Use Of Eye Protection Research Articles

Types of ocular injury and their antecedent factors: A systematic review and meta-analysis.

Ocular injuries are an important workplace hazard that can lead to vision loss, decreased functioning, and socioeconomic costs. The aim of this systematic review is to identify types of occupational ocular injuries and examine factors associated with these injuries. Four health sciences databases (Ovid Medline, Embase, PsycINFO, and CINAHL) were reviewed to identify evidence pertaining to occupational ocular injuries. This systematic review was registered with PROSPERO (registration number: CRD42018089876) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The PICO (Population/Intervention/Comparison/Outcome) tool was used to support, structure, and improve our search strategy. Overall, 12 studies with quantitative Critical Appraisal Skills Programme grading scores were assessed in a systematic review and meta-analysis of ocular injuries in the workplace. The systematic review identified four main factors associated with occupational ocular injury: (a) use of eye protection at the time of the ocular injury, (b) being male, (c) exposure to biological or chemical occupational hazards, and (d) risk-taking behavior. Differences in risk between countries of origin, occupational sectors, and dates of publication, suggest likely differences or changes in safety procedures. We recommend that employers ensure that safety equipment is tailored to the protection of their specific occupational hazards, and that employees are adhering to safety protocols.

Shedding light on a potential hazard: Dental light-curing units

BackgroundDental light-curing units (LCUs) are powerful sources of blue light that can cause soft-tissue burns and ocular damage. Although most ophthalmic research on the hazards of blue light pertains to low levels from personal electronic devices, computer monitors, and light-emitting diode light sources, the amount of blue light emitted from dental LCUs is much greater and may pose a “blue light hazard.” MethodsThe authors explain the potential risks of using dental LCUs, identify the agencies that provide guidelines designed to protect all workers from excessive exposure to blue light, discuss the selection of appropriate eye protection, and provide clinical tips to ensure eye safety when using LCUs. ResultsWhile current literature and regulatory standards regarding the safety of blue light is primarily based on animal studies, sufficient evidence exists to suggest that appropriate precautions should be taken when using dental curing lights. The authors found it difficult to find on the U.S. Food and Drug Administration database which curing lights had been cleared for use in the United States or Europe and could find no database that listed which brands of eyewear designed to protect against the blue light has been cleared for use. The authors conclude that more research is needed on the cumulative exposure to blue light in humans. Manufacturers of curing lights, government and regulatory agencies, employers, and dental personnel should collaborate to determine ocular risks from blue light exist in the dental setting, and recommend appropriate eye protection. Guidance on selection and proper use of eye protection should be readily accessible. Conclusions and Practical ImplicationsThe Centers for Disease Control and Prevention Guidelines for Infection Control in the Dental Health-Care Setting–2003 and the Occupational Safety and Health Administration Bloodborne Pathogen Standard do not include safety recommendations or regulations that are directly related to blue light exposure. However, there are additional Occupational Safety and Health Administration regulations that require employers to protect their employees from potentially injurious light radiation. Unfortunately, it is not readily evident that these regulations apply to the excessive exposure to blue light. Consequently employers and dental personnel may be unaware that these Occupational Safety and Health Administration regulations exist.

Eye Injuries across history and the evolution of eye protection.

To describe the history of eye injuries and the consequent evolution of eye protection. A comprehensive search of Medline and the grey literature using the terms 'ocular trauma' and 'eye protection' or 'injury prevention' and 'history'. References were used to identify other relevant publications. Publications were classified according to the setting of eye injury: occupational, recreational or combat-related. Eye protection has been described in a wide range of sources, including in literature and art. With advances in eye protection material and design, as well as government and societal promotion of appropriate eye protection usage in the workplace, the epidemiology of ocular trauma has changed over time. In developed countries, the use of eye protection in the workplace has reduced the proportion of occupation-related eye injuries over the last century, with a higher proportion occurring during sports or at home. New protection devices and policies have evolved to meet this change. Vision loss has broad implications for the individual and for society and despite available prevention strategies, ocular trauma is a significant cause of preventable monocular and bilateral vision loss. The use of appropriate eye protection has reduced the burden of ocular trauma. History provides lessons for informing current eye protection and eye injury prevention strategies.

