This article describes the principles of this method and the technical aspects. We give some examples of diagnosis and describe the various factors that influence it.


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  1. Delic NC, Lyons JG, Di Girolamo N, et al. Damaging Effects of Ultraviolet Radiation on the Cornea. Photochem Photobiol. 2017; 93(4): 920–929.
  2. Behar-Cohen F, Baillet G, de Ayguavives T, et al. Ultraviolet damage to the eye revisited: eye-sun protection factor (E-SPF®), a new ultraviolet protection label for eyewear. Clin Ophthalmol. 2014; 8: 87–104.
  3. Chawda D, Shinde P. Effects of Solar Radiation on the Eyes. Cureus. 2022; 14(10): e30857.
  4. Izadi M, Jonaidi-Jafari N, Pourazizi M, et al. Photokeratitis induced by ultraviolet radiation in travelers: A major health problem. J Postgrad Med. 2018; 64(1): 40–46.
  5. Elhusseiny AM, El Sheikh RH, Jamerson E, et al. Advanced spheroidal degeneration. Digit J Ophthalmol. 2019; 25(4): 68–71.
  6. Tandon R, Vashist P, Gupta N, et al. The association of sun exposure, ultraviolet radiation effects and other risk factors for pterygium (the SURE RISK for pterygium study) in geographically diverse adult (≥40 years) rural populations of India -3rd report of the ICMR-EYE SEE study group. PLoS One. 2022; 17(7): e0270065.
  7. Hӧllhumer R, Williams S, Michelow P. Ocular surface squamous neoplasia: management and outcomes. Eye (Lond). 2021; 35(6): 1562–1573.
  8. Ooi JL, Sharma NS, Papalkar D, et al. Ultraviolet fluorescence photography to detect early sun damage in the eyes of school-aged children. Am J Ophthalmol. 2006; 141(2): 294–298.
  9. Beheshtnejad AH, Ghassemi H, Abdolkhalegh H, et al. Clinical and Autofluorescence Findings in Eyes with Pinguecula and Pterygium. J Ophthalmic Vis Res. 2023; 18(3): 260–266.
  10. Yadav S, Gupta N, Singh R, et al. Role of Conjunctival Ultraviolet Autofluorescence in Ocular Surface Squamous Neoplasia. Ocul Oncol Pathol. 2020; 6(6): 422–429.
  11. Bilbao-Malavé V, González-Zamora J, Gándara E, et al. A Cross-Sectional Observational Study of the Relationship between Outdoor Exposure and Myopia in University Students, Measured by Conjunctival Ultraviolet Autofluorescence (CUVAF). J Clin Med. 2022; 11(15).
  12. de la Puente M, Irigoyen-Bañegil C, Ortega Claici A, et al. Could Children's Myopization Have Been Avoided during the Pandemic Confinement? The Conjunctival Ultraviolet Autofluorescence (CUVAF) Biomarker as an Answer. Biomedicines. 2024; 12(2).
  13. Rodriguez NG, Claici AO, Ramos-Castaneda JA, et al. Conjunctival ultraviolet autofluorescence as a biomarker of outdoor exposure in myopia: a systematic review and meta-analysis. Sci Rep. 2024; 14(1): 1097.
  14. Rajasingam P, Shaw A, Davis B, et al. The association between conjunctival and scleral thickness and ocular surface ultraviolet autofluorescence. Sci Rep. 2023; 13(1): 7931.
  15. Haworth KM. Effects of Ultraviolet Radiation Exposure on Oxidative Stress Markers on the Human Ocular Surface [dissertation]. Ohio State University, Columbus 2014: 158.
  16. Kumar I, Sundar J, Asokan R, et al. Role of conjunctival ultraviolet autofluorescence device, as an indicator of ocular ultraviolet radiation exposure in pterygium and pinguecula among outdoor workers in Southern India. Int J Community Med Public Health. 2022; 9(10): 3816.
  17. OʼSullivan R, Tom LM, Bunya VY, et al. Use of Crossed Polarizers to Enhance Images of the Eyelids. Cornea. 2017; 36(5): 631–635.
  18. Huynh E, Bukowska DM, Yazar S, et al. Quantification of sun-related changes in the eye in conjunctival ultraviolet autofluorescence images. J Med Imaging (Bellingham). 2016; 3(3): 034001.
  19. Tropospheric Emission Monitoring Internet Service [Internet]. De Bilt (Netherlands): Royal Netherlands Meteorological Institute (KNMI). 2024 Apr 2 (http://temis.nl).
  20. Radiation: Ultraviolet (UV) radiation [Internet]. Geneva (Switzerland): World Health Organization (WHO). http://who.int/news-room/questions-and-answers/item/radiation-ultraviolet-(uv) (2024 Apr 2).
  21. Sasaki H, Sakamoto Y, Schnider C, et al. UV-B exposure to the eye depending on solar altitude. Eye Contact Lens. 2011; 37(4): 191–195.
  22. Coroneo MT. Pterygium as an early indicator of ultraviolet insolation: a hypothesis. Br J Ophthalmol. 1993; 77(11): 734–739.
  23. Błażejczyk K, Błażejczyk A. Changes in UV radiation intensity and their possible impact on skin cancer in Poland. Geographia Polonica. 2012; 85(2): 57–64.
  24. Calbó J, Pagès D, González J. Empirical studies of cloud effects on UV radiation: A review. Rev Geoph. 2005; 43(2).
  25. UV Index: Information [Internet]. Washington (DC): National Oceanic and Atmospheric Administration (NOAA). http://cpc.ncep.noaa.gov/products/stratosphere/uv_index/uv_clouds.shtml (2024 Apr 2).
  26. Turner J, Parisi AV. Ultraviolet Radiation Albedo and Reflectance in Review: The Influence to Ultraviolet Exposure in Occupational Settings. Int J Environ Res Public Health. 2018; 15(7).