Eye Injury Prevention
Eye Injury at Work and Play The profile of eye injuries has changed dramatically over the years. At present, eye injuries are almost as likely to occur in the home and during sport and recreational activities as at work.
What hasn’t changed over time, is the disproportionate number of males affected, with up to nine males injured for every female. Studies have shown that eye injuries occur more often in young males than females, on weekends than weekdays and in people living in regional and remote communities compared to those living in the city.
Despite advances in prevention, eye injuries still occur and are a significant burden to the community. The World Health Organization estimates that approximately 55 million eye injuries that restrict activity by at least one day occur every year and that there are approximately 19 million people with unilateral blindness or low vision from injury.
Preventing Eye Injuries
Several factors have reduced the type and rate of eye injuries including: stricter occupational health and safety legislation to prevent exposure to hazards, raising awareness of hazards and introducing product standards for and broader use of eye protection. Figure 1 depicts some of the relevant changes in safety standards and legislation.
Better motor vehicle design, e.g. seatbelts, laminated windscreens and airbags, and improved regulation has helped prevent motor vehicle-related eye injuries. Road traffic-related eye injuries reduced significantly when seat belt use was made compulsory in 1972. However, the height of the occupant does play a role in how much protection seatbelts and airbags provide, with shorter individuals at greater risk of eye injury in the event of a crash. Therefore, children under 12 should not travel in the front seat of a motor vehicle and this is legislated in some countries.
Legislation for consumer products such as toys and cleaning products helped to reduce eye injuries. ‘Non-powder’ guns such as BB and airsoft guns are a significant contributor to eye injuries. Elastic luggage straps, commonly known as Ockey straps, now warnings following concerns about eye injury from these straps if released under pressure. The sale of fireworks is also more tightly regulated in some countries, because of the high risk of injury. One in 6 firework-related eye injuries result in severe vision loss. Despite the high risk of eye injury, many countries still do not restrict the sale of fireworks.
Education about hazards can also play a key role in eye injury prevention, particularly for children who are less able to detect and avoid risks commonly associated with eye injury. Because of their immaturity and lack of ability to understand hazards, children are particularly vulnerable to eye injuries. There are also added complications associated with injury, the potential for amblyopia and loss of stereopsis and difficulties associated with surgery. An injury to a child has the capacity to impact on learning opportunities as well as longer term social and occupational aspirations.
The Role of Eye Protection
Eye protection remains the last line of defence in eye injury prevention- when hazards cannot be eliminated we rely on eye protection. Eye injuries can still occur if eye protection does not fit well, is uncomfortable, obscures vision, or is not suited to the hazard involved. The Australian Standard dedicated to selection and use of eye protection remains the most valuable document in helping guide employers and eye care providers choose the right type of eye protection.(8) For most work sites in employers insist on certified eye protection. A certified product is regularly batch tested and the manufacturing facilities are audited regularly to ensure they meet EN166. Coatings and tints can play a valuable role in ensuring clear vision is maintained. Eye protection must be appropriate for the intended purpose and offer comfort to the wearer, even for long shifts.
We should remain aware of the dangers of wearing sunglasses and regular spectacles as a replacement for eye protection. In addition, individuals must be counselled against wearing their regular spectacles while doing activities in which high speed particles are produced, e.g. grinding, drilling, lawn mowing and weed trimming.
The role of eye care providers in eye injury prevention
Bringing eye protection out of the cupboard
For many years eye care providers have kept eye protection ‘under the counter’ and out of view. Increasingly eye injury prevention is forming an integral part of the primary health care role as well as an added revenue stream. With strong brands in the market now offering attractive and functional eye protection for prescription and non-prescription wearers, with the added assurance of certification, eye care providers should be encouraged to discuss and promote their patients’ eye protection needs both at work and home. They can also promote the necessity of eye protection and the consequences of vision loss through talks in schools and at local clubs.