Improving the availability, accessibility, and use of eye protection in patient care settings

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.

Work Related Ocular Injury: Nepal.

Occupational eye injuries comprise a major source of ocular trauma. Knowledge of the epidemiology of occupational eye injuries is essential to formulate viable safety strategies. To evaluate the demographics, patterns of protective eye wear use, and patterns of occupational eye injury among workers in Hetauda, Nepal. Community based cross-sectional prospective survey was carried out from September 2010 to July 2011. Survey included all workers irrespective of their age and those who are willing to participate in survey by filling details on structured questioners and comprehensive eye examination at community level. 1236 surveys were collected. 38.3% (473) of workers surveyed reported experiencing a work-related eye injury. Over two-thirds [68.3% (844)] of workers surveyed reported never wearing safety eyewear while at work. There was a positive correlation between male sex (P<0.001), reported previous work-related injury (P<0.001), and attending school (P=0.016) and use of personal protective equipment (PPE). The population studied demonstrates a significant level of work related injury. There are potentially modifiable factors that could lead to increased use of eye protection.

Ballistic Eye Protection: Why Are Soldiers Reluctant to Use Them?

The Israel Defense Forces (IDF), as well as many other armies, faces major challenges in balancing the need to protect soldiers from harm while not impeding their ability to fight. Eye protections available in the IDF are underused, for reasons that are as yet unclear. In this study, we aim to gain a better understanding of the influence of eye protection currently in use in the IDF on vision. In this cross-sectional study, subjects were assessed for best corrected visual acuity, contrast sensitivity, and binocular visual fields (Goldmann) in a crossover design (with and without eye protection). In addition, we established a comprehensive review on the subjective faults of the eye protection, both from personal experiences of soldiers who used them during their military service and from civilian volunteers who used them in a sterile laboratory setting. Visual acuity, contrast sensitivity and visual fields with and without the eye protection were assessed in 25 subjects. Eye protection did not cause any statistically significant change in visual acuity. However, the eye protection caused a statistically significant decrease in visual fields in all quadrants and in both isopters used. Significant restriction of the visual field can pose a major challenge for soldiers on the battlefield. The use of eye protection with wider lenses or no frame should be considered. Education and instruction should focus on increasing awareness among commanders and soldiers of the benefits of eye protection and fostering trust in the technology's capabilities. In parallel, it is crucial to educate soldiers about its disadvantages, and how such disadvantages can be overcome. We stipulate the findings to the standard IDF goggle and might not apply to other designs.

Assessing a ban on the use of UV tanning devices among adolescents in Ontario, Canada: first-year results

To describe the effect of the first year of a ban on UV tanning device (beds, lamps) use among those under 18years of age in Ontario, Canada. Online questionnaires were completed by adolescents in grades 7 to 12, aged less than 18 years: one when the ban was enacted (May 2014) and a second a year later (May 2015). Questionnaires asked grade, age, sex, and about use of UV tanning devices in the previous year. Recent users were asked about length, frequency, and location of use; service refusals and reasons; awareness of signs/warning labels; and use of eye protection. Weighted estimates and confidence intervals were generated. There were 1561 participants in 2014 and 2305 in 2015. No reduction was observed in UV tanning device use (6.9% vs. 7.9%) in the 12months preceding the survey. In 2015, most respondents used UV tanning devices in beauty establishments, which was a shift away from gyms and fitness centres as seen in 2014. Non-significant increases occurred in the proportions noticing warning signs/labels (57% vs. 71%), required to wear eye protection (92% vs. 99%), and refused service (17% vs. 21%). Most adolescents who were refused service did not use tanning devices that year (72%). Use did not change in the year following enactment of a ban on UV tanning devices among youth in Ontario. The ban did lead to improvements in service refusal, awareness of warning signage, and use of eye protection. As service refusal deterred future use, enhanced enforcement is important.

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees.

