For many years eye protection has been kept ‘under the counter’ and out of view. Yet with so many eye injuries occurring in the home and during sports, eye care professionals have an opportunity to significantly reduce eye injuries by making protection part of their regular sales pitch to patients.
The profile of eye injuries has changed dramatically since the very first papers on eye injuries were published early last century. In 1923, Garrow1 found that 70.7 per cent of the 1,000 cases of eye injuries he reviewed were work-related. The nature and distribution of eye injuries from this early data, which included a large number of eye injuries to manual labourers and coal miners, is significantly different from the current situation. 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 since last century is the disproportionate number of males affected, with up to nine males injured for every female. Studies in Australia 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.2 A recent paper based on data from regional NSW3 reported that while the highest rate of eye injuries was at work, eye injuries at home were a close second, followed by injuries in the garden, on farms and during sport.
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.4 The direct cost of hospitalisation from eye injuries for a two-year period in NSW alone was estimated at $7.5 million.5 Other estimates have put the total cost for Australia at $155 million a year.6
Preventing Eye Injuries
A number of factors have reduced the type and rate of eye injuries. These have included: stricter occupational health and safety legislation, raising awareness of hazards, the introducion of standards for, and broader use of eye protection. Figure 1 depicts some of the relevant changes in safety standards and legislation.
approximately 55 million eye injuries that restrict activity by at least one day occur every year
Better motor vehicle design, e.g. seatbelts, laminated windscreens and airbags, and improved regulation has helped reduce motor vehicle-related eye injuries. Road traffic-related eye injuries reduced from 17.7 to 9.6 per 100,000 when seat belt use was made compulsory in 1972.7 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.
In Australia, legislation pertaining to consumer products such as toys and cleaning products have helped to reduce eye injuries. Outside Australia, ‘non-powder’ guns such as BB and airsoft guns are a significant contributor to eye injuries. In Australia these guns are prohibited. Elastic luggage straps, commonly known as Ockey straps, now carry warnings following concerns about eye injury from these straps if released under pressure. The sale of fireworks in Australia is also more tightly regulated than in some countries. One in six firework-related eye injuries result in severe vision loss.8 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 to choose the right type of eye protection.9 For most work sites in Australia, employers insist on certified eye protection. A certified product is regularly batch tested and the manufacturing facilities are audited regularly to ensure they meet the standard. Products that are certified can be searched on the SAI Global website to confirm their certification status, (http://register.saiglobal.com/?stype=power). Products carry specific information to help ensure traceability as well as show application and type (see Figure 2). 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.10 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.
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.
Annette Hoskin is Research Fellow at the University of Western Australia’s Lions Eye Institute and optometrist with more than 20 years’ experience in the field of eye protection, eye injury prevention, compliance and quality control. Annette is a member of the International Standards Organisation (ISO) and Australian Standards (AS) Committees for Eye Protection and Spectacle frames and lenses. Annette’s work experience includes roles at the University of New South Wales, in development and assessment of sunglasses and eye protectors and technology transfer. Annette is based in Perth and currently shares her time between her research interests at UWA and a commercial role developing and advising on eye protection with Shamir Safety Optics (Eyres Optics).
1. Garrow A. A statistical enquiry into 1000 cases of eye injuries. Br J Ophthalmol. 1923;7:65-80.
2. AIHW 2009 Eye Related Injuries in Australia.
3. Northey LC, Bhardwaj G, Curran S, McGirr J. Eye trauma epidemiology in regional Australia. Ophthalmic Epidemiol. 2014;21:237-46.
4. Negrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5:143-69.
5. Long J, Mitchell R. Hospitalised eye injuries in New South Wales, Australia. The Open Epidemiology Journal. 2009;2(1-7).
6. Fong LP. Eye injuries in Victoria, Australia. Med J Aust. 1995;162:64-8.
7. Briner AM. Penetrating eye injuries associated with motor vehicle accidents. Med J Aust. 1976;1:912-4.
8. McGwin G, Jr., Hall TA, Xie A, Owsley C. Trends in eye injury in the United States, 1992-2001. Invest Ophthalmol Vis Sci. 2006;47:521-7.
