Eye Injuries and Eye Safety

OSHA reports $_______ in lost productivity, medical treatment and workers compensation anually

* $300 million

The National Institute for Occupational Safety and Health (NIOSH) database query estimated that there were ________ non-fatal eye injuries requiring hospital emergency room treatment

* 132,000

US Bureau of Labor Statistics reports more than ______ workplace eye injuries happen every year

* 20,000

Industrial Safety and Hygiene News reported _______ people go to the ER for eye injuries

* 300,000

What causes serious eye injuries?

* 34% are caused by blunt objects * 26% are caused by sharp objects * 10% are caused by motor vehicle crashes * 6% are caused by BB or pellet guns * 6% are caused by gunshots

Fireworks and eye injury

* 42% of firework injuries involved the head and neck regions * 21% of firework injuries affected the eye * 10-19 year old children have the highest rate of injury * Males are 3x more likely to be injured by fireworks * 1/3rd of fireworks related eye injuries cause permanent damage to the eye * 1/4th result in permanent loss of vision or blindness

Where do eye injuries occur?

* 43% of serious eye injuries occur in the home * 20% in industrial settings * 15% on streets/highways * 13% related to sport/recretation

SR coating reduces impact resistance ____%

* 57%

How many eye injuries are related to sports and recreation occur each year?

* 600,000 * 42,000 require emergency room attention * Most eye injuries for children 11-14 years old occur during sports * Nearly 1/4th of reported cases of visual impairment resulting from trauma are due to sports and other recreational activities * Over 100,000 physician visits each year are related to eye injuries from sports, resulting in a cost of over $175-200 million

AR coating reduces impact resistance _____%

* 63%

How many children do not utilize protective eyewear?

* 84.6%

____% of injuries are avoidable with proper eye protection

* 90%

Occupational Safety and Health Administration (OSHA)

* A division of the US Department of Labor * Enforces workplace safety * Mandates protective eyewear where it is indicated * Safety glasses are considered personal protective equipment (PPE)

Occupational Absorptive Lenses

* Almost complete absorption of UV and IR * High absorption in blue and red regions of visible spectrum

Z87.1: Additional Standards

* Also covers: - Side Shields - Goggles (splash, droplets, sprays- D3, nuisance and fine dust- D4 and D5) - Face Shields - Visible light (L marking), UV light (U marking) and IR light (R marking)

For children 14 and under, which sport is the leading cause of eye injury?

* Baseball

For ages 15-64, which sport is the leading cause of eye injury?

* Basketball

Heat Tempering: Advantages

* Cheap to do, easy to perform

40% of eye injuries are from _________ sectors

* Construction, mining and manufacturing

Shade number

* Derived from optical density * Is equal to 7/3 (Density) - 1

Class 2/2M Visible Lasers (400 to 700 nm)

* Do not present a hazard because of aversion responses * 2M is potentially hazardous if viewed with an optical instrument

Flaws on the ______ of the lens decrease impact resistance

* Edge

OSHA PPE Rx Eyewear Requirements

* Employers must ensure that employees who wear prescription lenses or contacts use personal protective equipment (PPE) that incorporates the prescription or use eye protection that can be worn over prescription lenses * Workers who wear prescription glasses must also wear required eye protection * Eye and face protection that fits comfortably over glasses is available * Safety goggles and spectacles may incorporate prescription lenses * Workers have an extra pair of contacts or eyeglasses in case of contact lens failure (dusty, chemical environments) or loss * The employer shall ensure that each affected employee use appropriate eye or face protection when exposed to eye or face hazards from flying particles, molten metal, liquid chemicals, acids or caustic liquids, chemical gases or vapors or potentially injurious light radiation

Z87.1-2015: Frame Requirements

* Frames and shells shall meet the requirements for high mass impact and high velocity impact in order to be impact-rated * Components are tested as a complete device - For frames and shells used with Rx lenses, they are fitted with representative lenses - Nominal plano power, minimum lens thickness is 2.0 mm (0.079 in) * Frames and shells are exempt from the penetration requirement

Glassblower's Cataract

* From IR

Corneal flash burn

* From UV * Can occur in less than one second * Symptoms are 3-12 hours after exposure * Intense pain, photophobia, heavy tearing, redness, grittiness, blepharospasm

Chemical Tempering

* Glass can be chemically tempered with molten potassium nitrate * Exchange of sodium and potassium ions (potassium ions are larger) * Yields a packed surface layer ~0.1 mm thick

Laser Protective Eyewear

* Glasses or goggles used to protect eyes from damage from visible/invisible lasers * Filter out laser wavelength (band pass filter) * Can be goggles, or lenses incorporated protective eyewear * Intrabeam viewing of lasers usually requires protective goggles, even with a low power laser

Is there impact testing of coated lens?

* If the manufacturer applied it, yes

Heat Tempering

* Increases impact resistance by creating compressive stress/tension * Heat to ~700*C, cool rapidly to shrink the outer lens surface, pulling the surface inwards to form a protective shell * 2-3x greater impact resistance

How are splash goggles vented?

