Vision Standards and Contact Lenses

BY JOSEPH T. BARR, O.D., M.S., EDITOR
MAR. 1997

It's great that military personnel, astronauts, police officers, firefighters and other emergency men and women can wear contact lenses successfully and safely while performing their duties. I defend their right to do so as long as they, the people they work with and the public are safe, and the bad guys get what they deserve.

Based on my personal lens wearing experience, my professional experience and the literature, I know that contact lenses don't correct refractive error like a pin corrects a broken bone. Contact lens correction is temporary, whether it's successful daily wear or extended wear. Because of this, and because eyeglasses fog up, fall off and break, I believe there are certain professions that should require rational, scientifically valid, uncorrected vision standards.

Police officers in Los Angeles and in Maryland may now use contact lens correction as a substitute for passing an uncorrected visual acuity standard. But how do you police a police officer who's supposed to wear contact lenses on the job? Would you have the time or the motivation to watch your fellow officers while you're looking for perpetrators?

Those who defend the 'right' to wear contact lenses instead of passing an uncorrected visual acuity standard sometimes invoke the Americans with Disabilities Act. I don't feel that a high myope or an astigmat who is correctable to 20/20 or 20/30 is disabled. This is not an issue of individual rights, but of personal and public safety.

We all know that contact lens wearers are going to have bad things happen -- broken and lost lenses, inflammations, infections. Bailey, Classé, Schoessler, Fonn and others have pointed out how temporary and intermittent contact lens wear can be when it's not successful. Indeed, even successful contact lens wearers don't wear their lenses every day or even most waking hours.

Sheedy pointed out that, unlike athletes, emergency services personnel can't take a time-out to retrieve or fix a contact lens. Given that spectacles and contact lenses may not always be available, adequate uncorrected vision is needed. Sure, some police officers may move to desk jobs, but often they must work a beat for years. This active duty should require a standard for uncorrected vision.

In the early to mid 1980s, the AOA recommended vision standards for police officers. Regarding contact lenses, it said: The municipality must be aware of the limitations. There may be dislodged lenses and contact lens related sick days. Success should be documented and monitored before contact lenses can substitute for acceptable uncorrected vision.

In Los Angeles, a monitoring system was set up to assure that police officers were wearing their contact lenses. At random checks for lens wear compliance, on average, five percent of the officers who were supposed to be wearing contact lenses on duty were not. It's likely that some of those officers have low unaided visual acuity. It's also likely, based on past experience, that noncompliance will rise. Who knows if they'll ever drop their spectacles or have them fog up on a day when they're not wearing their contact lenses and facing lethal force?

If you were in a situation where the only person between you and an armed robber was a police officer who was wearing eyeglasses, would you pray he or she had acceptable uncorrected visual acuity? I would. CLS