Eye injuries in the workplace are very common. The National Institute for Occupational Safety and Health (NIOSH) reports about 2,000 U.S. workers sustain job-related eye injuries that require medical treatment each day. However, safety experts and eye doctors believe the right eye protection could have lessened the severity or even prevented 90% of these eye injuries.

Common eye injuries occurring at work can result from chemicals or foreign objects in the eye and cuts or scrapes on the cornea. Other causes of injuries include splashes with grease and oil, burns from steam, ultraviolet or infrared radiation exposure, and flying wood or metal chips.

In addition, health care workers, laboratory and janitorial staff, and other workers may be at risk of acquiring infectious diseases from eye exposure. Some infectious diseases can be transmitted through the mucous membranes of the eye as a result of direct exposure to blood splashes, respiratory droplets generated during coughing, or from touching the eyes with contaminated fingers or other objects.

Two major reasons workers experience eye injuries on the job are because they were:

  1. Not wearing eye protection, or
  2. Wearing the wrong kind of protection for the job.

The Occupational Safety and Health Administration (OSHA) requires the use of eye and face protection whenever there is a reasonable probability of injury that could be prevented by such equipment. Personal protective eyewear, such as goggles, face shields, safety glasses, or full face respirators must be used when an eye hazard exists. The eye protection chosen for specific work situations depends upon the type of hazard, the circumstances of exposure, other protective equipment used, and individual vision needs.


What are the potential eye hazards at work?

Potential eye hazards against which protection is needed in the workplace are:

  • Projectiles (dust, concrete, metal, wood and other particles)
  • Chemicals (splashes and fumes)
  • Radiation (especially visible light, ultraviolet radiation, heat or infrared radiation, and lasers)
  • Bloodborne pathogens (hepatitis or HIV) from blood and body fluids

The best methods of eye protection differ for each type of hazard. The protector must be matched to the potential hazard. High risk occupations for eye injuries include:

  • construction
  • manufacturing
  • mining
  • carpentry
  • auto repair
  • electrical work
  • plumbing
  • welding
  • maintenance

The type of safety eye protection you should wear depends on the hazards in your workplace:

  • If you are working in an area that has particles, flying objects, or dust, you must at least wear safety glasses with side protection (side shields)
  • If you are working with chemicals, you must wear goggles
  • If you are working near hazardous radiation (welding, lasers, or fiber optics) you must use special-purpose safety glasses, goggles, face shields, or helmets designed for that task

In addition, employers need to take steps to make the work environment as safe as possible. This includes:

  • Conducting an eye hazard assessment of the workplace
  • Removing or reducing eye hazards where possible
  • Providing appropriate safety eyewear and requiring employees to wear it

Your optometrist can assist your employer and you in evaluating potential eye hazards in your workplace and determining what type of eye protection may be needed. See AOA’s Occupational Vision Manual for more information.

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How can I protect my eyes from injury?

There are four things you can do to protect your eyes from injury:

  1. Know the eye safety dangers at your work.
  2. Eliminate hazards before starting work by using machine guards, work screens or other engineering controls.
  3. Use proper eye protection.
  4. Keep your safety eyewear in good condition and have it replaced if it becomes damaged.

Selection of protective eyewear appropriate for a given task should be made based on a hazard assessment of each activity. Types of eye protection include:

  • Non-prescription and prescription safety glasses — Although safety glasses may look like normal dress eyewear, they are designed to provide significantly more eye protection. They have lenses and frames that are much stronger than regular eyeglasses. Safety glasses must meet standards of the American National Standards Institute (ANSI). Look for the Z87 mark on the lens or frame.

    Safety glasses provide eye protection for general working conditions where there may be dust, chips or flying particles. Additional side protection can be provided by the use of side shields and wraparound-style safety glasses.

    Safety lenses are available in glass, plastic, polycarbonate and Trivex™ materials. While all four types must meet or exceed the minimum requirements for protecting your eyes, polycarbonate lenses provide the highest level of protection from impact.

