Do modern spectacles endanger surgeons? The Waikato Eye Protection Study.
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BACKGROUND: Despite documented cases of infectious disease transmission to medical staff via conjunctival contamination and widespread recommendation of protective eyewear use during surgical procedures, a large number of surgeons rely on their prescription spectacles as sole eye protection. Modern fashion spectacles, being of increasingly slim design, may no longer be adequate in this role. METHODS: A survey was conducted among the surgeons at Waikato Hospital from December 7, 2004 to February 1, 2005, to assess current operating theater eyewear practices and attitudes. Those who wore prescription spectacles were asked to assume a standardized "operating position" from which anatomic measurements were obtained. These data were mathematically analyzed to determine the degree of palebral fissure protection conferred by their spectacles. RESULTS: Of 71 surgical practitioners surveyed, 45.1% required prescription lenses for operating, the mean spectacle age being 2.45 years; 84.5% had experienced prior periorbital blood splashes; 2.8% had previously contracted an illness attributed to such an event; 78.8% participants routinely used eye protection, but of the 27 requiring spectacles, 68.0% used these as their sole eye protection. Chief complaints about safety glasses and facial shields were of fogging, poor comfort, inability to wear spectacles underneath, and unavailability. Our model predicted that 100%, 92.6%, 77.8%, and 0% of our population were protected by their spectacles laterally, medially, inferiorly, and superiorly, respectively. CONCLUSIONS: Prescription spectacles of contemporary styling do not provide adequate protection against conjunctival blood splash injuries. Our model predicts the design adequacy of currently available purpose-designed protective eyewear, which should be used routinely. (+info)
Macular degeneration in an arc welder.
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A male welder who had been working in an industrial machine plant for more than 20 years experienced acute intense pain in his left eye with continuous lacrimation while performing arc welding in 1997. Later in 1997, at the age of 39 yr, macular edema was found in his left eye. He was diagnosed with macular degeneration (MD) of the left eye in 2002, and with right eye MD in 2004. Radiation in the visible and near infrared (IR) spectra penetrates the eye and is absorbed by the retina, possibly causing thermal or photochemical damage. Such retinal damage may be permanent and, therefore, sight-threatening. The young age and history of an acute painful eye injury are not consistent with age related macular degeneration (AMD) but rather is likely maculopathy caused by welding arc exposure. (+info)
The influence of various factors on high school football helmet face mask removal: a retrospective, cross-sectional analysis.
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CONTEXT: Most research on face mask removal has been performed on unused equipment. OBJECTIVE: To identify and compare factors that influence the condition of helmet components and their relationship to face mask removal. DESIGN: A cross-sectional, retrospective study. SETTING: Five athletic equipment reconditioning/recertification facilities. PARTICIPANTS: 2584 helmets from 46 high school football teams representing 5 geographic regions. INTERVENTION(S): Helmet characteristics (brand, model, hardware components) were recorded. Helmets were mounted and face mask removal was attempted using a cordless screwdriver. The 2004 season profiles and weather histories were obtained for each high school. MAIN OUTCOME MEASURE(S): Success and failure (including reason) for removal of 4 screws from the face mask were noted. Failure rates among regions, teams, reconditioning year, and screw color (type) were compared. Weather histories were compared. We conducted a discriminant analysis to determine if weather variables, region, helmet brand and model, reconditioning year, and screw color could predict successful face mask removal. Metallurgic analysis of screw samples was performed. RESULTS: All screws were successfully removed from 2165 (84%) helmets. At least 1 screw could not be removed from 419 (16%) helmets. Significant differences were found for mean screw failure per helmet among the 5 regions, with the Midwest having the lowest failure rate (0.08 +/- 0.38) and the Southern (0.33 +/- 0.72), the highest. Differences were found in screw failure rates among the 46 teams (F(1,45) = 9.4, P < .01). Helmets with the longest interval since last reconditioning (3 years) had the highest failure rate, 0.47 +/- 0.93. Differences in success rates were found among 4 screw types (chi(2) (1,4) = 647, P < .01), with silver screws having the lowest percentage of failures (3.4%). A discriminant analysis (Lambda = .932, chi(2) (14,n=2584) = 175.34, P < .001) revealed screw type to be the strongest predictor of successful removal. CONCLUSIONS: Helmets with stainless steel or nickel-plated carbon steel screws reconditioned in the previous year had the most favorable combination of factors for successful screw removal. T-nut spinning at the side screw locations was the most common reason and location for failure. (+info)
Form-deprivation myopia in chick induces limited changes in retinal gene expression.
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PURPOSE: Evidence has implicated the retina as a principal controller of refractive development. In the present study, the retinal transcriptome was analyzed to identify alterations in gene expression and potential signaling pathways involved in form-deprivation myopia of the chick. METHODS: One-week-old white Leghorn chicks wore a unilateral image-degrading goggle for 6 hours or 3 days (n = 6 at each time). Total RNA from the retina/(retinal pigment epithelium) was used for expression profiling with chicken gene microarrays (Chicken GeneChips; Affymetrix, Santa Clara, CA). To identify gene expression level differences between goggled and contralateral nongoggled eyes, normalized microarray signal intensities were analyzed by the significance analysis of microarrays (SAM) approach. Differentially expressed genes were validated by real-time quantitative reverse transcription-polymerase chain reaction (qPCR) in independent biological replicates. RESULTS: Small changes were detected in differentially expressed genes in form-deprived eyes. In chickens that had 6 hours of goggle wear, downregulation of bone morphogenetic protein 2 and connective tissue growth factor was validated. In those with 3 days of goggle wear, downregulation of bone morphogenetic protein 2, vasoactive intestinal peptide, preopro-urotensin II-related peptide and mitogen-activated protein kinase phosphatase 2 was validated, and upregulation of endothelin receptor type B and interleukin-18 was validated. CONCLUSIONS: Form-deprivation myopia, in its early stages, is associated with only minimal changes in retinal gene expression at the level of the transcriptome. While the list of validated genes is short, each merits further study for potential involvement in the signaling cascade mediating myopia development. (+info)
Mandatory use of eye protection prevents eye injuries in the metal industry.
