Eye protection in workplace

Dr. Shadi Al Ashwal
Ophthalmologist
MSc, PhD
University of Florence
Shadymhmd@yahoo.com

• Injuries are responsible for 35-40% of
monocular blindness & 3.6% of bilateral
blindness
• The incidence of ocular trauma is 40,000 new
cases per year
• The mean age 30 years (range: 18-45 years)
Eye injuries in the workplace are very common,the
United States Eye Injury Registry (USEIR) mentioned
that:
Epidemiology of Eye Trauma
Dr. S.Alashwal

• 90% of eye injuries are preventable
• 90% of eye protection used by workers is not
appropriate
Dr. S.Alashwal
Statistics done by the OSHA shows that:

• 70% caused by flying or falling objects
• 70% of facial injuries occurred to the eye.
• 40% of workers do not receive eye safety training
.
Dr. S.Alashwal

Arch Ophthalmol. 2005;123(5):662-666. doi:10.1001/archopht.123.5.662
1st
2nd
3rd
Dr. S.Alashwal

Most of ocular injuries
occur in construction and
manufacturing by one of
following mechanisms :
• Projectiles,
• Ultraviolet radiation,
• Infrared radiation,
• Lasers
1. Construction and manufacturing
Dr. S.Alashwal

2. Welding
The UV light radiated from welding
arch cause flash burn eye injury
and photokeratitis
A case of photokeratitis caused by welding & associated with
punctate epithelial defect and corneal abrasion stained with
fluorescein stain( pre ttt in the left and post ttt in the right)

3. Health care workers
Blood borne diseases can
be transmitted by accidental
spread such as :
•Hepatitis B
•Hepatitis C
•HIV
Dr. S.Alashwal

• Flash burns from
electric arcs .
• Ultraviolet light.
4. Electrical work.
Dr. S.Alashwal

5. Office Environment
Dr. S.Alashwal

I- Identification the potential source of
danger
II. Create a safe work environment
III. Use proper eye protection
Dr. S.Alashwal

I. Identification potential source of danger
The employer should look after employees’ safety and identify
all sources of hazard which are classified according to their
nature into :-
1. Physical hazards (vibration, noise, and falls).
2. Chemical hazards (any chemical substances that could be
harmful )
3. Biological hazards ( bacteria and viruses affect health,
such as hepatitis B & HIV ).
Dr. S.Alashwal

• Chemicals should be handled
in a way to prevent splashing
• Never throw them
• Do not store chemicals above
eye level neither in the floor
Dr. S.Alashwal

• Eliminate hazards before start work
• Machines guarding
• Work screens
• Engineering controls
Dr. S.Alashwal

Three main types of eye protectors are available :
1. Safety glasses
2. Goggles
3. Face shields Dr. S.Alashwal

The American Academy of
Ophthalmology and the
American Society of Ocular
Trauma has recommend to
wear to a sunglasses which
is labeled with ANSI Z87.1
(American National
Standards Institute ANSI ).
this mark should be found
on the lens or frame.
1. Safety glasses
Dr. S.Alashwal

1. Safety glasses

Safety lenses for
safety glasses are
tested to withstand
impact from a ¼ inch
steel ball shot at 150
feet per second
1. Safety glasses
Dr. S.Alashwal

1. Safety glasses 2. Goggles
Good eye protection with
stronger lenses but do not
provide complete eye
protection from all elements in
the air because of small gaps
around the top, sides and
bottom
Complete 360 degree
coverage around the eyes and
includes a strap to help hold
the goggles securely against
your face, they contain
breathing or ventilation holes
to help with air flow.

1. Safety glasses 2. Goggles
Used in conditions where
dust or flying particles.
Used in cases with a lot of
dust as it protects against
hazards coming from any
direction .
Also in Chemical exposure
Additional side protection can
be provided by the use of side
shields
Worn over prescription
glasses and contact lenses .

✓ Protect from flying particles in
grinding, chipping, or using a wire
brush on welds
✓ Those with special filters protect eyes
from optical radiation exposure,
should be used for tasks such as
welding or working with lasers
✓ Chemicals or metals that can splash.
3.Face shields and helmets

✓ Face shields and helmets are
Secondary protective eyewear
and must be worn with primary
protective ( safety glasses or
goggles)
✓ Full face shields are used to
protect workers exposed to heat
or blood borne pathogens
✓ Used during working with molten
materials
3.Face shields and helmets

Waste of money and time both
worker and company
Visual impairment
Social consequences
Dr. S.Alashwal

Do’s and Don'ts of Eye injury
DO NOT, rub or press the eye
DO, flush the eye with water
Foreign bodies to the eye:
In case of eye injury with FB such as dust, the following
maneuvers should be done :-
DO examine eye with light

DO examine eye with light
DO Refer
Foreign bodies to the eye
Dr. S.Alashwal

DO NOT, remove any stuck objects in
the eye
DO NOT, flush the eye with water
Penetrating Ocular Injuries
such as :-
DO, cover with shield or sterile gauze
without press and refer patient
▪ Lid Laceration
▪ Corneal Laceration
▪ Conjunctival cut
Dr. S.Alashwal

Chemical eye Injuries
Chemical eye injuries are common in
labs and indoor jobs as well .
Complications and prognosis of injuries
are related to many factors, alkaline is
more dangerous than acids, the
duration between splashing of
substance and eye wash is important
because prolonged duration will allow
the cornea to absorb the chemicals and
bad outcomes can occur
Corneal opacity

All new construction and
remodeling shall meet the
requirements
Chemical eye Injuries require fast
interference which neccisate an
immediate irrigation using the nearest
source of water, if normal saline is
available the affected eye should be
washed out with 2 – 8 liters
continuously for 10- 15 min
Dr. S.Alashwal

