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Eye health and vision standards for lifeguards

Eye health and vision standards for lifeguards



Author: Arthur Clarke

Author: Arthur Clarke



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    Eye health and vision standards for lifeguards Eye health and vision standards for lifeguards Presentation Transcript

    • EYE HEALTH AND VISION STANDARDS FOR LIFEGUARDS Dr. Art Clarke, OD NJ State Park Service Water Safety Supervisor
      • Many agencies do not require lifeguards to wear sunglasses
      • Electromagnetic Spectrum
      • Wave Length Increases Left to Right
      • xrays ultraviolet visible light infrared microwaves
      • Ultraviolet Light (UV) affects eye health
      • Visible light is needed to see
      • Infrared Light is not thought to affect eye
    • Results of UV damage: Pinguecula
      • Growth on tissue over white of eye
      • Could result in:
        • Dry Eye
        • Unattractive appearance
    • Pterigium Growth on Cornea
      • Could result in:
        • Reduced vision
        • Astigmatism
        • Surgery to remove
        • Cornea transplant
        • Proximity to equator increases incidence
        • Florida receives twice as much UV light as Maine on any given day
    • Macula degeneration
      • No Cure
      • Dry-decreases visual acuity
      • Wet-results in legal blindness
    • Cataracts
      • Degeneration (clouding) of lens in eye reducing vision
    • Lifeguards must be required to wear ultraviolet blocking sunglasses to protect lifeguards against ultraviolet light damage
      • UV protection is a property of polycarbonate lenses
      • Glass and plastic lenses must be treated for UV protection
      • Darkness or tint has nothing to do with UV protection, clear lenses can have UV protection
      • Tint reduces brightness, it does not stop glare or UV light
      • Gray tint, color is more realistic
      • Brown tint distorts color but increases contrast, resolution and depth perception
      • Disability glare reduces or blocks out what you see
      • Tinted glasses darken glare but don’t reduce it
      • Polarization reduces some forms of glare with a filter in the lenses.
    • Polarization reduces some forms of glare with a filter in the lenses:
      • For personal eye health
      • To better observe the public
      • All the equipment and training is useless if a lifeguard can’t see a victim
      • The USLA has swimming, equipment and training standards BUT NO VISION STANDARDS.
      • Lifeguard vision standards vary among lifeguard agencies throughout the United States. Some agencies have no vision requirements. Many are lacking.
      • Optometric/Ophthalmological Associations and Government Agencies have no lifeguard vision recommendations
      • “ Seeing the victim” is at the top of most Lifeguard Emergency Response Charts. Vision is also used in subsequent steps of the response.
      • United Lifesaving Association (USLA) Agency Certification requires lifeguards to have “adequate vision”
      • What is “adequate vision”?
    • Examples of Vision Standards
      • One State Park’s Department has one vision standard for lifeguards in the Northern Region and a different standard in the Southern Region
      • The Northern Region standards are good, the Southern are poor. The Northern Region has lakes, the Southern has mostly ocean beaches
      • Some agencies let the MD giving the medical physical determine if the lifeguard has adequate vision
    • Common Agency Standard
      • Correction by glasses or contact lenses to a visual acuity of 20/20
      • Problems with this standard:
        • One eye 20/20?
        • Each eye 20/20?
        • Two eyes together 20/20?
        • Hard contacts or soft contacts?
        • How much blur is acceptable when lifeguards take off glasses for rescue?
        • There should be an uncorrected acuity standard .
    • Contact Lenses:
      • Hard contact lenses will float off if eyes are open while swimming
      • Soft contact may float off
      • If lenses float off what is lifeguard’s uncorrected acuity?
      • Greater chance of infection
      • FDA lets eye care practitioner decide if its safe for patient to swim with contact lenses
      • Wearing of contact lenses while swimming is controversial
      • Are contact lenses a risk or a benefit?
    • Frequency of vision testing:
      • Some agencies test vision standards every year or every 2 years
      • Some agencies test vision at start of lifeguard’s career and never again. However, vision changes with age.
    • Vision changes with age:
      • Nearsightedness (Myopia) often increases to age 25, especially college and graduate students.
      • Farsightedness (Hyperopia) can be compensated for with one’s focusing system to 20/20 or better at age 20. As focusing system ages people lose focusing ability and visual acuity decreases.
      • Presbyopia-loss of near vision in late thirties and forties, making first aids, reading gauges and taking information difficult.
    • Lifeguard Vision Standard
      • At very minimum there should be a corrected and uncorrected visual acuity (distance and near) standard for each eye tested at least every 2 years unless otherwise indicated.
    • Other considerations for a vision standard:
      • Peripheral vision
      • Color vision
      • Depth perception (Binocularity)
      • Contrast sensitivity
      • Lasik surgery
      • How brightness affects all findings above
      • Visual perception
      • Visual memory
      • Contact lenses
      • Lifeguard agencies, the USLA and the ILS should require all lifeguards to wear polarized sunglasses with ultraviolet protection.
      • Lifeguard agencies, the USLA and the ILS need a well-researched vision policy to provide the public with a consistently high level of service.
    • Questions?