Sports eyewear protective standards

Eye injuries sustained during sport comprise up to 20 per cent of all injuries to the eye serious enough for medical attention to be sought. The prevalence of eye injuries in sport is not easily assessed due to lack of authoritative participation rates, so most studies report total numbers in a time period. The evidence on the proportion of all ocular injuries that are from sport is reviewed. The relative frequencies in different sports are compared in a qualitative manner and the sports with greater numbers of ocular injuries are detailed. In common with occupational injuries to the eye, most sports eye injuries are considered preventable. The hierarchy of action for occupational risk is detailed and adapted to use in a sports scenario. All the available international, regional and national standards on sports eye protection are detailed and their provisions compared. The major function of the standards is to provide adequate protection against the hazard of the sport concerned. These are detailed and compared as a function of energy transfer. Eye protection must not introduce additional or secondary hazards (for instance, fracturing into sharp fragments on impact) and not introduce features that would deter the wearing of eye protection (for instance, restricting field of view to impede playing the sport). The provisions of the standards intended to limit secondary hazards are detailed and compared. The need for future work in standards writing and the activities of the International Standardization Organization in sports eye protection are detailed.     

THE INTRODUCTION OF AN EYE PROTECTION PROGRAMME*

It has been the experience of industry that eye protection programmes are fraught with a failure rate which, it seems, acts as a deterrent when management plan to deal with the problem of eye injuries in their production areas. There is no doubt that many programmes have failed and it has become apparent only after breakdown that the whole effort was a planned failure because the proper concept of eye protection was not understood. It should be realised by all concerned that if known eye hazards exist in the environment, then it is the personal, moral and legal responsibility of management to protect all persons entering that environment against injury. The proper acceptance of this responsibility will lead to firm management direction, through a fully considered company policy, that properly planned protective measures will be implemented to eradicate eye injuries. Implementation, as with any management policy, will be through executive administration, with the final responsibility held by supervision. Before successful programming is possible management must work closely with administrative supervision, safety committees, unions and optometrical services in analysing the actual extent of the problem and the real need of a programme before a meaningful policy statement can be made. With this background of information supervisory administration is enabled to implement policy while diplomatically but firmly applying the mandatory rule on the wearing of eye protective equipment without which the programme will not work successfully. It is predicted that the present disregard of this responsibility by much of industry will eventually lead to legislation under which a mandatory rule will apply to management. The good business of an eye protection programme is only slowly being recognised but the fine example set by some of our industrial leaders must surely be re-assuring to any who contemplate action against the problem of eye injuries.     

大力开展中国眼组织工程的研究和转化

眼组织工程是利用特定生物学活性的组织、细胞或支架材料在体外或体内构建成为眼部的组织和器官,用以维持、修复或诱导组织再生,使眼部组织器官功能得到改善或提高的一个科学方向.随着社会人口的老龄化和平均寿命的延长,眼组织工程与再生医学正逐渐成为眼科学的重要发展方向之一,其相关产品和技术研究将成为未来眼科医用替代类医疗器械的热点.大力发展中国的眼组织工程基础研究,不断革新眼组织工程技术是促进中国眼组织工程产业发展的基础,包括将相关领域的基础研究成果向工业化生产和应用等方面转化的研究,将大大提高中国在此领域的国际地位和研究市场竞争能力,为中国眼科学的发展提供新的动力.     

Serious fireworks-related eye injuries

OBJECTIVE. To analyze and compare epidemiological and clinical information on serious fireworks-related eye injuries from two affiliates of the United States Eye Injury Registry. METHOD. Retrospective review. RESULTS. In the Eye Injury Registry of Alabama (EIRA) database, 185 of the 4150 injuries (4.4%) were caused by fireworks. In the Hungarian Eye Injury Registry database, only two of the 1245 cases (0.1%, p=0.000001) were fireworks-related. In the EIRA, 79% of patients were males and 87% were under 31 years. A bystander was injured in 67% of the cases, being an average of 23 feet away; 39% of bystanders had a final vision =19/200. No injured person wore eye protection. Bottle rockets caused 80% of the 185 injuries. Overall, 20% of eyes had <5/200 final visual acuity. Twenty-five percent of bottle rocket-injured eyes, compared to 64% of those injured by other devices, had =20/40 final vision (p=0.000004). CONCLUSIONS. The rate of fireworks-related serious eye injuries has not decreased in Alabama in the last 16 years; most patients are young males. Since bystanders are at a measurable risk even at a distance of 100 feet, wearing eye protection is recommended to both bystanders and operators. Bottle rockets cause most of the injuries and the more severe ones, and should be the prime target for prevention. The benefit of a strict and enforced legislative ban on private fireworks displays is demonstrated by the much lower incidence figure in Hungary. Such a ban should be considered in other countries where fireworks-related eye injuries are common.     