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BACKGROUND: Eyes are frequently injured in occupational accidents. What is the preventive effect of mandatory eye protection in metalworking? METHODS: The injury incidence was determined before and after eye protection became mandatory in a metalworking yard. RESULTS: The incidence declined from 6.09 to 0.42 injuries per million working hours after eye protection became mandatory. CONCLUSIONS: Mandatory eye protection among metalworkers in Norway has high potential for preventing eye injuries and should be implemented. (+info)
Use of fluid-ventilated, gas-permeable scleral lens for management of severe keratoconjunctivitis sicca secondary to chronic graft-versus-host disease.
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Keratoconjunctivitis sicca (KCS) occurs in 40%-60% of patients with chronic graft-versus-host-disease (cGVHD) after allogeneic hematopoietic cell transplantation. Although immunosuppressive therapy is the primary treatment of chronic GVHD, ocular symptoms require measures to improve ocular lubrication, decrease inflammation, and maintain mucosal integrity. The liquid corneal bandage provided by a fluid-ventilated, gas-permeable scleral lens (SL) has been effective in mitigating symptoms and resurfacing corneal erosions in patients with KCS related to causes other than cGVHD. We report outcomes in 9 consecutive patients referred for SL fitting for cGVHD-related severe KCS that was refractory to standard treatments. All patients reported improvement of ocular symptoms and reduced the use of topical lubricants after SL fitting resulting from decreased evaporation. No serious adverse events or infections attributable to the SL occurred. The median Ocular Surface Disease Index improved from 81 (75-100) to 21 (6-52) within 2 weeks after SL fitting, and was 12 (2-53) at the time of last contact, 1-23 months (median, 8.0) after SL fitting. Disability related to KCS resolved in 7 patients after SL fitting. The use of SL appears to be safe and effective in patients with severe cGVHD-related KCS refractory to conventional therapies. (+info)
Infection control procedures in commercial dental laboratories in Jordan.
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The risk of cross-infection in dental clinics and laboratories has attracted the attention of practitioners for the past few years, yet several medical centers have discarded compliance with infection control guidelines, resulting in a non-safe environment for research and medical care. In Jordan, there is lack of known standard infection control programs that are conducted by the Jordanian Dental Technology Association and routinely practiced in commercial dental laboratories. The aim of this study was to examine the knowledge and practices in infection control among dental technicians working in commercial dental laboratories in Jordan. Data were collected from the dental technicians by a mailed questionnaire developed by the author. The questionnaire asked respondents to provide demographic data about age and gender and to answer questions about their knowledge and practice of infection control measures: use of gloves, use of protective eyeglasses and face shields, hepatitis B virus (HBV) vaccination, laboratory work disinfection when sent to or received from dental offices. and regularly changing pot water or pumice slurry. Of the total respondents, 135 were males (67.5 percent) and sixty-five were females (32.5 percent) with a mean age of twenty-seven years. The results showed that 24 percent of laboratory technicians wore gloves when receiving dental impressions, while 16 percent continued to wear them while working. Eyeglasses and protective face shields were regularly worn by 35 percent (70/200) and 40 percent (80/200) of technicians, respectively. Fourteen (14 percent) had received an HBV vaccination, and 17 percent inquired if any disinfection measures were taken in the clinic. Eighty-six percent of the technicians reported that pumice slurry and curing bath water were rarely changed. Only five dental technicians (two males and three females) were considered to be fully compliant with the inventory of infection control measures, a compliance rate of 2.5 percent with no significant difference between males and females (p>0.05). In conclusion, there is lack of compliance with infection control procedures of dental technicians working in commercial laboratories in Jordan. (+info)
The effect of swimming goggles on intraocular pressure and blood flow within the optic nerve head.
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PURPOSE: Goggles are frequently worn in the sport of swimming and are designed to form a seal around the periorbital tissue orbit. The resultant pressure on the eye may have the potential to affect intraocular pressure and blood flow of the optic nerve head. This study evaluates the influence of wearing swimming goggles on intraocular pressure (IOP) and blood flow of the ocular nerve head (ONH) in normal subjects. MATERIALS AND METHODS: Thirty healthy participants took part in this study. The IOP of each participant was measured using a Goldmann tonometer. Measurements were taken immediately before putting on swimming goggles, at 5, 10, 30, and 60 minutes after putting on swimming goggles, and then immediately after taking off the goggles. Blood flow of the ONH was measured using the Heidelberg retinal flowmeter. RESULTS: The average IOP before, during and after wearing the swimming goggles were 11.88 +/- 2.82 mmHg, 14.20 +/- 2.81 mmHg and 11.78 +/- 2.89 mmHg, respectively. The IOP increased immediately after putting on the goggles (p < 0.05) and then returned to normal values immediately after removal (p > 0.05). Blood flow of the ONH was 336.60 +/- 89.07 Arbitrary Units (AU) before and 319.18 +/- 96.02 AU after the goggles were worn (p < 0.05). CONCLUSION: A small but significant IOP elevation was observed immediately after the swimming goggles were put on. This elevated IOP was maintained while the goggles were kept on, and then returned to normal levels as soon as they were taken off. Blood flow of the ONH did not change significantly throughout the experiment. These facts should be considered for safety concerns, especially in advanced glaucoma patients. (+info)