Despite supporting evidence, many staff surgeons and surgical trainees do not routinely double glove. We performed a study to assess rates of and attitudes toward double gloving and the use of eye protection in the operating room. We conducted an electronic survey among all staff surgeons and surgical trainees at 2 tertiary care centres in Alberta between September and November 2015.We analyzed the data using log-binomial regression for binary outcomes to account for multiple independent variables and interactions. For 2-group comparisons, we used a 2-group test of proportions. The response rate was 34.3% (361/1051); 205/698 staff surgeons (29.4%) and 156/353 surgical trainees (44.2%) responded. Trainees were more likely than staff surgeons to ever double glove in the operating room (p = 0.01) and to do so routinely (p = 0.01). Staff surgeons were more likely than trainees to never double glove (p = 0.01). A total of 300/353 respondents (85.0%) reported using eye protection routinely in the operating room. Needle-stick injury was common (184 staff surgeons [92.5%], 115 trainees [74.7%]). Reduced tactile feedback, decreased manual dexterity and discomfort/poor fit were perceived barriers to double gloving. Rates of double gloving leave room for improvement. Surgical trainees were more likely than staff surgeons to double glove. Barriers remain to routine double gloving among staff surgeons and trainees. Increased education on the benefits of double gloving and early introduction of this practice may increase uptake.

Intraocular Foreign Body Trauma in Operation Iraqi Freedom and Operation Enduring Freedom: 2001 to 2011

We update the incidence of intraocular foreign bodies (IOFB) in soldiers admitted to Walter Reed Army Medical Center from 2001 to 2011 after sustaining combat injuries in Operation Iraqi Freedom and Operation Enduring Freedom. This consecutive retrospective case series included 890 eyes of 652 patients. Data were collected in the Walter Reed Ocular Trauma Database. Inclusion criteria were any American soldier or Department of Defense civilian with an IOFB injured in Operation Iraqi Freedom/Operation Enduring Freedom. Closed globe injuries with orbital foreign bodies, injury outside of a combat zone, or non-Department of Defense civilian trauma were the exclusion criteria. Primary outcome measures were final visual outcome and the number, size, and location of IOFBs. Secondary outcome measures included surgical procedures, use of eye protection, associated complications, source of injury and Ocular Trauma Score. There were 890 eye injuries in 652 patients evacuated to Walter Reed Army Medical Center between2001 and 2011. IOFBs were found in 166 eyes of 149 patients (18.6%; 95% confidence interval [CI], 16.2%-21.3%). Most patients had a single IOFB (80.7%). An IOFB was positively associated with Ocular Trauma Score grade 1 or 2 (0-65) injuries (odds ratio [OR], 1.58; 95% CI, 1.07-2.38; P= 0.01). There were 130 eyes (78.33%) that had recorded time from initial visual acuity to final visual acuity and it ranged from 8 to 2421 days (mean, 433.24 days). Thirty-eight (25.16%; 95% CI, 18.89%-32.67%) eyes had no change in visual acuity, 98 (64.90%; 95% CI, 57.00%-72.07%) had improved visual acuity, and 15 (9.93%; 95% CI, 6.01%-15.84%) had decreased visual acuity. IOFB was not found to predict final visual acuity of <20/200 in multivariate analysis when other injury features were known (P= 0.1). Pars plana vitrectomy was completed on 124 eyes (74.70%). Removal of IOFB was performed in 118 eyes (71.08%; average of 31.67 days after initial injury) with a delayed procedure occurring after primary closure and antibiotics owing to a lack of surgical capacity in Iraq and Afghanistan. Retinal detachment occurred in 48 eyes (28.92%) and proliferative vitreoretinopathy in 44 eyes (26.5%). IOFBs occur frequently in combat ocular trauma and are significantly associated with moresevereinjuries. However, IOFBs were not found to be a significant risk factor for visual acuity of <20/200.

Eye Protection: Survey of Dermatologists and Office Staff.

