The role of eye protection in work-related eye injuries

Purpose/Background: A recent survey of general hospitals by the Victorian Injury Surveillance System found that ocular trauma represented 15% of work-related injuries. As circumstances surrounding occupational eye injuries have been poorly documented previously, their associations to occupation, industry and work-safety practices, including safety eyewear use, need to be identified to develop appropriate preventive strategies for high-risk groups.
Design and Setting: From a prospective cross-sectional survey of all eye injuries treated at the Royal Victorian Eye and Ear Hospital, work-related cases were analysed for demographic, occupational and safety eye-wear information. Hospital-based data were supplemented by information from Workcover Authorities and Labour Force statistics to derive incidence and cost estimates.
Results: There were 9390 eye injuries during the 18-month survey period: 42% ( n = 3923) of total and 29% ( n =52) of penetrating ocular injuries occurred at work. The most frequently injured were metal, automotive and building trades workers grinding and drilling (41% of outpatients) and hammering (53% of penetrating eye injuries). Automotive workers had the highest frequency for penetrating injuries, and most were exposed to hammering and were also the least likely to wear safety eye-wear.
Conclusion: Eye injuries are frequent (10% of work-related injuries) and highly preventable by the correct use of safety eye-wear, a cost-effective intervention that may result in cost savings of £59 million for work-type activities in the occupational and domestic settings in Australia each year.     

Safety goggles should be worn by Australian workers

Eye injuries in the workplace are a major cause of morbidity and disability, despite well publicised standards for industrial eye protection. A prospective survey of 51 patients presenting to a metropolitan emergency department with a work-related eye injury revealed that 32 injuries (63%), occurred to workers wearing some form of protective eye wear. However only seven (14%) were wearing eye protection that complied with the Australian Standard AS 1336 for occupational eye protection. Thirty-six patients (71 %) had suffered previous eye injuries at work. Most injuries were'caused by medium velocity particles generated by power tools, generally causing superficial corneal injury. We conclude that education to reduce the widespread misuse of safety glasses by tradespeople and trades assistants during tasks for which goggles are recommended could considerably reduce the incidence of occupational eye injuries.     

Ocular paintball injuries

Paintball sport-related ocular injuries represent an increasing problem as the popularity of the sport increases and the number of participants grows. Although eye protective devices designed specifically for paintball sports are extremely effective in preventing such injuries, the failure to properly wear these devices has resulted in an alarming number of severe ocular injuries. Recent trends have indicated that an increasing percentage of paintball sport-related ocular injuries have occurred in unsupervised, noncommercial settings (i.e., backyard games) where the use of eye protective devices is not required. Paintball industry standards for eye protection have recently been developed and should be implemented for all participants.     

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.     

Indoor soccer-related eye injuries: should eye protection be mandatory?

BACKGROUND: Our objectives were to present the spectrum of eye injuries caused by indoor soccer, as seen at our institution, and to initiate discussion as to whether eye protection should become mandatory for this indoor sport. METHODS: Chart review of patients presenting to our institution with eye injuries from indoor soccer. RESULTS: Five cases were identified from 2001-2005, all occurring during the winter or late fall. Each injury was due to contact with the soccer ball itself. Initially, all 5 patients presented with commotio retinae (1 with a prominent retinal and vitreous hemorrhage and 2 with smaller retinal hemorrhages), 2 with hyphema and traumatic mydriasis, 1 with subconjunctival hemorrhage, and 1 with upper lid edema and ecchymosis. Three resolved uneventfully with 20/20 or better vision; however, in 2 there were findings of choroidal rupture with chorioretinal scarring. One of these had 20/20 vision and a discontinuous choroidal rupture peripherally, and the other had 20/40 vision and extensive chorioretinal scarring. One patient also showed a peculiar persistent iris scar. INTERPRETATION: Soccer-related eye injuries have been recognized as an important ophthalmologic problem in Europe and now increasingly so in North America. With the increasing popularity of indoor soccer in Canada, serious eye injuries have become more prevalent. On the basis of the prevalence and the nature and mechanism of the ocular trauma, we believe there may be a need to make eye protection mandatory for all forms of soccer.     

埃塞俄比亚西南地区眼外伤类型和预后因素的回顾性研究

目的：探究埃塞俄比亚西南部的眼外伤类型、严重程度和预后因素。
　　方法：回顾性研究。选取2009-04/09就诊于季马大学专科医院的眼外伤患者纳入本研究。所有患者均进行详细诊断,并接受全面眼科检查。 SPSS 13.0进行数据分析,P<0.05表示差异有统计学意义。
　　结果：眼外伤总患病率为3.03%。近99%的眼外伤为机械性损伤。多数眼外伤(53.2%)与工作相关,这些患者受伤时均未使用眼部防护装置。在170例眼外伤中,57.6%为闭合性眼外伤,42.4%为开放性眼外伤。闭合性眼外伤较开放性眼外伤的损伤程度较低,且有明显较好的视力预后(P<0.05)。最终视力和就诊时视力与从诊断到手术的时间间隔明显相关(P<0.05)。眼外伤致单眼失明患者59例(34.3%)。就诊晚、就诊时视力差、开放性眼外伤和并发症是导致低视力的危险因素。
　　结论：大多数眼外伤发生在工作场所,且有较大比例的眼外伤患者发展为单眼失明。为预防严重的眼外伤,应在家中和工作场所普及眼部健康教育知识并做好安全防护措施。     