* Indirectly to allow airflow, but to prevent chemical, infectious materials, or debris to enter goggles

Penetration test

* Lenses for all complete devices shall meet the protector acceptance criteria when penetrated by a weighted needle with a minimum total weight of 44.2 g (1.56 oz) when dropped from a height of at least 127 cm (50.0 in)

Protective eyewear must...

* Meet ANSI Z87.1 requirements * Be provided to the employee by the employer

4 Types of Eye Protectors for Sports

* Molded one piece front unit: frame and lenses together * Lenses are separate from the frame, then assembled. Lenses can be plano or Rx. * Protector without a lens * Full or partial face shield

Chemical Tempering: Advantages

* More impact resistance * Apply to complex shapes

Protective Eyewear Recommendations

* Must comply with ANSI Z87.1- high impact - Polycarbonate - Trivex * Side protection * UV protection (outdoor work and driving) * No glass

What percent of patients are wearing eye protection when injured?

* None- 78% * Unknown- 15% * Regular glasses- 3% * Safety glasses- 2% * Other- 2%

Class 1/M Lasers

* Not hazardous for continuous viewing or designed to prevent human access- low power lasers or higher power embedded lasers * Considered to be incapable of producing hazardous exposure conditions unless the beam is viewed with an optical instrument such as an eye-loupe or a telescope

Good Manufacturing Practices (GMP)

* Ophthalmic lenses are classified as class I medical devices * Class I medical devices are the least regulated by the FDA * Most class 1 devices are exempt from the pre-market notification [510(k)] requirements

Who is a manufacturer?

* Original manufacturer as well as anyone who puts the lens in final form (ie coating, grinding or edging) * Includes the laboratory and the dispenser who edges

ANSI Z87.1 (2015)

* Personal eye and face protection device standard * Penetration Test (lenses only) * Drop ball test * High mass impact test

Which lens material are the highest impact resistance?

* Polycarbonate and trivex

Class 3R

* Potentially hazardous but injury unlikely

Class 3B

* Present an eye and skin hazard if viewed directly * Do not produce a hazardous diffuse reflection except when viewed at close proximity

Class 4 Lasers

* Present an eye hazard from direct, specular and diffuse reflections * May be fire hazards and produce skin burns

ANSI Z80.1

* Production of spectacle lenses * 5/8th inch steel ball (0.56 oz) * Dropped from 50 inches

Drop ball test

* Projectile is a 25.4 mm (1.0 in) diameter steel ball, weighing 68 g (2.4 oz) * Guided from a test height of 127 cm (50 in) through a loose fitting guide tube ending 0.1 m (4 in) above the point of contact * Produces simple flexure fractures at edge

High mass impact test

* Projectile shall be made of steel and shall have a 30 degree conical tip * 3.18 mm (0.125 in) spherical radius * Minimum weight of 500 g (17.6 oz) * Diameter of 25 mm (1.0 in)

Face shields

* Protect the eyes, face and neck from debris, chemicals, spark and splatter * Necessary anytime there is a severe risk of splash, spray, highly hazardous material, or severe debris

ANSI Z87.1

* Protective eyewear * 1.0 inch steel ball, weighing 68 g (2.4 oz) * Test height of 127 cm (50 in)

Z87.1-2015: Markings

* Protector markings shall be placed in relatable proximity to each other on the product in the sequence specified below: - Manufacturer's marks or logos - Designation of standard (Z87 or Z87-2 for prescription devices) - Individual claims of compliance (impact-related marking (+), lens type and use applications)

Faceshields are _____ eye protection

* Secondary - Must be worn with primary protection such as goggles or safety glasses

Front surface lens fracture

* Simple elastic denting * Usually begins at a surface flaw

Why do coatings decrease impact resistance?

* The lens may flex with impact, but the more brittle coating will crack before an uncoated lens would * Released energy is transferred to the lens, can cause an elastic shockwave effect and break the lens

Who is responsible for impact resistance testing?

* The manufacturer

Back surface lens fracture

* The most common location, especially for minus lenses

ASTM F803

* The standard specification for eye protectors for most sports

T/F Batch testing of plastic lenses is allowed

* True

T/F Most lens blank manufacturers have statistically impact tested their lenses at typical finished powers and edged sizes to meet FDA requirements

* True

T/F Up to 30% of paintball-related injuries result in a best-corrected visual acuity of 20/200 or worse

* True

T/F If a lens is finished outside of manufacturer specifications, then the waiver does not apply

* True Ex: too thin, coated

Duty to Warn

* You must document that you discuss the benefits of impact-resistant materials, and if the patient declines * You are expected to inspect the fabricated spectacles prior to dispensing * Can use a duty to warn form as part of the pre-exam paperwork

Impact goggles provide _____ peripheral protection from flying particles than safety goggles

More * Impact goggles are perforated around the frame to allow maximum airflow * Do not provide protection against chemicals or infectious materials

T/F Data on ocular injuries is imprecise due to varying reporting methods

True