Ocular risks related to light overexposure in maritime professionals in the Provence-Alpes-Côte d’Azur Region, France: The PHOTOPPA study

PURPOSE: To assess the prevalence of light-induced toxic effects on the ocular and palpebral regions in maritime professionals chronically exposed to light radiation in the Provence-Alpes-Côte d'Azur region and to compare the results to a non-overexposed population. The study also investigates risk factors for and protective factors against ocular phototoxicity in exposed individuals. DESIGN: Single-center, cross-sectional comparative analysis. PARTICIPANTS: The study included 77 maritime professionals (overexposed group) and 70 non-overexposed individuals (control group). Participants were examined between July 2023 and June 2024 at the ophthalmology department of Sainte-Anne Military Hospital. METHODS: Cross-sectional comparative analysis was performed between the two groups. Participants underwent a clinical examination, including ocular imaging, focused on ocular conditions such as conjunctival lesions, cataracts, and macular changes linked to light overexposure, and completed questionnaires on sun exposure. RESULTS: The study found no connection between age-related macular degeneration (AMD) and solar overexposure but highlighted the significant role of light reflection from water in other ocular conditions. Four basal cell carcinomas were found in the exposed group, consistent with the pathogenesis of these skin cancers. A higher risk of conjunctival lesions (pinguecula and/or pterygium) and cortical cataracts was noted. Macular epithelial damage was linked to increased light exposure. Protective solar equipment reduced the risk of ocular damage in certain conditions. CONCLUSIONS: The PHOTOPPA study is the first to compare ocular pathologies related to light overexposure in maritime professionals. It confirms the increased risk of ocular conditions, emphasizing the importance of comprehensive sun protection to reduce light-induced ocular damage and possibly prevent AMD development.