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。     

A survey of eye safety practices among welders in Nigeria

Background : Welding is a common occupation in both developed and developing countries. The occupation is potentially vision-threatening if adequate safety measures are not taken to protect the eyes. Safety standards which guide such occupations are lacking in many developing countries including Nigeria. Therefore, it was considered of interest to study the welders in Nigeria in order to establish the current level of eye safety practice. Method : Questionnaires were administered to welders in Lagos area of Nigeria. Data from 339 completed questionnaires were analysed. Results : Less than half (43.7 per cent) of the welders used welding goggles when welding. Another 45.4 per cent used sun glasses, while others (10.9 per cent) did not use any device. In the week preceding the survey, 65.3 per cent of respondents reported having welded for a period without eye protection. About half (47.7 per cent) reported frequent exposure to nearby flashes when not welding. A majority of the welders reported that their eyes were sometimes or frequently irritated by fumes from welding. Conclusion : This study reveals that a large proportion of welders in Nigeria did not take adequate precautions to protect their eyes from hazards associated with welding. This finding is attributed to absence of ocular health safety standards in the country and inadequate knowledge of the potential occupational hazards by the welders. These results will be a strong tool in persuading the health authorities of the need to establish a committee to set safety standards, monitor compliance and to educate the welders and allied workers about the occupational hazards associated with the profession, and the need to take adequate safety precautions.     

Shotgun eye injuries. Ocular risk and eye protection efficacy.

BACKGROUND: Little is known about the efficacy of shotgun eye protection. Shotguns can easily propel pellets with enough energy to penetrate the human eye, and a large percentage of shotgun eye injuries occur during shotgun sports such as hunting, trap, skeet, and sporting clays. Many of these injuries are preventable with proper eye protection. Although it is known that polycarbonate is the best lens material for shotgun eye protection, there has been no research that addresses the vision protective system design and its influence on eye protection. METHODS: A field study was performed during which shotshells were fired at 1:1 scale photographs of human faces to determine the risk of ocular trauma. The protective efficacy of three types of polycarbonate protective eye wear (standard industrial safety glasses with snap-on side shields, wrap-around racket sport glasses, and three-piece glasses with integral side shields) was tested by firing shotshells at them at various distances. Both frontal and side protection was evaluated. RESULTS: Results showed that the eye is at a high risk (55% to 100%) of being hit with shot pellets at ranges of 15 to 40 yards. It also was determined that the protective eye wear will give good frontal eye protection from shotgun pellets but integral side shields and a headband are necessary to obtain adequate side protection. CONCLUSION: These findings, coupled with the poor visual prognosis of ocular shotgun injuries, indicate that polycarbonate protective eye wear with integral side shields and headbands should be worn by all involved with shotgun sports.     

Ophthalmic injuries in British Armed Forces in Iraq and Afghanistan

Aim

British military ophthalmologists have not been deployed in support of operations since 2003. Eye injuries in British forces receive definitive treatment on return to the United Kingdom. We report the injury patterns, management strategies, and outcomes for eye injuries in British Armed Forces in Iraq and Afghanistan.

Methods

Retrospective consecutive case series of eye injuries in British Armed Forces in Iraq or Afghanistan from July 2004 to May 2008. Outcomes assessed by final best-corrected visual acuity (VA; few patients lost to follow-up), rates of endophthalmitis, and proliferative vitreoretinopathy (PVR).

Results

There were 630 cases of major trauma, 63 sustained eye injuries (10%), and 48 sustained significant eye injuries. There were 21 open-globe injuries: 9 ruptures and perforating injuries, of which 7 were enucleated/eviscerated; 11 intraocular foreign body (IOFB) injuries, of which 1 was eviscerated. Primary repair was combined with posterior segment reconstruction in 9/11 cases with IOFB. Mean time to primary repair was 1.9 days (range 0–5). Intravitreal antibiotics were given at primary repair in five cases. All cases received early broad-spectrum systemic antibiotics. Median final VA was logMAR 0.25 excluding evisceration/enucleations. There were two cases of PVR and none of endophthalmitis.

Conclusions

The number of eye injuries as a proportion of all casualties is lower than recently reported. The injuries are more severe than in civilian practise. The outcomes were comparable with previous reports, this demonstrates that, in certain cases, primary repair can be safely delayed beyond 24 h in the patient''s best interests, in order to optimise the conditions for treatment.     

