Association of sunlight exposure with visual impairment in an Indian fishing community

Purpose: Indian fishermen belong to a marginalized population and are continuously exposed to extreme occupational hazards and sunlight. A high prevalence of visual impairment (VI) is reported in the coastal fishing community. We aimed to investigate the association between VI with sunlight exposure measurement (SEM). Methods: In this cross-sectional observational study, 270 eyes of 135 participants were enrolled from a coastal fishing village. Participants underwent a comprehensive ophthalmic examination which included best-corrected visual acuity, anterior and posterior segment examination. Ocular surface disease index (OSDI) and SEM questionnaire were administered to estimate the level of dry eye and ultraviolet-B exposure respectively. VI was defined as presenting visual acuity worse than 6/12 33 (LogMAR >0.3). Results: Mean age and spherical equivalent were 50.56 ± 11.72 years (range: 18 to 80 years) and 0.36 35 ± 1.68 diopters (D) (range: -7 to +3.0 D), respectively. Age, SEM, OSDI, fishing as an occupation, and 36 cataract were significantly associated with higher odds of VI in univariate analysis. Refraction, gender, education level, smoking status, amblyopia, systematic and other ocular diseases were not significantly associated with VI. In the multivariate analysis, age, SEM, and cataract remained significantly associated with a higher risk for VI. Area under-curve values for age and SEM scores demonstrate a fair index of discrimination for the detection of VI. Conclusion: SEM level is directly associated with a greater risk of VI among fishermen. The fishing community might benefit from regular eye examinations, awareness about the harmful effects of sunlight exposure, and preventive measures