9. AS/NZS1336 Eye and face protection- Guidelines. 2014. Standards Australia.
10. Hoskin AK, Philip S, Dain SJ, Mackey DA. Spectacle-related eye injuries, spectacle-impact performance and eye protection. Clin Exp Optom. 2015;98:203-9.
Eyres Safety Eyewear
Eyres Safety Eyewear has combined cutting-edge lens technology from Shamir with high-end stylish frames developed to meet Australia and New Zealand Standards. The companies’ combined expertise and extensive research brings optimum performance to its prescription eye protection packages.
Eyres Safety Eyewear can now offer superior multi-coating that won’t wear off or scratch. It leaves the lens clear and free of distracting reflections, perfect for those harsh and extreme environments. Easier than ever to keep clear vision!
Eyres Safety Eyewear is a certified frame and lens package that ensures maximum compliance with safety programs through optimum fit, comfort, clear vision and styles that people want to wear.
Contact: Shamir (AUS) 1300 663 209
Hoya has frames that cater to a wide range of needs and to jobs that demand specific eyewear safety features. The company’s frame portfolio comprises brands such as C-Safe, Bolle, Ugly Fish and Matador. This portfolio is continuously evolving with new and stylish designs to meet ever-changing consumer needs.
Hoya manufactures its low impact lenses from CR39 and medium impact lenses from Phoenix. Both materials have been tested in accordance to the standards and are available in single vision, bifocals and progressive lenses. Hard coat is standard and there are additional coating options that include grey tinting, photochromic options and VP multi-coat.
Contact: Hoya Account Manager
WorkSafe Eyewear has a great range of contemporary frames and lenses that comply with the new Australian Standards AS/NZS 1337.6 for Rx safety eyewear.
All frames are fitted with quality Opticare lenses in Worksafe Eyewear’s local optical laboratory which is endorsed by SAI Global, ensuring your patients enjoy great vision and a high level of eye protection.
Contact: Worksafe Eyewear (AUS) 02 8872 3042
Aviva and Mann
Progear Eyeguard eyewear significantly minimises the risk of serious eye injuries while your patients are playing sport.
Made from extremely durable polycarbonate and using special lens mounts, Progear frames guarantee protection. In fact Progear is the first sports eyewear line ever created to pass all three international sports safety standards at the same time – ASTM F803 (USA), EN 166 (Europe) and JIS T8147.5.1d (Japan). Products certified under these standards are subject to stringent tests of high speed impacts simulated for various sports.
Progear sports eyewear offers a wide field of vision and lenses can be custom fit with personal prescriptions. Great fit and wearer comfort are achieved with details that extend from the interior cushion and nose pads to the flexible headband mount.
Contact: Aviva and Mann Optical (AUS) 1300 850 882
Zeiss provides a wide range of high quality safety frames to complement its most technically-advanced safety lenses. The company’s premium lenses can be fabricated to the required thickness for certified/compliant safety lenses in accordance with the AS/NZS 1337.6 standard. They are available in both
single vision and progressive designs,
in polycarbonate and Trivex materials
and with state-of-the-art anti-reflective coatings and tints.
All Zeiss certified and compliant Rx safety packages include:
- Frame case
- Certified / compliant certificate
Contact: Zeiss Account Manager
PSG Eyewear manufactures and wholesales prescription safety eyewear. The company’s stated objective is to increase awareness of ‘eye safety’ among employees and employers throughout Australia and New Zealand by offering the broadest range of high quality prescription safety solutions that are AS/NZs1337.6 certified compliant and manufactured under SAI Global license #SMKH 21382. All PSG frames exceed regular standards for ophthalmic frames and are available in metal (conductive) and plastic (non-conductive) materials to suit a variety of work environments and patient needs.
PSG lens designs range from single vision to progressives and extended focus etc. with clear, polarised and Transitions all available.
Independent optometrists in Australia and New Zealand who distribute PSG are supported by a dedicated customer service and training team.
Contact: PSG (AUS) 02 9914 3740