Splash injuries to mucosal membranes during procedures have been well documented in dermatology and carry a potential risk of blood-borne virus transmission. The risk to the ocular mucosa can be minimized with proper eye protection. To examine the prevalence of wearing eye protection during dermatologic procedures by physicians, trainees, and office staff in dermatology. A Cross-sectional observational study of US dermatologists, residents, nurses, and medical assistants was performed regarding eye protection during dermatologic procedures. The rates of wearing eye protection in every dermatologic procedure are as follows: dermatologists 42.3%, residents/fellows 39.6%, and nurses/medical assistants 25%. Ninety-eight percent of respondents thought blood-borne illnesses could be transmitted by splash injury. The rates of having splash injury during your career are as follows: dermatologists 73.1%, residents/fellows 16.7%, and nurses/medical assistants 50%. The rates of having a splash injury within the last year are as follows: dermatologists 11.5%, residents/fellows 8.3%, and nurses/medical assistants 35.7%. The use of eye protection is an important component of the personal protective equipment to help prevent transmission of blood-borne illnesses. Dermatologists and staff should strive to increase awareness and the use of face masks with eye shields or face mask with separate eye protection in every dermatologic procedure.

The UK Paediatric Ocular Trauma Study 2 (POTS2): demographics and mechanisms of injuries.

PurposePediatric ocular trauma is an important cause of visual morbidity worldwide, accounting for up to one-third of all ocular trauma admissions. It has long-term implications for those affected and significant economic consequences for healthcare providers. It has been estimated that 90% of all ocular trauma is preventable. Targeted strategies are required to reduce the incidence and the severity of pediatric ocular trauma; this requires an understanding of the epidemiology and characteristics of these injuries and the children involved.MethodsProspective, observational study of pediatric ocular trauma cases presenting to UK-based ophthalmologists over a 1-year period; reporting cards were distributed by the British Ophthalmological Surveillance Unit, and clinicians were asked to report incidents of acute orbital and ocular trauma in children aged ≤16 years requiring inpatient or day-case admission. A validated, standardized questionnaire was sent to reporting ophthalmologists to collect data on the demographics and circumstances of injury.ResultsMedian age at presentation was 7.7 years, with boys more than twice as likely to be affected than girls (M:F =2.1:1.0). Almost 50% of injuries occurred at home, with 25% occurring in school or nursery. A total of 67% of injuries occurred during play, and 31% involved a sharp implement.ConclusionPediatric ocular trauma remains an important public health problem. At least three-quarters of all injuries are preventable through measures, including education of children and responsible adults, restricting access to sharp implements, improving adult supervision, and appropriate use of eye protection.

Occupational ocular incidents in dentists: a multicentre study in southwestern Saudi Arabia

Dental practitioners are at high risk of occupational ocular incidents during their daily work practice. The aim of this study was to assess the prevalence, pattern and determinants of ocular incidents and to establish the use of eye protection by dental staff in southwestern Saudi Arabia. This multicentre cross-sectional study was conducted among dental practitioners working in private, military and Ministry of Health dental clinics in southwestern Saudi Arabia. A predesigned self-report questionnaire was used to elicit information on demographics, splash or foreign body ocular incidents, postincident practices and use of eye protection. Of the 233 dental practitioners examined, 29.6% and 51.1% reported ocular incidents as a result of foreign bodies and fluid splashing, respectively. The risk of ocular incidents as a result of fluid splashing was significantly higher in the absence of postgraduate qualification [odds ratio (OR) = 3.04, 95% confidence interval (95% CI): 1.70-5.43], poor compliance with wearing eye protection (OR = 2.52, 95% CI: 1.49-4.28) and long work hours (OR = 2.16, 95% CI: 1.17-3.96). The most frequent postexposure practice was to rinse eyes under running water (87.5%). Approximately 4.2% and 9.2% of dental practitioners reported incidents of ocular injury and infection, respectively, and 14% reported that they never wore any eye protection. Occupational ocular incidents as a result of splashing and foreign bodies are relatively common among dental practitioners in southwestern Saudi Arabia. The absence of postgraduate qualification, poor compliance with wearing eye protection and working long hours are predictors of ocular incidents. Awareness about eye safety is therefore considered mandatory for dental practitioners in southwestern Saudi Arabia. Also, dental clinic administrators should provide and promote the use of eye protection.

