Background: Ocular surface epithelial dysplasia involves a spectrum of
diseases ranging from only minor eye irritation to blindness and pote
ntially death. Methods: A case-control study involving 60 patients wit
h ocular surface epithelial dysplasia treated between 1972 and 1991 an
d 60 age- and sex-matched individuals was conducted to compare relativ
e ultraviolet light exposures over their lifetimes. A standardized sel
f-administered ultraviolet exposure questionnaire was used for assessm
ent. Results: Risk factors identified include phenotypic features such
as fair skin (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.1
,25.6), pale iris (OR, 1.8; 95%; CI, 0.9,3.8), and propensity to sunbu
rn (OR, 3.8; 95% CI, 0.7,19.7), history of previous skin cancers remov
ed (OR, 15; 95% CI, 2.0,113.6), and being outdoors more than 50% of ti
me in the first 6 years of life white living 30 degrees or less from t
he equator (OR, 7.5; 95% CI, 1.8,30.6). Conclusion: These risk factors
suggest that ocular surface epithelial dysplasia is an ultraviolet li
ght-related disease.