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At least 307 records · Page 17Linked to original sources

Ocular damage due to chlorhexidine versus eyeshield thermal injury.

BACKGROUND: Ocular damage may occur from a number of mechanisms during laser use. OBJECTIVE: To review issues relevant to ocular protection during laser resurfacing. METHODS: The authors were consulted to evaluate the thermal energy transferred from the outer to the inner (ie, corneal contact) surface of stainless steel eyeshields following direct exposure to the carbon dioxide (CO2) resurfacing laser beam. Measurements were obtained using thermocouples (attached to the inner surface of the eyeshields) and analyzed with a computer-based acquisition system. RESULTS: A maximum eyeshield temperature increase of 13 degrees C above the ambient temperature was noted following one pass with a CO2 resurfacing laser (Sharplan continuous CO2 laser with Clinicon SureScan scanner, 15 W, 950 microsec pulse duration, square spot of 9 mm). CONCLUSION: The eyeshields analyzed in this study minimized thermal transfer following a single direct hit with a CO2 resurfacing laser. An understanding of the potential mechanisms of ocular injury is essential in preventing its occurrence.

Anti-Infective Agents, Local↗

The surgical looking glass: a readily available safeguard against eye splash injury/contamination during infiltration of anesthesia for cysts and other "porous" lesions of the skin.

BACKGROUND: "Breaks" in barrier precautions are a definite abrogating influence on the effectiveness of "universal precautions." Dermatologists and dermatologic surgeons are exposed to significant infectious agents on a daily basis, especially due to the high number of minor surgical procedures performed. Backsplash, spray, and eye splash of bodily fluids during these procedures place the surgeon at a high risk of contamination/infection via the conjunctival membranes. The surgical looking glass is a simple utility based on inexpensive equipment already in place in the physician's office which protects the eyes and face during infiltrative anesthesia or incision of cysts and other lesions. OBJECTIVE: To offer a simple and inexpensive utility to assist with protection from and reduction of contamination/infection of the ocular mucous membranes during surgical procedures. METHODS: Utilizing one or two readily available microscope slides overlying the injection site during local infiltrative anesthesia, backsplash or spray can be contained. RESULTS: This utility is effective in containment of backsplash or spray of anesthesia or bodily fluids during even minor surgical procedures. CONCLUSION: The surgical looking glass can enhance safety and promote "universal precautions" during even minor surgical procedures or infiltration of anesthesia into more porous areas or lesions for the practicing dermatologist or dermatologic surgeon. The pragmatic, practical, and inexpensive nature of the surgical looking glass invites its use on a daily basis by the practicing dermatologist.

Anesthesia, Local↗

Retinal evaluation after 810 nm Dioderm laser removal of eyelashes.

BACKGROUND: When operating hair removal lasers on the face or in the periorbital region, even with an ocular shield in place, patients often report seeing "flashing lights" each time the laser is fired. This phenomenon suggests stimulation of retinal photoreceptors and raises laser safety issues. OBJECTIVE: To perform retinal electrophysiologic studies to evaluate the safety of hair removal lasers in the periorbital region. METHODS: Five patients with severe trichiasis secondary to trachoma were studied. The 810 nm Dioderm laser (Cynosure, Inc., Chelmsford, MA) was used to treat the eyelash follicles on the lower eyelid of each patient. Cox III metal eye shields (Oculo-Plastik, Inc., Montreal, Canada) were placed behind the eyelids of both eyes during the laser procedure. Prior to irradiation, a comprehensive ophthalmic evaluation including pupillary and slit-lamp examination, funduscopy, and full-field electroretinograms (ERGs) was performed. A comprehensive ophthalmic evaluation including ERG testing was repeated 30 minutes and 3-6 months after completion of treatment. An independent blinded assessor evaluated the ERG studies. Subjective reports of laser light sensation, pain, and discomfort during and after the laser procedure were also assessed. RESULTS: There was no detectable change in slit-lamp, pupillary, or funduscopic evaluations after periorbital laser irradiation. Similarly the pre- and posttreatment ERGs were unchanged. Three patients reported seeing flashing lights during the procedure. CONCLUSION: We found no ERG evidence of retinal damage after laser hair removal in the periorbital region, with Cox III-type ocular shields over the eyes, even when patients subjectively reported "flashing lights" during laser irradiation.