  • Goggles — Goggles provide impact, dust and chemical splash protection. Like safety glasses, safety goggles are highly impact resistant. In addition, they provide a secure shield around the entire eye and protect against hazards coming from any direction.

    Goggles can be worn over prescription glasses and contact lenses to provide protection from flying objects and chemical splashes and in dusty environments.

  • Face shields and helmets — Full face shields are used to protect workers exposed to chemicals, heat, or bloodborne pathogens. Helmets are used for welding or working with molten materials. Face shields and helmets should not be used as the sole means of protective eyewear. They need to be used in conjunction with safety glasses or goggles. Wearing safety glasses or goggles under face shields also provides protection when the shield is lifted.
  • Special protection — Other types of protection, such as helmets or goggles with special filters to protect the eyes from optical radiation exposure, should be used for tasks such as welding or working with lasers.

One way to ensure that safety glasses provide adequate protection is to be sure they fit properly. Also, eye protection devices must be properly maintained. Scratched and dirty devices reduce vision, cause glare and may contribute to accidents.

Protective eyewear works best when you know how to use it properly. Combined with machine guards, screened or divided work stations, and other engineering controls, using the correct protective eyewear can help keep you safe from any type of eye hazard.

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Can contact lenses be worn safely for industrial jobs?

Contact lenses can’t provide significant protection from eye hazards in the work place. However, there is no evidence that the wearing of contact lenses increases the risk of eye injury.

Contact lenses may actually contribute to worker safety and productivity because they often provide improved vision in the workplace. Individuals who wear contact lenses usually obtain a wider field of vision than with eyeglasses and often have less visual distortion, especially with higher power lens prescriptions. In addition, wearing contact lenses instead of eyeglasses can provide a better, more comfortable fit of eye safety equipment, such as goggles and full face respirators.

The American Optometric Association believes (see the Guidelines for the Use of Contact Lenses in Industrial Environments ) that workers should be permitted to wear contact lenses in most eye hazardous environments. However, eye protection must be worn over contact lenses exactly as would be required of all workers performing the same job.

Contact lenses may be worn safely under a variety of environmental situations. In some cases, such as when hazardous chemical fumes are present, a determination of contact lens wear may need to be made on a case by case basis. Check with your employer on their safety policy regarding the wearing of contact lenses. Your optometrist can assist your employer and you in determining whether you can safely wear contact lenses in your workplace.

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What should be done in an eye emergency?

Seek medical attention as soon as possible following an injury, particularly if you have pain in the eye, blurred vision, loss of vision or loss of field of vision. There are several simple first aid steps that can and should be taken until medical assistance is obtained.

First aid for eye emergencies:

Chemicals in the eye

  • Immediately flush the eye with water for at least 15 minutes. Place the eye under a faucet or shower, use a garden hose, or pour water into the eye from a clean container.
  • If you are wearing contact lenses, do not wait to remove the lenses. Begin flushing the eye immediately. This may wash the lens out of the eye.
  • Do not try to neutralize the chemical with other substances.
  • Do not bandage the eye.
  • Seek immediate medical attention after flushing.

Particles in the eye

  • Do not rub the eye.
  • Try to let your tears wash the speck out or irrigate the eye with an artificial tear solution.
  • Try lifting the upper eyelid outward and down over the lower eyelid to remove the particle.
  • If the particle does not wash out, keep the eye closed, bandage it lightly and seek medical care.

Blows to the eye

  • Gently apply a cold compress without putting pressure on the eye. Crushed ice in a plastic bag can be placed gently on the injured eye to reduce pain and swelling.
  • In cases of severe pain or reduced vision, seek immediate medical care.

Cuts and punctures to the eye or eyelid

  • Do not wash out the eye.
  • Do not attempt to remove an object that is stuck in the eye.
  • Cover the eye with a rigid shield, like the bottom half of a paper cup.
  • Seek immediate medical care.