Eye1 and Eye2: gene loci that modulate eye size, lens weight, and retinal area in the mouse

PURPOSE: Vision is critically dependent on genetic factors that influence the rate and duration of eye growth. The genetic basis of variation in eye size in mice was explored, and genes that modulate eye weight, lens weight, and retinal area were mapped. METHODS: Eyes of approximately 700 mice were weighed. Data were corrected by regression analysis to eliminate effects of sex, age, and body weight. Interval mapping was used to locate quantitative trait loci (QTLs) using recombinant inbred strains and F2 intercrosses between strains C57BL/6J and DBA/2J. RESULTS: Major QTLs were discovered near the centromere of chromosome 5 (Eye1: genomewide P < 0.005) and on proximal chromosome 17 near the mast cell protease 6 gene (Eye2, P < 0.05). Both QTLs have significant effects on eye size, lens weight, and retinal area. The DBA/2J alleles at Eye1 and Eye2 are partially dominant and increase eye weight by as much as 1.0 mg. Analysis of 183 F2 progeny confirmed and refined the chromosomal assignments of both Eye1 and Eye2. CONCLUSIONS: Eye1 and Eye2 are the first loci known to control normal variation in eye size in any mammal. The hepatic growth factor gene (Hgf), a potent mitogen expressed in the retina, pigment epithelium, and choroid, is a strong candidate for Eye1. The human homolog of Eye2 should map to chromosome 6p, 16q13.3, or 19q13, whereas that of Eye1 should map to 7q.     

An evaluation of tear film breakup time extension and ocular protection index scores among three marketed lubricant eye drops

PURPOSE: To report the performance of an artificial tear containing propylene glycol and polyethylene glycol as active demulcents with hydroxypropyl-guar as a gelling agent (Systane Lubricant Eye Drops; Alcon, Fort Worth, TX) and compare it with that of 2 artificial tears containing carboxymethylcellulose (Refresh Tears and Refresh Endura Lubricant Eye Drops; Allergan, Irvine, CA). METHODS: This was a single-center, 3-visit, randomized, double-masked crossover study that evaluated the effect of Systane versus Refresh Tears and Refresh Endura using tear film breakup time (TFBUT) and ocular protection index (OPI) in subjects with dry eye (n = 50). TFBUT values (5, 10, 15, 20, 30, 45, and 60 minutes after instillation) divided by interblink interval (IBI) yielded OPI scores. RESULTS: Systane significantly improved TFBUT at 5, 10, 15, 20, and 60 minutes versus Refresh Tears and at 5, 10, 15, 20, and 30 minutes versus Refresh Endura. Systane OPI scores were significantly higher than Refresh Tears at 15 and 30 minutes and than Refresh Endura at 5 minutes. CONCLUSIONS: This study suggests that Systane Lubricant Eye Drops was more effective than Refresh Tears at prolonging TFBUT up to 20 minutes after instillation and more effective than Refresh Endura at prolonging TFBUT up to 30 minutes after instillation. These data show that Systane is an effective first-line dry eye therapy and a superior ocular surface protector compared with Refresh Endura and Refresh Tears in the sample test population.     