Knocked by the shuttlecock: twelve sight‐threatening blunt‐eye injuries in Australian badminton players

BackgroundNon‐penetrating ocular injuries from badminton shuttlecocks can result in severe damage and life‐long complications. This case series highlights the morbidity of such injuries, particularly in regard to post‐traumatic glaucoma.MethodsThis is a retrospective case series of 12 patients with shuttlecock‐related blunt eye injuries sustained during badminton play without eye protection. By approaching colleagues through conference presentations and networking, the authors have attempted to gather all known cases of shuttlecock ocular injury managed in tertiary ocular emergency departments or private ophthalmological clinics in Victoria and New South Wales, Australia in 2015.ResultsThis is the first multicentre case series to describe badminton‐related ocular injuries in Australia. Our case series demonstrates, in particular, long‐term glaucoma‐related morbidity for patients over a large age range (16 to 77 years), with one patient requiring ongoing management 26 years following their initial injury. The cases reported further add to the literature promoting awareness of badminton‐related ocular injury.ConclusionsWe encourage player education and advocacy on badminton‐related eye injuries and appropriate use of eye protection to reduce associated morbidity.

Corneal and Corneoscleral Injury in Combat Ocular Trauma from Operations Iraqi Freedom and Enduring Freedom.

To examine the incidence and the etiology of corneal and corneoscleral injuries in the setting of combat ocular trauma, and to determine what effect these injuries have on overall visual impairment from combat ocular trauma. Retrospective, noncomparative, interventional case series, analyzing U.S. service members who were evacuated to the former Walter Reed Army Medical Center (WRAMC). Primary outcome measures were types of corneal injuries, length of follow-up at WRAMC, globe survival, and anatomical causes of blindness. Secondary outcome measures included surgical procedures performed, use of eye protection, source of injury, and visual outcomes. Between 2001 and 2011, there were 184 eyes of 134 patients with corneal or corneoscleral injuries. The average age was 26 years (range, 18-50); 99.3% were male, 31.9% had documented use of eye protection. The average follow-up was 428.2 days (3-2,421). There were 98 right-eye and 86 left-eye injuries. There were 169 open-globe and 15 closed-globe injuries with corneal lacerations occurring in 73 eyes with injuries to Zone I. Most injuries were attributable to an intraocular foreign body (IOFB; 48%), followed by penetrating (19.6%) and perforating (16.3%) injuries. The most common presenting visual acuity was hand motion/light perception (45.7%), yet, at the end of the study, visual acuity improved to 20/40 or better (40.8%). The majority of injuries in eyes with visual acuity worse than 20/200 involved the cornea and retina (58%). Injuries solely to the cornea accounted for only 19% of all injuries sustained. Ocular injuries in military combat have led to significant damage to ocular structures with a wide range of visual outcomes. The authors describe corneal and corneoscleral injuries in combat ocular trauma by classifying injuries by the anatomical site involved and identifying the main source of decreased visual acuity. In combat ocular trauma, corneal or corneoscleral injuries are not the sole etiology for poor vision. A cohesive approach among multiple ophthalmic subspecialties is needed when treating combat ocular trauma.

Self-Reported Visual Quality of Life After Combat Ocular Trauma.

To describe the visual outlook and quality of life of service members after combat ocular trauma. In a single-center, prospective observational study of service members sustaining ocular trauma, participants underwent a series of ocular examinations and noninvasive tests, including the National Eye Institute Visual Functioning Questionnaire (VFQ-25). Of the 165 enrolled participants, 137 completed the VFQ-25. The mean VFQ-25 composite score was 74.4 ± 20.7 (range: 1.4-100). Among 118 participants with visual acuity assessment, 92% had best corrected visual acuity (BCVA) of 20/20 or better in at least one eye. Among participants with severe vision loss (BCVA ≤20/200), there was no statistically significant difference in self-reported general health compared to those without severe vision loss (p = 0.17). However, there was a significantly lower visual quality of life reported in the composite score and all of the 11 subscales of the VFQ-25. While this study provides evidence that combat ocular trauma is associated with a lower visual quality of life, limitations include the relatively small sample size and the limited documentation of the use of eye protection at time of injury among participants.