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Below are some suggestions to help alleviate some of the symptoms of CVS:

  • Don’t take a vision problem to work. Even if you don’t need glasses for driving, reading or other things you do, you still may have a minor vision problem that can be aggravated by computer use. You may need a mild prescription to wear only on the job to reduce vision stress. A thorough eye exam every year for computer users is a good idea.
  • Be sure your glasses meet the demands of your job. If you wear glasses for distance vision, reading, or both, they may not give you the most efficient vision for viewing your computer screen, which is about 20 to 30 inches from your eyes. Tell your optometrist about your job tasks and measure your on-the-job seeing distances. You may benefit from one of the new lens designs made specifically for computer work.
  • Take alternative task breaks throughout the day. Make phone calls or photocopies. Consult with co-workers. Do anything that doesn’t require your eyes to focus on something up close.
  • Reduce room lighting to half normal office levels. An easy way to do this is to remove half the bulbs from ceiling fixtures. Use desk lamps for tasks that require more light.
  • Minimize glare on your computer screen with a glare reduction filter (look for one with the American Optometric Association’s Seal of Acceptance); by repositioning your screen; and by using drapes, shades or blinds. You can also ask your optometrist about eyeglass lens tints and coatings that can reduce glare.
  • Use an adjustable copy holder to place reference material at the same distance from your eyes as your computer screen and as close to the screen as possible. Your eyes won’t have to keep changing focus when looking from one to the other and you won’t have to keep moving your head or eyes back and forth.
  • Adjust your work area and your computer for your comfort. Most people prefer a work surface height of about 26 inches for computer use. Desks and tables are usually 29 inches high. Place your computer screen 16 to 30 inches from your eyes. The top of the screen should be slightly below horizontal eye level. Tilt the top of the screen away from you at a 10 to 20 degree angle.
  • Clean your computer screen frequently. Dust and fingerprints can reduce clarity.

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  • Suggestions for Computer Vision Syndrome Sufferers

Computer Vision Syndrome describes a group of eye and vision-related problems that result from prolonged computer use. Many individuals experience eye discomfort and vision problems when viewing a computer screen for extended periods. The level of discomfort appears to increase with the amount of computer use.

The most common symptoms associated with Computer Vision Syndrome (CVS) are

  • eyestrain
  • headaches
  • blurred vision
  • dry eyes
  • neck and shoulder pain

These symptoms may be caused by:

  • poor lighting
  • glare on the computer screen
  • improper viewing distances
  • poor seating posture
  • uncorrected vision problems
  • a combination of these factors

The extent to which individuals experience visual symptoms often depends on the level of their visual abilities and the amount of time spent looking at the computer screen. Uncorrected vision problems like farsightedness and astigmatism, inadequate eye focusing or eye coordination abilities, and aging changes of the eyes, such as presbyopia, can all contribute to the development of visual symptoms when using a computer.

Many of the visual symptoms experienced by computer users are only temporary and will decline after stopping computer work. However, some individuals may experience continued reduced visual abilities, such as blurred distance vision, even after stopping work at a computer. If nothing is done to address the cause of the problem, the symptoms will continue to recur and perhaps worsen with future computer use.

Prevention or reduction of the vision problems associated with Computer Vision Syndrome involves taking steps to control lighting and glare on the computer screen, establishing proper working distances and posture for computer viewing, and assuring that even minor vision problems are properly corrected.

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What causes Computer Vision Syndrome?

Viewing a computer screen often makes the eyes work harder. As a result, the unique characteristics and high visual demands of computer viewing make many individuals susceptible to the development of vision-related symptoms.

Viewing a computer screen is different than reading a printed page. Often the letters on the computer screen are not as precise or sharply defined, the level of contrast of the letters to the background is reduced, and the presence of glare and reflections on the screen may make viewing difficult.

