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Peripheral Light Focusing by the Anterior Eye and the Ophthalmohelioses
Abstract
ABSTRACT\ Peripheral focusing of light by the anterior eye may provide a unifying concept to explain the location and etiology of sun-related eye conditions (ophthalmohelioses). Using a bovine eye model, along with computer-assisted ray-tracing techniques to model limbal focusing, we demonstrated a correlation between the locations of the foci of scattered incident light (resulting in a 20-fold concentration of light at the limbus) and the usual locations of pterygium and cortical cataract. These findings suggest the need for improved ocular protective devices, particularly ones that provide lateral protection of the eye against the increased ultraviolet insolation resulting from thinning of the ozone layer.
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“supporting the notion that most of UV damage is induced by oblique peripheral rays (40).”
From Photoprotection: a Review of the Current and Future Technologies (2010) · cites this paper as [40]
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“They proposed and experimentally demonstrated that tangentially incident light at the temporal limbus travels across the anterior chamber and comes to focus on the opposing corneal side near the nasal limbus [28].”
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Self-citationLocalization of cortical cataract in subjects of diverse races and latitude.
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Self-citationUV radiation ocular exposure dosimetry.
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BackgroundSelf-citationUltraviolet fluorescence photography: patterns in established pterygia.
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“Thus, Coroneo(3,4) argued that for this reason cortical spokes began in the temporal region.(3,4) Eye & Contact Lens Volume 37, Number 4, July 2011 Intraocular and Crystalline Lens Protection”
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Self-citationThe use of conjunctival ultraviolet autofluorescence (CUVAF) as a biomarker of time spent outdoors
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“40 The average CUVAF intensity measure was found to be greater nasally than temporally in the current study but CUVAF area and total CUVAF intensity did not differ between these locations.”
Walsh, J. E., Bergmanson, J., Koehler, L. V., Doughty, M. J., Fleming, D., & Harmey, J. (2008) · Physiological Measurement · doi:10.1088/0967-3334/29/3/008 · Cited by 28
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“Furthermore, oblique rays can be focused into the nasal equatorial region of the lens (Coroneo et al. 1991).”
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“can result in the peripheral light focusing effect wherein tangential light rays will be directed onto the nasal aspect of the eye.(11,26) These peripheral UV rays can be damaging; the intensity of light passing”
BackgroundConjunctival Ultraviolet Autofluorescence as a Measure of Past Sun Exposure in Children
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“It has been proposed that UV-mediated limbal damage acts as a trigger for pterygium pathogenesis, and that focusing on the anterior eye results in light being focused with 20 times the intensity of scattered incident light onto the nasal limbus (27).”
BackgroundSelf-citationThe Role of Ultraviolet Radiation in the Ocular System of Mammals
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“Both cortical cataracts and pterygium involve predominately the nasal aspect of the eye [123,124], which supports that most of UV damage is induced by oblique peripheral rays [125].”
BackgroundMatrix metalloproteinases and their inhibitors in squamous cell carcinoma of the conjunctiva.
Girolamo, N. D., Atik, A., McCluskey, P., & Wakefield, D. (2013) · The ocular surface · doi:10.1016/j.jtos.2013.01.006 · Cited by 23
“The limbal predilection for this disease may be related to “peripheral light focussing,” a phenomenon thought to cause focal limbal damage in patients with UV-induced ocular surface diseases.(35,36) However, the factors that dictate development of OSSN are currently unknown.”
BackgroundUV Protection in the Cornea: Failure and Rescue
Volatier, T. L. A., Schumacher, B., Cursiefen, C., & Notara, M. (2022) · Biology · doi:10.3390/biology11020278 · Cited by 21
“This occurs specifically with UV entering at the temporal limbus that is then concentrated to the nasal limbus (see Figure 3) [36].”