A case-control study of eye injuries in the workplace in Hong Kong

OBJECTIVE: Eye injury in the workplace is common worldwide. This study proposed to explore both risk and preventive factors re eye injuries in Hong Kong. DESIGN: Case-control study. PARTICIPANTS: A total of 239 work-related eye injury patients, and 253 subjects without a history of any eye injury as controls. METHODS: Patients with all incident cases of work-related eye injuries attending the ophthalmology clinics of 3 major public hospitals in Hong Kong during the first 3 months of 2000 were invited to participate. Controls were selected from the general population and were frequency matched to patients based on gender. Patients were interviewed face-to-face by trained interviewers in the ophthalmology clinics, using a structured questionnaire. Telephone interviews were used for controls. MAIN OUTCOME MEASURES: Risk and protective factors associated with eye injuries. RESULTS: Among eye injury cases, 158 patients (66.1%) reported having incurred 1 episode of eye injury during employment, 49 (20.5%) having suffered 2 episodes, and 32 (13.4%) having experienced >/==" BORDER="0">3 eye injuries at work. Most of the patients (85.4%) did not wear any protective devices at the time of injury. Subjects who wore safety glasses regularly were less likely to have eye injuries (odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.14-0.62). Having a safety requirement for wearing safety glasses was negatively associated with eye injuries (OR = 0.31, 95% CI = 0.15-0.62). Multivariate analysis indicated that exposures to certain work hazards and working in the construction industry were positively associated with eye injuries. Subjects who worked longer in their current job, who reported having received job safety training before employment, or whose machines or equipment were maintained or repaired regularly by employers were at lower risk of experiencing eye injuries. CONCLUSIONS: Construction workers and those exposed to multiple hazards may get eye injuries at work. They should be provided with protective devices that are effective in preventing such exposures. Health education and safety training are important in preventing eye injuries. Maintenance and repair of machines and equipment may effectively reduce or eliminate the sources of exposures.     

MOTIVATION IN EYE PROTECTION PROGRAMMES*

Although the need for eye protection against impact hazards is well recognized, eye protection programmes are of no value unless they are used. The methods of compulsion are costly, limited in application, frequently unsuccessful and unlikely to produce a satisfactory permanent solution. Methods in which the wearer is strongly motivated to use eye protection may ultimately prove to be more effective; although there is as yet insufficient knowledge to guarantee success, some relevant factors are known. Those methods that motivate towards the use of eye protection include the need for vision correction, fear of injury, jealousy of others, choice, and the effects of training; those that motivate against acceptance include the use of eye protection that is technically inefficient, cumbersome or uncomfortable in any way, or, more particularly, is aesthetically unpleasing. Strong influences which may be for or against acceptance are exerted on the individual by the reaction of the working group. The need for more investigational work into group motivational factors is suggested.     

Eye protection from airborne allergens

The need for eye protection from hazards such as flying objects, particles, dust, noxious gases and chemicals is well established, and is part of normal safety procedures where these hazards exist. There have been recent reports that eye protection from airborne allergens may be an effective method for reducing the symptoms of allergic conjunctivitis and hay fever. This review examines the literature on these devices which appear to offer an alternative to conventional drug therapy.     

PERSONAL EYE PROTECTORS: PERFORMANCE REQUIREMENTS AND TESTING

The performance requirements for personal eye protectors are identified and discussed under the two headings of (a) the factors that influence wearer acceptance and (b) strength. The relative importance of these two groups of factors is shown to vary with the application. Their relevance is therefore discussed in the two differing but complementary contexts of (i) intermittent and (ii) constant, day-long use. This section suggests that, for day-long use, protection should be afforded by properly fitted, optically correct spectacles glazed with lenses of allyl resin or toughened glass. This is supplemented by the additional intermittent use of high-impact protectors for special operations. The bulk of the paper is devoted to an examination of the ways in which eye protector strengths are measured. It is emphasized that testing methods should simulate real-life hazards. Clinically observed eye injuries consist of blunt trauma from large missiles and penetrating injuries from small ones. These can be conveniently simulated in the laboratory by dynamic tests using (a) a 25 m.m. (one inch) steel ball in a drop tower system and (b) a 3 m.m. (118 inch) steel ball in a ballistic system. These tests are proposed. Sample size, missile type and test procedures are also discussed in detail.     

EYE PROTECTION AGAINST OPTICAL RADIATION

The generation of light by industrial processes such as welding and smelting is usually accompanied by the production of radiation that may be hazardous to the eye. The nature of this radiation and its effects on the various parts of the eye are described. Appropriate eye protection is often necessary when it is not possible or practicable to shield the radiation source completely. Newer materials used for eye protection against optical radiation from industrial processes may appear on visual inspection to be adequate and may even comply with (current foreign standards specifications but can, nevertheless present a hazard in use or in common examples of misuse. Eye protection against solar radiation is discussed briefly in the context of safety through visual efficiency.     