Viewing distances and angles used for computer work are also often different from those commonly used for other reading or writing tasks. As a result, the eye focusing and eye movement requirements for computer viewing can place additional demands on the visual system.

In addition, the presence of even minor vision problems can often significantly affect comfort and performance at a computer. Uncorrected or under corrected vision problems can be major contributing factors to computer-related eyestrain.

Even people who have an eyeglass or contact lens prescription may find it’s not suitable for the specific viewing distances of their computer screen. Some people tilt their heads at odd angles because their glasses aren’t designed for looking at a computer. Or they bend toward the screen in order to see it clearly. Their postures can result in muscle spasms or pain in the neck, shoulder or back.

In most cases, symptoms of CVS occur because the visual demands of the task exceed the visual abilities of the individual to comfortably perform them. At greatest risk for developing CVS are those persons who spend two or more continuous hours at a computer every day.

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How is Computer Vision Syndrome diagnosed?

Computer Vision Syndrome can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on visual requirements at the computer working distance, may include:

  • Patient history to determine any symptoms the patient is experiencing and the presence of any general health problems, medications taken, or environmental factors that may be contributing to the symptoms related to computer use.

  • Visual acuity measurements to assess the extent to which vision may be affected.
  • A refraction to determine the appropriate lens power needed to compensate for any refractive errors (nearsightedness, farsightedness or astigmatism).
  • Testing how the eyes focus, move and work together. In order to obtain a clear, single image of what is being viewed, the eyes must effectively change focus, move and work in unison. This testing will look for problems that keep your eyes from focusing effectively or make it difficult to use both eyes together.

This testing may be done without the use of eye drops to determine how the eyes respond under normal seeing conditions. In some cases, such as when some of the eyes’ focusing power may be hidden, eye drops may be used. They temporarily keep the eyes from changing focus while testing is done.

Using the information obtained from these tests, along with results of other tests, your optometrist can determine if you have Computer Vision Syndrome and advise you on treatment options.

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How is Computer Vision Syndrome treated?

Solutions to computer-related vision problems are varied. However, CVS can usually be alleviated by obtaining regular eye care and making changes in how you view the computer screen.

Eye Care

In some cases, individuals who do not require the use of eyeglasses for other daily activities may benefit from glasses prescribed specifically for computer use. In addition, persons already wearing glasses may find their current prescription does not provide optimal vision for viewing a computer.

  • Eyeglasses or contact lenses prescribed for general use may not be adequate for computer work. Lenses prescribed to meet the unique visual demands of computer viewing may be needed. Special lens designs, lens powers or lens tints or coatings may help to maximize visual abilities and comfort.

  • Some computer users experience problems with eye focusing or eye coordination that can’t be adequately corrected with eyeglasses or contact lenses. A program of vision therapy may be needed to treat these specific problems. Vision therapy, also called visual training, is a structured program of visual activities prescribed to improve visual abilities. It trains the eyes and brain to work together more effectively. These eye exercises help remediate deficiencies in eye movement, eye focusing and eye teaming and reinforce the eye-brain connection. Treatment may include office-based as well as home training procedures.

Viewing the Computer

Some important factors in preventing or reducing the symptoms of CVS have to do with the computer and how it is used. This includes lighting conditions, chair comfort, location of reference materials, position of the monitor, and the use of rest breaks.

  • Location of computer screen – Most people find it more comfortable to view a computer when the eyes are looking downward. Optimally, the computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and 20 to 28 inches from the eyes.

