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Photoprotection.

UNLABELLED: Many agents affect the transmission of ultraviolet light to human skin. These include naturally occurring photoprotective agents (ozone, pollutants, clouds, and fog), naturally occurring biologic agents (epidermal chromophores), physical photoprotective agents (clothing, hats, make-ups, sunglasses, and window glass), and ultraviolet light filters (sunscreen ingredients and sunless tanning agents). In addition, there are agents that can modulate the effects of ultraviolet light on the skin (antioxidants and others). All of the above are reviewed in this article. LEARNING OBJECTIVE: At the conclusion of this learning activity, participants should be able to provide an overview of all aspects of photoprotection.

4-Aminobenzoic Acid↗

Photoprotection by window glass, automobile glass, and sunglasses.

In daily activity, much time is spent indoors and in vehicles. Although the adverse effect of ultraviolet (UV) radiation is now well recognized and active public education programs on photoprotection have been undertaken, the role of window glass in photoprotection has been rarely addressed. It has been known for some time that window glass filters out UVB and transmits UVA and visible light. Recent developments in the glass industry have resulted in glass that provides broad UV protection without the historically associated loss of visible light transmission. Factors affecting UV-protective properties of glass are glass type, glass color, interleave between glass, and glass coating. In this article, photoprotection by window glass, automobile glass, and sunglasses is reviewed.

Activities of Daily Living↗

Risk of conjunctival contamination in total joint arthroplasty.

This study arose from a concern about the transmission of infection through conjunctival contamination during total joint arthroplasty surgery. A prospective analysis of 110 sets of personal face and eye protective equipment (Sterishields) used for 29 total hip arthroplasties (THA) and 26 total knee arthroplasties (TKA) were examined for macroscopic contamination. In additition, a postal questionnaire regarding the perceived risk of eye contamination and current practice of eye protection used during TKA and THA surgery was sent to 1500 Fellows of the British Orthopaedic Association. All Sterishields demonstrated macroscopic contamination with an average of 203 blood and fat spots. The number of these was significantly higher in the lower half of the Sterishields. Of the 834 useable replies, 48% of respondents did not use adequate eye protection routinely. Twenty-eight percent felt that no eye protection was needed, while 45% felt that the eye protection available compromised their vision and so did not use it. One hundred and seven respondents (13%) reported being aware of eye contamination, while 21 (2.5%) respondents were aware of at least one case of conjunctival infection following contamination. This study demonstrates that there is a high risk of conjunctival contamination with fat and blood in major total joint arthroplasty. The reported use of appropriate eye and face protection in the UK has been shown to be low (52%).

Arthroplasty, Replacement, Hip↗

Head-mounted goggles for murine form deprivation myopia.

Recently a murine model has been developed for use in form deprivation myopia experiments. Due to the small size of the head and eye, methods to blur visual input to the mouse eye are challenging. Previous methods to induce form deprivation include lid suture and gluing diffuser goggles directly to the fur around the eye. In this paper we describe a new method of goggling using a head pedestal and goggle, which improves compliance and allows for better ocular health. Nob mice, previously shown to be highly susceptible to form deprivation myopia, were used for these experiments. Immediately following baseline refraction using an infrared automated photorefractor, mice were either goggled with a diffuser attached directly to the fur or with a head-mounted goggling apparatus. The goggle apparatus consists of five main components: goggle and frame, head pedestal, acrylic cube for stabilization, and balancing bar. Mice were goggled for 2 weeks in which ocular health and goggle position was monitored and then had a final refraction. The use of head-mounted goggles resulted in 75% fewer instances of goggle loss and 55% fewer ocular complications compared to goggles glued to the fur. Both goggling methods induced a myopic shift of approximately 5 diopters. The head-mounted goggle apparatus provides an improved method for inducing form deprivation in mice and offers the ability to easily take repeated refractive measurements as well as allowing for the use of defocusing lenses.

Animals↗

Detection and treatment of perioperative corneal abrasions.

Corneal abrasion is the most common ocular injury occurring in the perioperative period. Corneal abrasion may occur during general anesthesia, monitored anesthesia care, regional anesthesia, or in the immediate recovery period. This injury is not usually apparent until the patient is in the PACU, and the perianesthesia nurse may be the first clinician to detect this complication. Preventive measures and vigilant care can help reduce the incidence of corneal abrasion in susceptible patients. Early detection and prompt intervention may help reduce the incidence of ocular morbidity. The purpose of this article is to explore the incidence, mechanism of injury, prevention, recognition, and treatment of perioperative corneal abrasion.

Anesthesia, General↗

Protective eyewear for young athletes.

American Academy of Pediatrics and the American Academy of Ophthalmology strongly recommend protective eyewear for all participants in sports in which there is risk of eye injury. Protective eyewear should be mandatory for athletes who are functionally one-eyed and for athletes whose ophthalmologists recommend eye protection after eye surgery or trauma.

Adolescent↗

Eye injuries on the battlefields of Iraq and Afghanistan: public health implications.

BACKGROUND: The U.S. Army faces major challenges in balancing the need to protect a soldier from harm while not impeding his ability to fight. Unfortunately, the incidence of combat eye injuries has increased over time, despite the development of protective measures. METHODS: A cross-sectional study of soldiers evacuated from Operation Iraqi Freedom and Operation Enduring Freedom with eye injuries was performed from March 2003 through December 2004. Data for this study came from the Military Office of the Surgeon General (OTSG) Patient Tracking Database. RESULTS: A total of 368 patients (451 eyes) were evacuated for eye-related problems. From March 2003 through December 2004, 15.8% (258 of 1,635 patients, 309 eyes) of all medical evacuations were a result of battle eye injuries (BI), 17.3% (283 of 1,635 patients, 337 eyes) were a result of eye injuries (BI and nonbattle injuries [NBI] combined), and 22.5% (368 of 1,635 patients, 451 eyes) of all evacuations were because of eye-related complaints alone (BI, NBI, or disease) or in combination with other bodily injuries. CONCLUSION: Developing combat eye protection that meets the unique requirements of the military, issuing eyewear to soldiers, and supporting and enforcing its use, will provide the best eye protection for American soldiers during military training exercises and future conflicts.

Afghanistan↗

Observed use of sunglasses in public outdoor settings around Melbourne, Australia: 1993 to 2002.

BACKGROUND: Wearing sunglasses may reduce the risk of cataract and of skin cancer in the periorbital area. Understanding predictors of sunglasses use may help identify groups with lower usage patterns. METHODS: An annual observational field survey of teenagers and adults at leisure at outdoor venues around Melbourne, Australia was conducted between 11 am and 3 pm on mainly sunny, summer weekends (n=42,207). The serial cross-sectional survey assessed sun protection behaviors, including use of sunglasses from 1993 to 2002, and other variables hypothesized to predict sun-related behavior (sex, age, SES, activity level and setting, size of social group, and weather conditions). Predictors of use of sunglasses were assessed using multivariate logistic regression. RESULTS: 36.2% of those observed wore sunglasses, and this increased only slightly over the years. Sunglasses use was most common among those observed on sunny days, in no or partial shade, in parks/gardens and at pools/beaches, less active people and people on their own or in pairs, people observed in higher socio-economic areas, females, people 20-50 years of age, and people wearing head and clothes cover. CONCLUSION: Sunglasses use should be encouraged among the population in general and especially among golfers, tennis players, teenagers, males, and people in lower SES areas.

Adolescent↗