Occupational sun exposure and dry maculopathy and/or cataract in two Italian coastal populations with high solar irradiance: a 2026 comparative observational study between Ischia and the coastal areas south of Livorno.

Background: Occupational solar radiation exposure represents a recognized risk factor for several ocular disorders, particularly cataract formation, while its relationship with age-related macular degeneration (AMD) remains incompletely understood. Objective: To compare the prevalence of lens abnormalities and dry age-related macular degeneration in two populations of outdoor coastal workers chronically exposed to solar radiation and to explore the possible association between long-term occupational sun exposure and ocular alterations. Methods: A cross-sectional comparative observational study was conducted between June and July 2026 in two Italian coastal populations characterized by high environmental solar irradiance: Ischia Island (n = 68) and the coastal area south of Livorno (n = 72). Eligible participants were fishermen, sailors, mooring operators and lifeguards aged 41-50 years with at least 10 years of occupational outdoor activity during peak daylight hours. Ophthalmological assessment included visual acuity testing, Amsler grid examination, anterior segment biomicroscopy and fundus evaluation. Results: No mature cataracts were identified. Lens abnormalities compatible with incipient cataract or lens sclerosis were observed in 81.81% of workers from Ischia and 79.86% of workers from the Livorno coastal area. Dry maculopathy was identified in a limited number of participants, and no statistically significant differences were observed between the two populations. Conclusions: The findings suggest a high prevalence of early lens changes among workers occupationally exposed to prolonged solar radiation in marine environments. Although no difference emerged between the two study populations, the results support the need for preventive occupational eye health measures and further longitudinal investigations.