Spectrum and outcomes of open globe injuries presenting to a tertiary Eye Centre in Singapore

PurposeTo study the demographics and clinical outcomes of consecutive open globe injuries presenting to a tertiary centre in Singapore.MethodsData was prospectively collected for all open globe injuries presenting to a tertiary ophthalmology unit in Singapore between January 2014 and December 2015. Main clinical outcomes were the interval to surgical intervention and visual outcome at 6 months.ResultsWe collected 11 cases with a mean duration of follow‐up of 6.5 ± 3.9 months. The mean age was 42.9 ± 22.3 years and 81.8% were male. 10 cases (90.9%) were from industrial accidents and the remaining 1 (9.1%) was due to a fall. Eye protection was worn in only 27.3% (n = 3) of cases. Indications for surgery included penetrating injuries (n = 7), intraocular foreign bodies (IOFB) (n = 3) and globe rupture (n = 1). Nearly all cases (n = 10) sought medical attention within 7.4 ± 5.7 h of the injury, and the mean interval to surgical intervention in these cases was 4.1 ± 2.6 h. The remaining 1 case presented 1 week after the injury, and underwent surgery 5 days after presentation, for a metallic IOFB impacted in the sclera. No cases developed endophthalmitis. The mean number of surgeries required was 1.6 ± 0.7. At presentation, the mean visual acuity (VA) in the affected eye was 2.0 ± 1.1 logMAR and the mean ocular trauma score was 68.7 ± 17.5. There were 8 cases (72.7%) remaining to follow‐up at month 6, with a mean VA of 0.98 ± 1.12 logMAR, and 7 of 8 cases (87.5%) showed improvement in VA compared to presentation.ConclusionsIn our study, open globe injuries in Singapore are quite uncommon, occurred predominantly in males, often secondary to industrial accidents, and use of eye protection was often inadequate. In a tertiary ophthalmology practice, the majority received prompt surgical repair and had improvement in visual acuity at 6 months follow‐up.

Outcomes of eye injuries with retained intraocular foreign material at Groote Schuur Hospital, Cape Town

BackgroundRetained intraocular foreign body (IOFB) is a specific subgroup of open globe injury which is often preventable with appropriate use of eye protection. We describe the spectrum of injuries resulting in IOFB, outcomes and complications following vitrectomy surgery and context specific risk factors which may influence outcomes at our hospital.MethodsRetrospective cohort study of 43 consecutive cases of IOFB that underwent vitrectomy surgery.ResultsThe median age was 34.6 years and 95.3% were male. The presenting visual acuities ranged from 6/6 (LogMAR 0.00) to Perception of Light (PL) with a median of Hand Motions (HM) (Interquartile Range (IQR) 6/24-HM). Hammering metal was the most common cause of injury (44.2%); 72% of injuries occurred while performing premeditated high-risk activities. The foreign body was metallic in 76.7% of cases and penetrated the cornea in 69.8% of cases. Lens injury occurred in 65.1%. The retina was impacted in 36 cases (83.7%), four of which impacted the macula. Macula impact was associated with poor visual outcome ( p = 0.049, Fisher’s exact). Four cases (9.3%) had endophthalmitis. The median final visual acuity was 6/24 (IQR 6/9–6/60). Visual acuity improved in 63.4.0%. Ten cases (23.8%) were worse than 3/60. Better presenting vision was associated with better visual outcomes ( p = 0.049, Fisher’s exact). The Ocular Trauma Score predicted outcomes well in better prognosis categories but underestimated final visual outcomes in the poor prognosis category. Central corneal scarring contributed to reduced visual outcomes.ConclusionThe majority of IOFB injuries are preventable with appropriate use of eye protection. Visual outcomes are better than other causes of open globe injury. Resource constraints contribute to suboptimal final visual outcomes.

Trauma team utilization of universal precautions: if you see something, say something.

