editor's perspective
Contact Lenses Aren't Safe Enough

In our November 2003 issue, Jason Nichols, OD, MS, MPH, and Gregory Good, OD, PhD, presented an excellent review of the current situation regarding "Contact Lenses and the Work Environment." Eye injuries in construction, agricultural settings, forestry and fishing and manufacturing strike about 85 people out of every 10,000 per year. In addressing occupational eye safety, the US Surgeon General has initiated Healthy People 2010.

Sixty-two percent of industry eye accidents involve situations in which workers didn't wear or didn't have access to safety glasses, and for another 10 percent the safety glasses fit incorrectly or weren't adjusted properly. You should recommend safety glasses made from polycarbonate materials or Trivex where the risk of flying particles or chemical splash is high and in cases of high-risk patients (previous eye injury). Provided that workers wear safety eye wear and follow other eye safety guidelines, contact lens wear around hazardous chemicals is acceptable except when banned by regulation or in the presence of 1,2 dibromo-3-chloropropane, ethylene oxide and dianiline methyl chloride.

Eye safety under adverse conditions is a hot topic whether in the workplace, home or recreation environment. I heard an alarming statistic while driving to work recently about the large increase in eye injuries from paint ball games. Most of these paint ball players are young males who often don't comply with wearing safety eye glasses, and it's likely that half of them who need vision correction wear contact lenses. Usually contact lenses protect the eye from injury rather than exacerbate it, but contact lenses aren't enough. Basketball and baseball players often wear contact lenses and yet almost 39 percent of the nearly 44,000 eye injuries predicted in the United States annually occur in these sports. High-risk patients should use "Rec Specs" or other protective eyewear during sports.

Getting patients to comply with any treatment such as contact lens replacement schedules, contact lens care and wearing safety eye wear involves human behavior change. The Health Belief Model of promoting healthy behaviors in individuals recommends that for compliance to occur, individuals must:

• perceive that they're susceptible (it can happen to them)
• perceive that the risk is severe (eye injuries can be serious)
• perceive the benefits of compliance (know that good contact lens care and wearing safety eye wear can protect them)
• perceive that barriers aren't prohibitive. For example, they won't look ugly in their protective eyewear and it can be comfortable and cosmetically pleasing

You may never know if you protect your patients when you prescribe protective eye wear, but if you do, you'll surely be happy you did.