BackgroundA novel role for CRIM1 in the corneal response to UV and pterygium development
Maurizi, E., Schiroli, D., Atkinson, S. D., Mairs, L., Courtney, D., O’Hagan, B. M. G., McGilligan, V., Pagnamenta, A. T., Taylor, J. C., Vasquez, J. J. D., et al. (2018) · Experimental Eye Research · doi:10.1016/j.exer.2018.10.012 · Cited by 22
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BackgroundEvaluation of Ocular Surface Temperature in Patients with Pterygium
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Impression Cytology of Pterygium
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“Some studies demonstrated that the UV radiation might be focused at the nasal limbus by light incident at the temporal comea (34,35).”
Do Demodex mites play a role in pterygium development?
Tarkowski, W., Moneta-Wielgos, J., & Młocicki, D. (2017) · Medical Hypotheses · doi:10.1016/j.mehy.2016.09.003 · Cited by 18
The Limbal Epithelial Progenitors in the Limbal Niche Environment
Zhang, Y., Sun, H., Liu, Y.-S., Chen, S.-L., Cai, S., Zhu, Y.-T., & Guo, P. (2016) · International Journal of Medical Sciences · doi:10.7150/ijms.16563 · Cited by 17
“This structure is highly pigmented due to the presence of melanocytes [1, 52, 53].”
BackgroundFurther evidence for heredity of pterygium
Romano, V., Steger, B., Kováčová, A., Kaye, S., & Willoughby, C. (2016) · Ophthalmic Genetics · doi:10.3109/13816810.2015.1111911 · Cited by 17
Anterior eye focusing of peripheral ultraviolet and visible radiation albedo
Cullen, A. P., Oriowo, O. M., & Voisin, A. (1997) · Clinical and Experimental Optometry · doi:10.1111/j.1444-0938.1997.tb04857.x · Cited by 17
Epidemiologic study of pterygium in a Saharan population
Bueno-Gimeno, I., Montés-Micó, R., España-Gregori, E., & Pons, Á. (2002) · doi:10.1007/s12009-002-0058-9 · Cited by 16
The effect of single and repeated UVB radiation on rabbit lens
Fris, M., Čejková, J., & Midelfart, A. (2006) · Graefe's Archive for Clinical and Experimental Ophthalmology · doi:10.1007/s00417-007-0747-6 · Cited by 15
“As previously described in the diabetic lens [5], the toxic levels of glucose enter lens cells and activate aldose reductase.”
BackgroundTemporal and spatial growth patterns in the normal and cataractous human lens.
Kwok, L., & Coroneo, M. (2000) · Experimental Eye Research · doi:10.1006/exer.2000.0883 · Cited by 15
Self-citationYu, H.-C., Lin, C.-L., Chen, Z. T.-Y., Hu, F.-R., Sung, F., & Wang, I. (2014) · The ocular surface · doi:10.1016/j.jtos.2013.08.003 · Cited by 14
“Ray-tracing analysis revealed that incident light from temporal limbus focuses on the nasal limbus, the usual location of the pterygia, with a 20-fold concentration of intensity.(4) UV radiation is considered the main environmental cause of skin cancers and the associated risk has been increasing over recent years.”
Background4-Hydroxyhexenal- and 4-Hydroxynonenal-Modified Proteins in Pterygia
Sano, I., Kaidzu, S., Tanito, M., Hara, K., Okuno, T., & Ohira, A. (2013) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2013/602029 · Cited by 13
“Hindawi Publishing Corporation Oxidative Medicine and Cellular Longevity Volume 2013, Article ID 602029, 7 pages http://dx.doi.org/10.1155/2013/602029”
BackgroundInfluentialTechnical Report: Solar Ultraviolet Protection from Sunglasses.
Rabbetts, R., & Sliney, D. (2019) · Optometry and Vision Science · doi:10.1097/opx.0000000000001397 · Cited by 12
Colitz, C. M. H., Walsh, M. T., & McCulloch, S. D. (2016) · Journal of Zoo and Wildlife Medicine · doi:10.1638/2014-0157.1 · Cited by 14
“As in humans, we hypothesized that natural UV light enters via the temporal limbus, causing most damage medially due to peripheral light focusing, also called the Coroneo effect.(11) Coroneo, et al.”
