MIDTERM TOPIC 1 & 2 ENVIRONMENTAL OPTOMETRY

“NO OTHER PHYSICAL DEFECT IS SO Minimum standard of care

AMENABLE TO CORRECTION AS IS FAULTY
VISION, AND HARDLY ANY OTHER SO AFFECTS 1. Complete an occupational history on each adult
JOB PERFORMANCE..” patient, including assessment and
interpretation of it
VISION, in two important ways, stand apart
from other human factors related to job success 2. Identifying and diagnose conditions that may
be occupationally induced and make
 The quality of visual performance can be appropriate referrals if necessary
measured quickly, comprehensively and
dependably 3. Assess their patient’s visual needs and provide
 When vision is below desirable levels it can be treatment for maximizing their on-the-job
improved readily in a high percentage of cases performance
and at relatively low cost to the individual 4. Initiate preventive measures for patients and
Environmental Optometry other with the same eye and vision risk

 Branch of optometry that broadly considers the PREVENTION OF EYE INJURIES

relationship of people’s eye and vision to all
aspects of their environments, including home,
school, work, recreation, transportation,
underwater and outer space.
Occupational Optometry
 Branch of environmental optometry that
considers all aspects of the relationship
between work and vision, visual performance,
eye safety, and health.
Optometrist has a key role in preventing eye
injuries and visually related injuries to co-
workers
1. Prescribe eye protection designed for specific
job, usually in form of safety spectacle
2. Make certain that a person has good visual skills
for his or her job

INCLUDES:

 worker’s eye and visual system

 worker and the workplace environment

Emphasis of occupational optometry is

high quality patient with two major
priorities:

1. Prevention of work related diseases. , injuries,

and vision disorders ; and

2. Enhanced performance of workers on the job

A secondary but important concern of

occupational optometrist is disease prevention
and health promotion
Goals of primary care and occupational
optometry
1. To incorporate environmental optometry into
private practice and assess the impact of vision
disorders and eye diseases on the ability of
patients to work
2. To assess the impact of work and the work
environment on the performance of the worker
on the job, at home, and during recreation
3. To understand the relationship between health
and work and to recognize, diagnose, treat, and
prevent work-related illnesses and injuries.
Trends affecting Optometrists
1. A growing awareness that exposures to
hazardous substance in workplace, home, and
general environment may cause or contribute
to the origins of dse and influence its natural
history
2. An increasing awareness of the effects of the
visual environment (lighting, contrast, glare
and exposure to ultraviolet, infrared, ionizing,
and microwave radiation) on vision, vision
performance and perception.
3. An increasing concern regarding the economic
and social costs of premature mortality and
preventable disability and injuries
 MIDTERM TOPIC 1 & 2 ENVIRONMENTAL OPTOMETRY
4. A continuing increase in the costs of health care
and the benefits of reducing costs through
preventing diseases and injuries by early
detection and effective management
5. An expansion of legislation, regulation, case
law, and labor-management agreements that
increase responsibility of employers for the
physical and mental health of their workers.
6. An increasing number of women in the work
force and concerns for the future reproductive
health of both women and men.
7. A transformation our economy from an
industrial to an information-based system and
the increasing complexity of the work place
8. An aging of the work force
9. An increasing insistence of workers to be
informed and to participate in all areas that
affect their personal welfare
10. An increasing interest by employers, insurance
carriers and public in health promotion and dse
prevention
Occupational History
- Optimal patient management requires taking
occupational case histories:
- That assess work related task
- Vision requirements
- determining the need for vision and eye
protection, also;
- Risk from environmental hazards
- Impact of current eye disease and vision dso.
on job performance
- Diagnose work-related occupational disease
Occupational Health History
- Is fundamental to the assessment of the work-
relatedness of health problems and should
become a routine component of any
comprehensive health history
Two components:
1.) The survey or basic occupational history
- if needed, the diagnostic occupational
history
2.) The task analysis
SURVEY (BASIC) OCCUPATIONAL
HISTORY
KEY POINTS:
1. Description of current and past jobs and
occupations
2. Employment status (including unemployed,
retired)
3. Exposure to hazards ; and
4. Assessment of work-reletadness of the chief
complaint or diagnosis
Classification of hazards:
1. Physical ( radiation, noise, extreme
temperatures, heavy lighting and repetitive
motion)
2. Chemical ( lead, mercury, dust, gases, fumes,
solvents, acids, caustics)
3. Biologic ( virsuses, bacteria, parasites, fungi)
4. Psychologic ( boredom, work shift fatigue, risk
of falling, repetition)
5. Ergonomic (improper tool or work area
design, unnecessary lifting, poor vision
condition)
DIAGNOSTIC OCCUPATIONAL HISTORY
- Used when the survey occupational history
increases the optometrist’s suspicion that the
patient’s signs or symptoms are related to work
or the environment.
Four Key Steps in taking diagnostic
history (occupational):
1. A listing of all jobs
2. Identification of all places of employment and
products manufactured where appropriate.
3. Description of all operations performed on the
job
4. Assessment of illnesses in other workers similar
to those of the patient
Task analysis
 A detailed assessment of patient’s work related
tasks. The assessment is done to maximize
vision performance and minimize or eliminate
eye and vision hazards
 Done to maximize vision performance and
minimize or eliminate eye and vision hazards
Task analysis requires the assessment of
the following data:
1. Job Description
2. Distance from the worker’s eyes to the work
areas
 MIDTERM TOPIC 1 & 2 ENVIRONMENTAL OPTOMETRY

3. Work movement
4. Work area size, centrally and peripherally
5. Visual attention requirements Factors which determine the toxicity of a
6. Work and surround area illumination substance
7. Color discrimination requirements a) Composition of chemicals
8. Stereoacuity requirements b) Physical state
9. Position of work surface c) Amount
10. Eye and vision hazards d) Concentration
11. Size of task details e) Particular size
12. Peripheral vision requirements f) Route of absorption (oral, topical,
injection, inhalation, etc.)

