Coral stone landscape and pterygia; is there an association?

The author examined 753 adults from 5 atolls that form a part of "Outer Islands" region of Republic of Marshall Islands (RMI), during his supervisory tour (July -Nov 2002); the visit aimed at providing primary health care services to the communities of outer islands region. Only the pterygia are highlighted in the following text. Each individual had a detailed interrogation followed by physical examination and glucometer assay of fasting blood. The dominant ocular pathologies included pterygia (14.5%), cataract (12%) and aphakia (1.5%). Of these 109 cases of clinically asymptomatic pterygia, 95 (92%) were bilateral; the disease prevailed more among women (62%). Interestingly, residents of these atolls (esp. women) attended to daily chores on grounds (adjoining their dwellings) covered with brightly shining coral stones. There was no causal association of diabetes mellitus (DM) pterygium when compared with non- diabetics. It is likely that the atoll residents were exposed not only to atmospheric ultra violet radiation (UVR), but also to ultra violet reflections from such bright coral stones beds accentuating the total effect comparable to the role of sandy beaches.