106例学龄儿童眼外伤临床分析

目的:探讨学龄儿童眼外伤的特点,并提出相应的防治措施。方法:对近7年我院收治的106例（10眼）学龄儿童眼外伤情况进行分析。结果:学龄儿童眼外伤的常见致伤物有玩具枪、烟花爆竹、剪刀、针等。以挫伤性前房积血、角膜穿通伤为多见。治疗前失明率（0.05以下为盲）占44.9％,治疗后下降到16.8％,复明率为83.2％。结论:眼外伤严重危害儿童视力,重视预防工作,大力开展保护眼睛的科普知识教育,可降低其发生率。     

东南沿海地区战士LASIK术后眼外伤的调查统计分析

目的:调查东南沿海地区战士LASIK术后眼外伤的原因、LASIK术后时间、伤后来诊时间、伤情及伤后视力,分析视力恢复预后与LASIK术后时间、伤后来诊时间、致伤原因及致伤物的关系。方法:收集2000-01/2006-12门诊战士人数7179例,其中LASIK术后眼外伤患者22例(22眼),18～21岁,男19例(19眼),女3例(3眼),均为单眼受伤。详细记录LASIK术后发生眼部外伤后的致伤原因、致伤物、来诊时间、伤情、视力受损情况,总结视力预后与LASIK术后时间、来诊时间、致伤物及致伤原因的关系。结果:(1)致伤因素:体育运动中受伤:3眼,占13.7%;训练受伤5眼,占22.7%;劳动致伤9眼,占40.9%;其它:5眼,占22.7%,以训练受伤和劳动致伤最常见占63.6%,其中锐器致伤明显重于钝器伤。(2)伤后来诊时间:受伤后3d内来诊最常见,占77.3%。(3)LASIK术后时间:LASIK术后6mo以内16眼,占72.7%;7～12mo4眼,占18.2%:12mo以上2眼,占9.1%。LASIK术后6mo以内最常见,而且术后6mo以内受伤者出现角膜瓣移位或错位最常见,伤情明显重于术后6mo以上的患者。(4)受伤原因与伤情:角膜瓣移位或错位16眼,占72.7%,仅角膜上皮剥脱4眼,占18.2%.同时伴有角膜瓣下异物、瞳孔散大、前房积血、暂时性的眼压升高,留下不可逆性的外伤性瞳孑L散大等12眼,占54.5%。劳动或训练中受伤的视力明显低于其它原因致伤的视力,伤情也明显重于其它原因致伤者。(5)伤情与预后:训练受伤和劳动致伤最常见,伤情最重,预后最差。结论:军人LASIK术后眼外伤的主要原因为训练和劳动中受伤,LASIK术后6mo以内最常见。眼部症状中角膜瓣相关并发症最多见,眼部受伤程度与预后密切相关。提示:LASIK术后病情稳定后再入伍,LASIK术后战士更要特别注意眼睛防护。     

Fishing Down Under: case report and review of management of a fishhook injury of the eyelid

A 21‐year‐old man presented to the emergency department of the Royal Victorian Eye and Ear Hospital with a fishhook embedded in his unprotected left upper eyelid. The fishhook was removed after exploration of the left eye by vertical eyelid incision. Subsequent eyelid reconstruction by lid margin adaptation was performed. Management of these injuries depends on type of hook, the involved ocular structure and location of the hook. This is an update on management options, where triage and surgical approaches are discussed. This case illustrates the risk to the eyes while fishing. Persons with an interest in fishing should be advised to wear eye protection.     

Implantable miniature telescope: Lessons learned

BackgroundThe Implantable Miniature Telescope (IMT?) is a telescopic prosthesis that, combined with the optics of the cornea, constitutes an intraocular magnifying system. It is indicated for use in patients with stable, nonfoveal sparing, bilateral, stable, age-related macular degeneration (end-stage) with associated scotomas. The telescope prosthesis is implanted in only one of the patient's eyes. In this way, the implanted eye provides improved visual acuity, and the nonimplanted eye continues to provide peripheral vision for ambulation. Two hundred seventeen patients with end-stage AMD were enrolled in a prospective, multicenter, open-label trial (IMT-002) beginning in 2003. The implanted eye was the worse eye for most patients based on a selection rule set by the U.S. Food and Drug Administration (FDA) protocol; however, in most cases (90%), visual acuity improvement goals were met with the device. This report will retrospectively look at 2 selected patients implanted at the Emory Eye Center in Atlanta as part of that trial to derive lessons for subject and eye selection criteria.Case ReportsTwo cases were selected to represent patients' levels of functional success and satisfaction. Determination of their visual and functional outcome at 1-year postimplantation was based on best-corrected visual acuity and the National Eye Institute Visual Functioning Questionnaire 25-Item quality-of-life survey. Four years after implantation, 1 patient continued to use the telescope prosthesis eye for all visual activities; the other patient did not perceive any benefit from the device and continued to primarily use the fellow nonimplanted eye. The benefit of the telescopic prosthesis was most likely accounted for by the level of visual acuity in both eyes postimplantation and eye dominance.ConclusionProper eye selection chosen for implantation with the telescope prosthesis appears to be an important if not critical factor in determining patient satisfaction for visual processing and functional success. Based on the author's experience with the IMT, optometrists can aid the multidisciplinary team by preoperatively determining which eye, if implanted, offers the optimal potential functional benefit for appropriate candidates.     