Aged↗

Risk factors for pterygium in an adult Jordanian population.

PURPOSE: To evaluate the risk factors for the development of pterygium in a Middle Eastern country (Jordan) and to compare our finding with those from other countries. METHODS: This study was conducted in Irbid District, in northern Jordan, a region located 31 degrees north of the equator, with a stable, subtropical climate. In this case control study, 96 adult subjects presenting with pterygium were interviewed and compared to 192 control subjects who were group-matched for age and sex. A standard questionnaire and eye examination were completed for both groups. RESULTS: There was a strong positive association between pterygium and environmental factors. The most striking increase in the risk of pterygium occurred in subjects who worked outdoors compared to those who worked indoors, with an odds ratio of 5.47. Current and previous sunlight exposures were associated with a higher risk of developing pterygium, with odds ratios of 3.54 and 4.52, respectively. Previous use of sunglasses represented a protective element, but the protective role of recent use of sunglasses was not statistically significant. CONCLUSION: There is a statistically significant association between outdoor work, sunlight exposure and pterygium formation. Efforts should be made to educate outdoor workers to wear sunglasses and brimmed hats. Public education should focus on avoidance of unnecessary sunlight exposure.

Adult↗

Precautions against cross-infection during operations for maxillofacial trauma.

One hundred oral and maxillofacial units in the UK were sent a postal questionnaire. Surgical staff of all grades were asked which infection-control measures were taken during the treatment of maxillofacial fractures. Two hundred and ninety-four questionnaires were completed, a response rate of 49%. If the patient was known to be infected by a blood-borne viral disease, significantly more surgeons used standard barrier precautions such as eye protection, fluid-resistant gowns, drapes, ball-ended clips, adhesive tapes and intermediate trays (P<0.0001). Bone-plating techniques were used in preference to wire osteosynthesis (P<0.0001). Only 31 (10.5%) of surgeons routinely used double gloves but 250 (85%) did so if the patient was an infection risk (P<0.0001). Universal precautions were not applied equally to all patients.

Blood-Borne Pathogens↗

[Characteristics and frequency of cortical cataracts at an early stage (Reykjavik Eye Study in Iceland)].

BACKGROUND: The frequency and characteristics of cortical cataract localization within a dilated pupillary area were investigated in a population-based cataract epidemiological survey performed in the city of Reykjavik in Iceland. MATERIALS AND METHODS: Among 1045 randomly selected individuals, the right eyes of 277 persons with mild cortical lens opacification (Grade I) were selected for our study. The localization of cortical cataracts was examined using retroillumination images, which were divided into 56 circular and radial sections, and calculations were made of the percentages for each opacified area. A questionnaire was used to record the number of hours spent outdoors during week days, the time of the day and whether the subjects wore spectacles, sunglasses or hats when outside. RESULTS: The percentage of cortical opacification was significantly higher in the lower nasal quadrant than in all other quadrants (p < 0.05). Furthermore, the percentage of opacification localized in the lower nasal quadrant was higher in individuals with a longer history of outdoor activity than those without (p < 0.05). The percentage of opacification in individuals, who have had the habit of wearing sunglasses for outdoor activities lasting longer than half an hour during weekdays in their 20's and 30's was lower in all quadrants and statistically significantly lower in the upper temporal quadrant (p < 0.05) compared to those not wearing sunglasses. CONCLUSION: This suggests that wearing sunglasses is effective in preventing the development and/or progression of cortical cataracts.

Aged↗

Risk of eye splash in obstetric procedures.

A prospective cross-sectional study was designed to determine the rates of upper facial splash during obstetric deliveries. Macroscopic splashes on the attached eye shields of surgical masks, worn for obstetric deliveries were enumerated for a sample of parturients during a 3-month period. Masks were collected for 68 vaginal and 44 cesarean deliveries, 31% of all deliveries during the study period. For cesarean deliveries, 68% (30) of all masks worn by primary surgeons had at least one splash; 57% (17) of which were heavily contaminated (more than five splashes). For the first assistant, 68% (30) of all masks had at least one splash; 23% (7) of which were heavily contaminated. During vaginal deliveries 44% (30) of masks worn by the delivering physician had at least one splash; 20% (6) of which were heavily contaminated. The primary surgeon in a cesarean section was 1.6 times as likely to be splashed (P < 0.04) when compared with vaginal deliveries and 4.6 times as likely to be heavily contaminated (P < 0.003). Estimated blood loss and the rate of eye splash were linearly related. Method of delivery was not independently associated with eye splash. These findings suggest that the risk of contamination by splash during obstetric procedures is high, particularly for cesarean deliveries because these deliveries tend to have greater blood losses.