BackgroundEvolution of TUNEL-labeling in the Rat Lens After In Vivo Exposure to Just Above Threshold Dose UVB
Kronschläger, M., Yu, Z.-H., Talebizadeh, N., Meyer, L., Hallböök, F., & Söderberg, P. (2013) · Current Eye Research · doi:10.3109/02713683.2013.783079 · Cited by 12
Sudhalkar, A. (2012) · Eye · doi:10.1038/eye.2011.322 · Cited by 11
Look past the cooperative eye hypothesis: reconsidering the evolution of human eye appearance
Perea‐García, J. O., Teuben, A., & Caspar, K. R. (2025) · Biological reviews/Biological reviews of the Cambridge Philosophical Society · doi:10.1111/brv.70033 · Cited by 9
Somatic Variants in the Human Lens Epithelium: A Preliminary Assessment
Mesa, R. A., Tyagi, M. G., Harocopos, G. J., Vollman, D. E., & Bassnett, S. (2016) · Investigative Ophthalmology & Visual Science · doi:10.1167/iovs.16-19726 · Cited by 8
“This is an interesting observation because that region is exposed to more sunlight than the rest of the epithelium, 34 and it is there that cortical cataracts often develop initially.”
Ultraviolet and Visible Transmittance of Soft Contact Lenses with and without Ultraviolet Blockers
Kapfelsberger, A., Eckstein, J., von Ahrentschildt, A., Bischoff, J., Marx, S., & Sickenberger, W. (2021) · Optometry and Vision Science · doi:10.1097/opx.0000000000001796 · Cited by 9
Domdey, M., Kluth, M., Maßlo, C., Ganss, C., Frank, M., Frank, N., Coroneo, M., Cursiefen, C., & Notara, M. (2022) · Stem Cell Research · doi:10.1016/j.scr.2022.102936 · Cited by 8
“…matrix metalloproteinases (MMPs) including MMP1, 13, 2 and 9 (Di Giro-lamo et al., 2000), along with putative stem cell markers (Chui et al., 2011) suggesting LESC may be involved in pterygium onset and progression as we had earlier postulated (Coroneo et al., 1991a; Coroneo et al., 1991b).”
Self-citationOcular Surface Diseases in Marine Mammals.
Colitz, C. M. (2019) · Veterinary Clinics of North America Exotic Animal Practice · doi:10.1016/j.cvex.2018.08.007 · Cited by 8
PARP ‐1/ PAR Activity in Cultured Human Lens Epithelial Cells Exposed to Two Levels of UVB Light
Cencer, C. S., Chintala, S. K., Townsend, T. J., Feldmann, D. P., Awrow, M., Putris, N., Geno, M., Donovan, M. G., & Giblin, F. J. (2017) · Photochemistry and Photobiology · doi:10.1111/php.12814 · Cited by 10
“An even greater threat to lens transparency may be UV light entering from the side of the eye since this radiation can focus up to 20x stronger in the peripheral region of the lens on the nasal side (13-15).”
Heterogeneity of Limbal Basal Epithelial Progenitor Cells
Hayashida, Y., Li, W., Chen, Y., He, H., Chen, S.-Y., Kheirkah, A., Zhu, Y., Matsumoto, Y., & Tseng, S. C. G. (2010) · Cornea · doi:10.1097/ico.0b013e3181ea4b13 · Cited by 8
Masili, M., Duarte, F. O., & Ventura, L. (2024) · Scientific Reports · doi:10.1038/s41598-023-50831-9 · Cited by 7
Ijiri, S., Kobayashi, A., Yoshita, T., Yokogawa, H., & Sugiyama, K. (2007) · Cornea · doi:10.1097/ico.0b013e31802e1e3b · Cited by 7
A novel sensor array for field based ocular ultraviolet radiation measurements.
