Contact lens survey. Implications for the occupational health nurse.
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Likely contamination of a surgeon's conjunctiva by patients' body fluids is surprisingly frequent. Blood and fat are the most common agents but cellular implantation may occur. Possible contamination was documented in 37 of 60 orthopedic procedures. Power tools, hammering and the use of rongeurs are the main culprits in producing a forced spray most likely to cause contamination. Reduction of the hip at the time of replacement arthroplasty is often associated with propulsion of blood. Not a single case of possible contamination resulted from the pumping action of a severed vessel. Since orthopedic surgeons work in a high-risk environment, safety glasses are recommended to prevent contraction of viral diseases such as hepatitis B and acquired immune deficiency syndrome by way of the conjunctiva. The glasses will also protect the surgeon from bacterial and cellular conjunctival contamination, in addition to preventing physical damage secondary to propelled bone and cement.
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An eye protection program is needed in occupational medicine policies. Typical eye injuries and eye accidents, as they relate to occupational accidents, justify the management advocating such a program. A recommended model for a functional eye protection program is provided and defined.
The dental office can be a source of ocular injury due to mechanical, chemical, microbiological, and electromagnetic insult. Survey questionnaires were sent to all Indian Health Service dentists in the Oklahoma area to assess knowledge of and compliance with measures to prevent eye injuries. After distribution of eye safety information, a second questionnaire was sent to assess any changes in compliance with wearing protective eyewear. Recommendations are given for measures to prevent eye injuries in the dental office.
The standard of care expected of optometrists continues to be defined by the courts. Misdiagnosis of ocular disease and liability for injuries caused by ophthalmic products remain the leading causes of litigation. Documentation of findings, warnings, and key management decisions is an essential aspect of clinical practice and must not be neglected by clinicians.
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This article summarizes the clinical and experimental data leading to the Canadian Standards Association (CSA) certification of six eyeguards for racquet sports in Canada in November 1986. A parallel approach involving the American Standard of Testing and Materials (ASTM) is discussed and eyeguards meeting specifications are illustrated.
Photochemotherapy (PUVA) with oral administration of the photosensitizer 8-methoxypsoralen and irradiation with UVA light has become a proved method for the therapy of psoriasis. The treatment is based upon repeated PUVA exposures, which are monitored by exact dosimetry within the desired therapeutic ranges. The present study, which covers an observation period of 3 years, is engaged with the practicability of the PUVA method for the treatment of the various forms of psoriasis, mycosis fungoides, atopic eccema and lichen planus, and, on the other hand, with its side effects and potential long term hazards. Photochemotherapy was shown in clinical routine as an highly effective treatment, which lead to complete clinical remission in all diseases investigated. By maintenance treatment patients with psoriasis could be kept in remission even for long periods of time. Following the dosage parameters toxic side effects were rare and reversible. Histological, histochemical and ultrastructural investigations showed no alteration of skin under photochemotherapeutic conditions. Experimentally induced massive PUVA overdosage, however, led to damage of epidermis and corium and to long lasting benign changes of the melanin pigment system. To study potential long term side effects (hepatotoxicity of 8-methoxypsoralen, cataract formation, development of degenerative or hyperplastic skin changes and disturbances of the immunologic reactivity) laboratory investigations, histologic, ophthalmologic and immunologic studies have been performed. During an observation period of up to 3 years no evidence of long term side effects was found.
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