Adult↗

[Etiology of non-penetrating corneal injuries].

BACKGROUND: Non-penetrating injuries of the cornea are frequent. Complications like corneal infiltrations, or corneal ulcera, may follow. MATERIAL AND METHODS: This prospective study included 144 patients with non-penetrating corneal injuries. Records contained epidemiological data, field of activity, profession, cause of the injury, and stress during the trauma. RESULTS: 97% of the patients were men, 78% of the injuries occurred during working hours, 41% of the patients were from metal working professions, 73% of the accidents happened with grinding machines and drilling machines. Only 6.9% of patients weared adequate glasses. The cause of trauma was deflection and working without glasses. In 32% of patients stress played a role in the cause of injuries. CONCLUSIONS: Most of the corneal, non penetrating injuries happened during the working hours by deflection, and by neglecting safety glasses. With the use of safety glasses the number of corneal non-penetrating injuries could definitely be reduced.

Accidents, Occupational↗

[Eye injuries caused by Gotcha games].

BACKGROUND Gotcha has become a new leisure-time activity among young people. The high speed dye bullets are threatening the eyes unless using safety goggles. PATIENTS In the last 1 1/2 years there were three young patients treated in our clinic because of serious eye injuries. They were under 18 years old and they had borrowed the weapons from adults. None had used safety goggles. We were able to show the suitability of goggles by own experiments. CONCLUSIONS Therefore we demand, that Gotcha playing must be allowed only to adults who are wearing safety goggles.

Adolescent↗

[Retinitis photoelectrica caused by electro-welding].

The authors report on a student who developed bilateral photoretinitis as a result of failing to use a welding shield properly while arc-welding. The case is unusual in that no symptoms of photophthalmia occurred at any time. The course of the accident is described and the special features of the case are discussed.

Accidents, Occupational↗

[Congruent corneal cap of metal foil as protection of the eye against light and heat from operation lamps].

A protective cap of aluminum foil, covering the cornea, offers effective protection from the light and heat of surgical lamps. None of the 120 patients who underwent surgery in the course of a year, for implantation of Siensky-Kratz posterior chamber lenses (Intermedics), developed cystoid macular edema, the protective cap having been used whenever possible during the operation. The glare of the lamps, which is a torture for non-anesthetized patients, should alone be considered reason enough to cover the eye with a protective cap of this kind.

Cataract Extraction↗

[Eye injuries in a large chemical factory].

In an investigation carried out in a large chemical factory it was found that the time lost as a result of eye lesions diminished by 50% between 1971 and 1981. The percentage of foreign employees involved in these accidents (19.5%) was almost the same as the proportion they represent of the total personnel. Accident rates were found to be lowest on Mondays and Wednesdays; peak accident times were in the late morning and early afternoon. Although there has been a considerable improvement in the availability of protective eyewear in recent years, it is still not worn often enough. In 60% of the eye accidents considered here protective goggles should have been worn.

Accidents, Occupational↗

[PUVA treatment and the problem of ocular damage (author's transl)].

Recently, psoriasis has been shown to respond favorably to PUVA treatment, i.e., local or systemic therapy with a photosensitizer (e.g., 8-methoxypsoralen) and subsequent long UV irradiation. The possibility of this treatment damaging the eye is discussed in the light of various experimental results. As toxic changes only occur when photosensitizer and UVA act jointly, the eyes of PUVA-treated patients must be shielded from any ultraviolet exposure by UV-absorbing protective glasses with side shields. Such glasses should have no significant absorption in the visible range. The new Spectra Shield process enables lenses to be coated in such a way that virtually no UV or IR radiation is transmitted.

Eye Protective Devices↗

Goggle migraine.

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Adult↗