Sight threatening conditions as shown in photos
Symblepharon
Severe
KeratoconjunctivitisCorneal opacity

Blow (contusion) to the eye
Anterior Posterior Compression
with increase eye pressure
Simple
complications
such as hyphema
or corneal
abrasion
Advance complications
which may have short term
or long term complications

Blow (contusion) to the eye
Advance long term complications such as vitreous
hemorrhage or cataract
Dr. S.Alashwal

Effect of Heat & Ultraviolet radiation on Eyes
Ultraviolet (UV) light is an electromagnetic
radiation with a wavelength from 100 nm
to 380 nm (400nm)

Ultraviolet radiation is classified into three subtypes
according to the wavelength. They are UVC,UVB and UVA
Dr. S.Alashwal

• UVC has the lowest
wavelength 100-280
nanometer (nm) but the
highest-energy because
energy is inversely
proportional with the
wavelength.
• UVC are the most harmful to
eyes and skin, fortunately, the
atmosphere’s ozone layer
blocks virtually all UVC
UVC
Dr. S.Alashwal

UVB
• It has 290 -320 nm wavelength, filtered partially by
the ozone Layer but some still reach the earth.
• Cornea can absorb 90 -100 % of UVB rays .
• Low doses of UVB cause dark skin condition (suntan)
• Higher doses exposure to UVB can be harmful
resulting into sunburn, skin cancer, photokeratitis and
cataract
.

UVA has the highest wavelength 320-400 nm,
therefore radiation can pass through the cornea and
reach the lens and retina
.
UVA
Dr. S.Alashwal

UV Index developed by the National Weather Service
(NWS) and Environmental Protection Agency EPA
predicts each day’s ultraviolet radiation levels on a simple
1 to 11+ scale.
Extreme risk level

• Malignancy of eyelid and surrounding skin
• Pterygium
• Conjunctivitis
• Photokeratitis
• Cataract
• Age related macular degeneration AMD
What are the effects of UV on the eye?
Dr. S.Alashwal

U/V Effect on the Eye Lid
• Prolonged exposure to the
UV radiation can lead to a
malignancy of eyelid and
surrounding skin such as
Basal cell carcinoma
Dr. S.Alashwal

• Skin aging and wrinkles are considered
to occur duo to UV radiation exposure
• It is proposed that UV radiation has the ability to alter
normal genes switching the cells into cancerous
Dr. S.Alashwal
U/V Effect on the Eye Lid

U/V Effect on the conjunctiva
Actinic conjunctivitis
Dr. S.Alashwal

Pterygium
U/V Effect on the conjunctiva
Pterygium is and it is believed to be developed duo to
some environmental and dry conditions. UV radiation
has a major role in its development as well.
Dr. S.Alashwal

• UV radiation and other radiation have a destructive
ability to corneal layers and these effects could be
classified based on duration into acute or chronic.
• Two important forms of acute complications of
radiation (including UV) of keratitis caused by
radiation are Snow photokeratitis and welder`s
keratitis
U/V Effect on the cornea
Dr. S.Alashwal

• Photokeratitis is an
inflammation of cornea
caused by sun exposure
without any protection
could be happened more
particularly in climbers
and skiers in condition.
• Corneal epithelium
accounts for most of the
absorption of UVA (315-
400nm),because of high
protein and nucleic acid
content of the epithelial
cells

Light clouds only
block about 10%
of UV and in
winter, UV
exposure can be
up to 100 times
higher when
reflected off
snow
Dr. S.Alashwal

Welding arcs give off radiation over a broad range of
wavelengths from 200 nm to 1,400 nm and cause photokeratitis
if eye protector was not worn .
Acute photokeratitis are characterized by :
✓ Pain
✓ Temporary vision loss lasting 1-2 days
✓ Need conservative treatment for few days
Dr. S.Alashwal

Chronic complications of
UV radiation on the
cornea are duo to the
degeneration and
accumulation of materials
occur on the cornea
stroma such as in case of
climatic droplet
keratopathy
Dr. S.Alashwal

One of the studies
which investigated the
UV effect on the lens
is the Chesapeake
Bay study.It mentioned
that the relative risk of
cortical cataract
increased with level of
average annual UVB
exposure
Taylor HR, West SK, Rosenthal FS, Munoz B,
Newland HS, Emmett EA (1989) Corneal changes
associated with chronic UV irradiation. Arch
Ophthalmol 107(10):1481–1484
U/V Effect on the Lens

U/V Effect on the Lens
Further studies have
demonstrated the
UVB’s correlation with
cataract development
,they estimated a 10%
decrease in the ozone
layer can lead to an
increase of 1.6 million
to 1.75 million cataract
cases.
Dr. S.Alashwal

UV Effect on the retina
UV radiation has been blamed to be one of the
predisposing factors of Age-related macular
Degeneration (AMD), although further studies
are needed to investigate this effect

I. Sunglasses
Protect your eyes from heat & UV radiation
2. Bigger glasses with
more coverage
1. The best
sunglasses
offer 100
percent UV
absorption
Dr. S.Alashwal

I. Sunglasses
3. Polarized lenses cut
glare, not UV.
This does not offer more
protection from the sun, but can
make activities like driving or
being on the water safer or more
enjoyable
4.Color, darkness and cost doesn't
matter.
Dr. S.Alashwal

II. Wide-brimmed hats
Protect face and eyes from sun effects
Dr. S.Alashwal

Provide plenty of cool water and encourage employees
to hydrate frequently
III. Cool water
Protect your eyes from heat & UV radiation?
Dr. S.Alashwal

V. Training course for safety
procedures
VI. Reducing outdoors
activities in hot season
Dr. S.Alashwal
IV. Shaded area for workers

THANK YOU FOR YOUR ATTENTION

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