The essentials of data sources in eye epidemiology

The extensive literature on eye epidemiology was selectively reviewed to provide a concise and comprehensive summary on the current status of available data sources. The topics being covered were epidemiologic data evaluation, data handling, card registration, computer analysis, geographic factors, socio-economic conditions, personal attributes, genetic backgrounds, twin analysis and laboratory procedures for host defense factors including humoral and cellular immunity. Also, the scope of this article encompassed such major practical issues as glaucoma, cataract and other blinding diseases as well as traffic and occupational hazards.Epidemiologic information thus obtainable through data searching may prove to be instrumental in the identification of any potential preventive measures in ophthalmology and public health.This investigation was supported by research grant EY-00840 from the National Eye Institute, Bethesda, Maryland, and Research to Prevent Blindness, New York, N.Y.     

外科全麻手术术中眼损伤分析

目的评价目前外科全麻手术术中眼部保护方法的效果。以便做好围手术期眼部损伤的预防工作。方法对2013年我院手术室实施的561例手术时间2h以上的外科全麻手术进行总结分析。结果在561例手术中出现眼损伤4例。男2例,女2例。俯卧位3例,占75％;侧卧位1例;平卧位未发生眼部损伤。其中3例为双眼结膜轻度水肿,术后24～48h内恢复;1例术后左眼视力正常,右眼视力降至数指／15cm,治疗后出院时视力为数指／2m。4例的手术时间均在4h以上。结论外科全麻手术时的眼部保护非常重要,尤其是对手术时间过长,手术体位比较特殊,如俯卧位、侧卧位者,更应注意眼部保护。     

Industrial vision revisited.

With the Occupational Safety and Health Act of 1970 and other government agencies addressing the protection of employees from occupational hazards at their work place, there has been a reemphasis in the industrial eye care field. Industrial vision programs are reviewed and an overview of the Army's occupational vision program is presented. If optometry is to continue progress in this sphere of public health, optometrists must become more involved in and knowledgeable of the visual requirements of the local industrial community, and the profession should consider the establishment of a certification program for occupational doctors of optometry.     

伊朗亚兹德2005至2006年住院患者外伤性视力丧失的研究

目的:调查伊朗亚兹德2005/2006住院患者外伤性视力丧失的情况,并探讨造成视力丧失的原因和预防方法。方法:回顾性分析2005-08/2006-08期间在ShahidSa-doughi医院住院的所有眼外伤患者(70例)的临床资料,包括年龄、性别、致伤原因、损伤类型、初次治疗的时间、入院和出院时的视力、手术处理程序和最终结果。而且,采用国际上公认的BETT制定的分类标准对眼外伤进行分类。结果:以简易方法选取了共70例眼外伤患者,男女性别比例为2.8∶1。眼外伤最频繁的致伤原因是金属物体(34.3%),尤其是在≤10a和≥30a的年龄组,其次是事故(22.8%)和袭击(17.2%)。大多数病例(51.4%)等候初次治疗的时间为6～24h。38.6%的病例为眼钝挫伤,其余61.4%的病例为眼穿通伤。在眼钝挫伤和穿通伤病例中,最终视力状况最多为光感(51.8%,41.8%),最少为手动(7.5%,4.7%)。手术结果保留眼球且视力基本满意的占72.9%,眼球摘除的占24.2%。结论:鉴于眼外伤发生率高,而且往往造成严重的视力丧失,在大多数事故中,父母的关注、眼部安全保护措施和及早治疗应被视为能否最终保留眼球的重要因素。