Duration of Exposure
Dangers (Hazards) to Vision
1. Acute – exposure is very short (within
minutes or few days)
Mechanical Hazards 2. Sub-acute – longer than and up to 90
days
- A type of general confined space 3. Chronic – exposure fpr many days or
hazard that exist when electrical or over a month or years
mechanical equipment may be
accidentally activated BIOLOGICAL HAZARDS
- Mechanical agents are normally
described as: - People who work in health related field
 Large (>2mm) or Small (2mm - Doctors, nurses, and dentist
or less) - Hepatitis B Virus
 Blunt (Edges that rip or tear - HIV
tissue) or Sharp (Edges that - COVID 19
make a smooth cut or puncture ERGONOMIC HAZARDS
in tissue)
 Fast moving or Slow moving Definition:
 Stationary
 Any combinations of the given - Study of the engineering aspects of the
4 relationship between human workers and
their working environment
Mechanical hazards are agents that are
likely to cause:  Good posture
 Poor lifting technique
 Penetrating laceration – puncture  Poor fitting of progressives
 Non-penetrating laceration – cut  Neck ache
 Abrasion – scratch/scrape  Poor posture
 Contusion – damage from pressure
exerted by the material PSYCHOSOCIAL

Common MECHANICAL injury - Stress

- Communication breakdown
a) Chiseling ; hammering - Job overload
b) Woodworking - Boredom
c) Grinding - Burnout
d) Nailing - Job uncertainty
e) Drill and lathe use - Noise pollution
f) Automobile accidents - Poor ventilation
g) Explosives
Radiation
Chemical Hazards
- Electromagnetic radiation outside the
Toxicology – the science concerned with range of 400-700 nanometer(nm) does
poisons and how they affect the body not significantly contribute to visual
perception and some may be harmful
to ocular tissue
MIDTERM TOPIC 1 & 2 ENVIRONMENTAL OPTOMETRY

a) UV-A – 315-400nm(less damage to

body)
b) UV-B – 280 -315nm Chemical Splash Goggles
c) UV-C – 100-280nm - Tight fitting eye protection that
d) IR-A -extending 760-780nm-1400nm completely covers the eyes, eye socket
e) IR-B -1400nm-3000nm and facial area surrounding the eyes
f) IR-C – 3000nm-1mm - Provides protection from impact, dust
PERSONAL PROTECTIVE EQUIPMENT and splashes

Definition: An equipment worn to

minimize exposure to hazards that cause
serious workplace injuries and illnesses

• Ability to protect against specific

workplace hazards

American National Standards Institute

(ANSI) standard Z87.1-1989 Dust goggles- sometimes called direct
ventilated goggles, are tight fitting eye
Testing Process protection designed to resist the passage of
large particles into the goggles
- Basic and high-impact for lenses and
frames
- Exposure to non-ionizing radiation and
chemicals
- Durability to flammables and corrosion

Minimum Requirements of Eyes and Face

Protective Equipment

1. Provide adequate protection against

the particular hazard for which they are Fluid Resistant Shield – the shield is fluid
designed or intended resistant or impervious and provide splash
2. Be reasonably comfortable to use protection from biological material, such as
3. Fit snugly and shall not unduly interfere human or non-human primate body fluids
with the movements of the user
4. Durable, easily cleaned and capable of
disinfected
5. Be kept clean and in good condition
6. Made of non-combustible or slow-
burning materials
7. Distinctively marked as industrial safety
wear with the manufacturer’s name or
trademark on the lenses
8. Should provide unrestricted vision and Face Shield- the shield extend from the
movement eyebrows to below the chin and across the
9. Should allow unrestricted functioning width of the employee’s head
of any other required PPE
• Face shields protect against potential
Safety glasses splashes or sprays of hazardous liquids.
When worn for protection against UV,
- have safety frames constructed of must be specifically designed to protect
metal or plastic and impact-resistant the face and eyes from hazardous
lenses. Side protection is required radiation
MIDTERM TOPIC 1 & 2 ENVIRONMENTAL OPTOMETRY

Helmet – a rigid device worn by the operator

which shield the eyes, the face, the neck and
the portion or all of the other parts of the head,
and is held in place by suitable means

Laser Eyewear – Protective eyewear is

required for Class 3 and 4 laser use where
radiation of the eye is possible

Welding Shield

- Constructed of vulcanized fiber or

fiberglass and fitted with a filtered lens,
welding shields protect eyes from burns
caused by infrared or intense radiant
light
- Also protect both the eyes and the face
from flying sparks, metal splatter and
slag chips produced during welding,
brazing, soldering and cutting
operations

Face mask - Device worn before the eyes and

a portion or all of the face, whose predominant
function is to protect the face

Hood - hand rigid device which completely

covers the head, and portion of the shoulder