Fleming, D., Walsh, J. E., Moore, L. A., Bergmanson, J., & McMahon, D. (2006) · Radiation Protection Dosimetry · doi:10.1093/rpd/nci346 · Cited by 7
Prevalence of Pinguecula and Pterygium in Patients With Thyroid Orbitopathy
Özer, P. A., Altıparmak, U. E., Yalnız-Akkaya, Z., Kasim, R., & Duman, S. (2010) · Cornea · doi:10.1097/ico.0b013e3181c296ab · Cited by 10
“These facts strongly suggest that pterygia and pinguecula are causally related to prolonged actinic damage(2) and they are the most obvious examples of the ophthalmohelioses (sun-related diseases of the eye), the term initially used by Coroneo in the literature.(11) One study demonstrated the mutagenic effect of UV-B…”
BackgroundLatitude and Incidence of Ocular Melanoma
Vajdic, C., Kricker, A., & Armstrong, B. (2007) · Photochemistry and Photobiology · doi:10.1111/j.1751-1097.2007.00094.x · Cited by 6
Photoregulatory functions drive variation in eye coloration across macaque species
Perea‐García, J. O., Massen, J. J. M., Ostner, J., Schülke, O., Castellano‐Navarro, A., Gazagne, E., José‐Domínguez, J. M., Francés, V. B., Kaburu, S., Ruppert, N., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-80643-4 · Cited by 5
Suleiman, D., Liman, A., Waziri, G., Iliyasu, Y., & Ahmed, S. (2021) · International ophtalmology · doi:10.1007/s10792-022-02411-5 · Cited by 5
Optical performance of welding curtains and existing standards
Dain, S., Sliney, D., & Naumov, A. (2021) · Journal of Occupational and Environmental Hygiene · doi:10.1080/15459624.2021.1921183 · Cited by 5
Optical Analysis and Reappraisal of the Peripheral Light Focusing Theory of Nasal Pterygia Formation
King-smith, P., Mauger, T., Begley, C., & Tankam, P. (2020) · Investigative Ophthalmology and Visual Science · doi:10.1167/iovs.61.2.42 · Cited by 5
Handing it to pterygium: Explaining pterygium laterality.
Coroneo, M., Tat, L. T., Chen, H., Grupchev, D. I., Grupcheva, C., & Ip, M. H. (2020) · The ocular surface · doi:10.1016/j.jtos.2020.12.001 · Cited by 4
Self-citationWaszczykowska, A., Bartosiewicz, K., Podgórski, M., Zmysłowska-Polakowska, E., & Jurowski, P. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9092693 · Cited by 4
“The well-known Coroneo effect (the ability to refract light rays through the cornea and focus them 20-fold stronger in the nasal conjunctival region than temporal) may explain the higher incidence of CUVAF in the nasal region in a healthy population [13,14].”
BackgroundPhototoxic Consequences of the Corneal Dome
Kwok, L. (1997) · doi:10.1007/978-94-011-5698-1_37 · Cited by 4
Metadata
- Authors
- Coroneo, M. T., Müller-Stolzenburg, N. W., & Ho, A.
- Affiliations
- UNSW Sydney (AU)
- ORCID
- Venue
- Ophthalmic Surgery, Lasers and Imaging Retina
- Publisher
- SLACK, Inc.
- Published
- 1991-12
- Volume
- 22
- Issue
- 12
- Pages
- 705-711
- ISSN
- 1542-8877 (ISSN-L)
- 2325-8160
- 2325-8179
- OpenAlex
- W2465418419
- Cited by
- 141
- References
- 19
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 11 · 2012: 3
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ophthalmic surgery, lasers & imaging retina (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Ocular and Laser Science Research
- Health Sciences › Medicine › Ophthalmology › Ocular Surface and Contact Lens
- Health Sciences › Medicine › Ophthalmology › Ophthalmology and Visual Impairment Studies
- Keywords
- anterior eye, pterygium, cortical cataract, light scattering, ray tracing
- MeSH terms
- Animals, Anterior Eye Segment, Cattle, Computer Simulation, Eye Diseases, Eye Protective Devices, Models, Biological, Scattering, Radiation, Sunlight, Ultraviolet Rays, Vision, Ocular, Visual Pathways
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