The risks deriving from the lack of compliance with universal safety precautions (USPs) are unequivocal. However, the adoption of these prophylactic precautions by healthcare providers remains unacceptably low. We hypothesized that trauma teams are not routinely adhering to USPs and that a brief educational intervention, followed by real-time peer feedback, would substantially improve compliance rates. This before-and-after interventional study took place in the resuscitation bay of a Level I Trauma Center during trauma team activations. Six USPs were examined: hand washing (before and after patient contact), use of gloves, gowns, eye protection, and masks. Surgery and Emergency Medicine attending physicians, residents, and nurses, who had direct patient contact, were included. Following 162 baseline observations, an educational intervention in the form of brief lectures was conducted, emphasizing the danger to self from dereliction of USPs. Subsequently, 167 post-intervention observations were made after a one-month period of knowledge decay. Finally, real-time feedback was provided by trauma team leaders and study staff. Adherence to prophylactic measures was recorded again. Baseline compliance rates were dismal. Only hand washing prior to patient interaction, the use of eye protection, and the use of masks improved significantly (p<0.05) after the educational initiative. However, compliance rates remained suboptimal. No difference was noted regarding the three other USPs. Impressively, following real-time behavioral corrections, compliance improved to nearly 90% for all USPs (p<0.05). Compliance with OSHA-required USPs during trauma team activations is unacceptably low, but can be dramatically improved through simple educational interventions, combined with real-time peer feedback.

Ocular Health and Safety Assessment among Mechanics of the Cape Coast Metropolis, Ghana.

Purpose:To conduct an ocular health and safety assessment among mechanics in the Cape Coast Metropolis, Ghana.Methods:This descriptive cross sectional study included 500 mechanics using multistage sampling. All participants filled a structured questionnaire on demographic data, occupational history and ocular health history. Study participants underwent determination of visual acuity (VA) using LogMAR chart, external eye examination with a handheld slit lamp biomicroscope, dilated fundus examination, applanation tonometry and refraction.Results:Out of 500 mechanics, 433 were examined (response rate, 87%) comprised of 408 (94.2%) male and 25 (5.8%) female subjects. The prevalence of visual impairment (i.e. presenting VA < 6/18) among the respondents was 2.1%. Eye injuries were reported in 171 (39.5%) mechanics probably due to the large number of workers, 314 (72.5%), who did not use eye protective devices. Mechanics in the auto welding category were at the highest risk of sustaining an eye injury (odds ratio [OR], 13.4; P < 0.001). Anterior segment ocular disorders were mostly pterygia while posterior segment eye disorders included glaucoma suspects and retinochoroidal lesions. The development of pterygia was associated with the number of years a mechanic stayed on the job. Eye care seeking behavior among the participants was poor.Conclusion:Eye injuries were prevalent among the mechanics as the use of eye protection was low. Eye safety should be made an integral part of the public health agenda in the Cape Coast Metropolis.

Causes of combat ocular trauma-related blindness from Operation Iraqi Freedom and Enduring Freedom.

The incidence of eye injuries in military service members is high in the combat setting. This is the first study that identifies the primary reason for poor visual acuity (worse than 20/200). This is a retrospective, noncomparative, interventional case series analyzing US Operation Iraqi and Enduring Freedom members who were evacuated from the theater of operations to Walter Reed Army Medical Center from 2001 through 2011. Primary outcome measures were the length of follow-up, globe survival, and anatomic causes of blindness. Secondary outcome measures included surgical procedures performed, use of eye protection, nonocular injuries, incidence of traumatic brain injury, source of injury, visual outcomes, and predictability of Ocular Trauma Score (OTS) on visual outcome. Univariate analysis was performed using χ and Fisher's exact test. A p < 0.01 was considered significant because of the multiple hypotheses tested. There were 265 eyes of 239 patients who had final best-corrected visual acuity of worse than 20/200. The average age was 27.4 years (range, 19-53 years). Of the patients, 97.5% were male, and 28.9% had documented use of eye protection. The average follow-up was 350.19 days (range, 3-2,421 days). There were 128 right-eye and 133 left-eye injuries, with a total of 26 bilateral injuries. There were 206 open-globe and 56 closed-globe injuries, which were further subdivided into zones. Open-globe Zone III injuries (81.6%) were the number one cause of blindness, and most injuries were caused by improvised explosive devices (64.2%). Enucleation was the most common surgery performed (40.6%) and therefore the leading cause of blindness, followed by a multifactorial cause and direct traumatic optic neuropathy. Ocular trauma is common among combat injuries. Close to a third of service members that experience an ocular trauma become legally blind. Further research is needed to focus on strategies to prevent injury and improve visual outcomes. Prognostic/epidemiologic study, level V.