CONTROL OF OCULAR HAZARDS

The basic approach to the control of ocular hazards must be consistent with standard safety engineering techniques used in controlling any other specific hazards. Eye hazards, as they exist in the plant, must be identified and then eliminated wherever possible by an alternative non-hazardous process or controlled by the installation of engineering devices. For any residual eye hazards an appropriate eye protector must be selected and provided for the operators concerned. Australian Standards CZ7, 27 and Z45 — 1967 Industrial Eye Protection is a comprehensive document and a most valuable source of information on all aspects of eye protection. Table 1 of CZ 7 itemises the hazards by group and type, the typical processes giving rise to such hazards, typical methods of controlling the hazards and the suitable types of eye protectors with notes on their usage. Eye hazards will vary considerably both in extent and severity depending on the nature of the industry. In general however, the hazard of flying fragments, particles and objects is the most extensive found in industry and the related eye protector in the form of safely spectacles accordingly assumes major significance in an eye protection program.     

Comparison of ocular trauma between normalized and the COVID-19 epidemic periods in China: a multi-center cross-sectional study

AIM: To compare the feature of ocular trauma between normalized period and the COVID-19 epidemic period in China, and to provide a profile for eye injuries in special times in future. METHODS: This is a multi-center cross-sectional study with 30 participated hospitals involving the China Ocular Trauma Society members. All hospitalized cases who visited the Ophthalmology Department in participated hospitals with eye injuries during the normalized period (2019) and the COVID-19 epidemic period (2020) were included in this study. Demographic characteristic of cases, date of injury, sites and types of injury were collected. RESULTS: This study involved 13 525 (61 cases with both eyes) injured cases. There were 7269 (53.74%) eye-injured cases and 6256 (46.26%) eye-injured cases in 2019 and 2020 separately. Compared with 2019, the incidence of ocular trauma in retirees, housewives and unemployed increased with year-on-year of 4.96%, 102.67%, and 11.64% among all occupations. In 2020, the incidence of eye injuries decreased in all injury sites except for an increase in home (30.29% year-on-year). The incidence of mechanical eye injuries decreased, while that of non-mechanical eye injuries (chemical/thermal/radiation) increased (47.45% year-on-year). There were 255 (3.51%, 255/7269) and 376 (6.01%, 376/6256) non-mechanical injured cases in 2019 and 2020 (Pearson Chi2=47.33, P<0.001) separately. CONCLUSION: During the COVID-19 epidemic period, the total cases of ocular trauma decrease but the proportion of non-mechanical ocular trauma increase. Penetrating is still the highest proportion among all types of mechanical ocular trauma. From a preventive point of view, protection for retired persons, housewives and unemployed persons should be improved during public health events period.     

Sports-related eye injury. A preventable problem

Sports-related eye injuries pose a substantial and preventable problem. Ophthalmologists, by educating their patients regarding the risks of eye injuries in various sports and the benefits and availability of protective equipment, have the potential to prevent injury to well over 100,000 eyes each year. General guidelines and recommended levels of eye protection for various sports are given. The appendix lists suppliers of protective equipment.     

尼日利亚阿巴卡利基地区的眼外伤情况

目的:回顾尼日利亚阿巴卡利基地区眼外伤疾病的原因及视力结果。方法:阿巴卡利基联邦医疗中心事故急诊科或眼科收治的患者中,凡眼部损伤持续时间在18mo以上者(2000-06/2001-11),其治疗记录均得到回顾分析。结果:研究期间共108例眼外伤患者(男60,女48)。致伤活动包括:打斗/袭击30例(27.2%),玩耍/运动22例(20.4%,),农业活动18例(16.7%),家务劳动16例(14.8%)。致伤物体主要有棍棒、石头、拳头和公路交通事故相关物体。只有9例患者在伤后24h内前往医院接受治疗。治疗结果钝器伤患者视力最佳,刺伤患者视力最差。并发症主要包括白内障、角膜疤痕、青光眼。结论:阿巴卡利基地区的眼外伤疾病大多都可以预防,应加强公众的防治意识,使其了解相关方法,从而降低发病率。     

Sports Eye Injuries A Preventable Disease

Each year, sports are responsible for over 100,000 preventable eye injuries. A face-protector standard was developed for hockey. Certified protectors effectively eliminated eye and face injuries to 1,200,000 players averting a projected 70,000 injuries and saving over $10,000,000 in medical expenses annually. The principle of absorbing energy in a protective device before the eye is injured is applied to other sports (racket sports, baseball, basketball). Recommendations are made on eye protection for athletes. Better data collection and standards for sports and children's eyewear are encouraged.     

眼科工伤评残标准及其应用

本文介绍了眼科工伤评残分析标准，共分１０级４０条。对评残依据作了详细说明，如视功能（视力、视野）障碍的评定，立体视觉损伤程度的评价，非工伤致残眼在评残时的处理及职业眼病评残等。