  • Reference materials – These materials should be located above the keyboard and below the monitor. If this is not possible, a document holder can be used beside the monitor. The goal is to position the documents so you do not need to move your head to look from the document to the screen.
  • Lighting – Position the computer screen to avoid glare, particularly from overhead lighting or windows. Use blinds or drapes on windows and replace the light bulbs in desk lamps with bulbs of lower wattage.
  • Anti-glare screens – If there is no way to minimize glare from light sources, consider using a screen glare filter. These filters decrease the amount of light reflected from the screen.
  • Seating position – Chairs should be comfortably padded and conform to the body. Chair height should be adjusted so your feet rest flat on the floor. If your chair has arms, they should be adjusted to provide arm support while you are typing. Your wrists shouldn’t rest on the keyboard when typing.
  • Rest breaks – To prevent eyestrain, try to rest your eyes when using the computer for long periods. Rest your eyes for 15 minutes after two hours of continuous computer use. Also, for every 20 minutes of computer viewing, look into the distance for 20 seconds to allow your eyes a chance to refocus.
  • Blinking – To minimize your chances of developing dry eye when using a computer, make an effort to blink frequently. Blinking keeps the front surface of your eye moist.

Regular eye examinations and proper viewing habits can help to prevent or reduce the development of the symptoms associated with Computer Vision Syndrome.

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by: Anthony P. Cullen, MSc, OD, PhD, DSc, FCOptom, FAAO

The American Optometric Association has adopted the following policy statement concerning the use of contact lenses in industrial environments:

“Contact lenses may be worn in some hazardous environments with appropriate covering safety eyewear. Contact lenses of themselves do not provide eye protection in the industrial sense.”

Most successful contact lens wearers wish to wear their contact lenses in all aspects of their lives, including the workplace. This may conflict with government or industry imposed restrictions on the use of contact lenses in a given industrial environment. These restrictions, in turn, may be unreasonable and discriminatory.

In risk management it is necessary to balance risk with benefits and to differentiate perceived risk from actual risk. Because both contact lens or certain environments may produce adverse ocular effects it is tempting to assume that there may be additive or synergistic effects when contact lenses are worn in that environment. When considering the advisability of wearing contact lenses in a given industrial setting a number of questions should be addressed:

  • Is there an actual hazard?
  • Does the wearing of contact lenses place the eye at greater risk than a naked eye?
  • Does the removal of the contact lens increase the risk to the eye, the wearer or co-workers?
  • Is the risk different for various contact lens materials and designs?
  • Are there other risks to the wearer or co-workers?
  • Do contact lenses decrease the efficacy of other safety strategies?

Ocular hazards are greater in some occupations than others. Those who prescribe contact lenses for industrial workers should be concerned as to the advisability of wearing the lenses in a given environment. The type of work may influence the selection of lens material and design, and wearing the replacement schedules. The following factors may be of value in making these decisions:

  • The toxic chemicals and/or physical agents that may be encountered
  • Raw material and by-products involved
  • Potential for ocular exposure
  • Protective equipment provided, available and used
  • Hygiene facilities available
  • Presence or absence of health and safety personnel
  • Factors that may influence compliance with cleaning and wearing schedules

An evaluation of the published material, including laboratory and human studies, and well documented case reports, indicates that contact lenses may be worn safely under a variety of environmental situations including those which, from a superficial evaluation, might appear hazardous. Indeed, some types of contact lenses may given added protection to spectacle lens and non-spectacle lens wearers in instances of certain fume exposure, chemical splash, dust, flying particles and optical radiation. The evidence also refutes the claims that contact lenses negate the protection provided by safety equipment or make the cornea more susceptible to damage by optical radiation, in particular arc flashes. Thus a universal ban of contact lenses in the workplace or other environments is unwarranted.

Regulations limiting the wearing of contact lenses in any given circumstance must be scientifically defensible and effectively enforceable. They should not be based on perceived hazards, random experience, isolated unverified case histories or unsubstantiated personal opinions.

Conversely, it would be imprudent for a practitioner to prescribe contact lenses in order to circumvent uncorrected visual acuity standards in those occupations where individuals may be required to function without correction on some occasions or in environments contraindicated for the type of lens prescribed.

All practitioners must stress that personal protective equipment, including safety eyewear, is not replaced by contact lenses.

Where circumstances create the necessity eye protection must be worn.

May 1998

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