Ocular Trauma is one of the leading causes of uni-ocular blindness in the world and renders a large proportion of the population in their productive age groups visually impaired.
A review of the literature reveals that work related eye injury is common, especially in machining and grinding jobs, and that eye protection is under used even in the industrialized world. Lathe machinists are an especially vulnerable group. Concentrating on injury prevention can cut treatment costs.
Most eye injuries involve projectile foreign bodies, and involve workers with limited experience and those not wearing personal protective equipment. (Ballal 1997)
Ocular injuries in the industrial world occur at a relatively stable 0.37% per year; with 2.88% producing permanent consequences, giving an injury rate of 1 per 10,000 workers per year; the risk being three times higher in the agricultural sector. (Cruciani et al, 1997)
Intraorbital projectile metallic foreign bodies can be a source of significant ocular morbidity. (Finkelstein 1997)
The most common eye injuries are non-perforating. Eye injuries in the workplace are a major cause of socio-economical damage, morbidity and disability, despite well-publicized standards for industrial eye protection. The most common type of eye injuries observed in the occupational setting are corneal foreign body injuries. (Nicaeus 1996)
Tools and machinery accounted for 24.2% of all injuries in a survey in England. This survey also revealed that protective eye wear, where indicated, was available to only 48.6% of patients, and only 19.4% actually used it. (Desai 1996)
A US survey has found that occupational eye injuries predominantly effect
males, Hispanics and individuals 20-24 years of age, with an injury rate of 5.02, 3.72 and 4.64 per 100,00 employed per year). (Baker 1996)
The principal hazards in manual spot welding with high-current electrodes are high-speed droplets of molten metal produced by the process. Easy protection is afforded by wrap-around polycarbonate eye shields. (Chou 1996)
Ocular trauma accounts for 15% of all work-related trauma in Australia. Workers on grinding and drilling machines are the commonest effected. (Fong 1995)
An extensive Danish survey has revealed that most ocular injuries occur during the use of drilling, welding or grinding equipment. The incidence was 0.8/1000/year. 98% of the cases were men. Foreign body lesions were seen in 60% of cases, and actinic conjunctivitis in 30%. The authors concluded that although none of the injuries were serious, they were often very painful and demanding of resources, and all of them could have been prevented by the use of proper eye protection. (Holmich 1995)
Specific occupational groups are at increased risk of ocular injury and often not using eye protection. In the UK, firefighters have a 3.5% chance of sustaining an eye injury each year requiring medical attention, giving an ocular injury rate of 1 per 50,000 working hours, with only 20% reporting use of protective equipment. (Owen 1995)
The epidemiology of penetrating eye injuries in Ireland is such that they are predominantly occupational, and involving skilled manual and farm workers. The left eye is more frequently involved as compared to the right eye. (Hassett 1994)
US data on construction workers reveals that the commonest nonfatal injuries are those to the hands and eyes. (Hunting 1994)
Previous studies have revealed bad lighting as the cause of 5% of all industrial accidents (American National Safety Council), and, together with the optical fatigue, it engendered, contributed to as many as 20% of them.
The irony is that most of the eye-care programmes focus on treatment which bears a proportionately high cost compared to educating the masses in preventive strategies and primary eye care.
There are certain professions where workers are more prone to ocular trauma than others and there is a gross difference in the incidence in the formal and informal sectors. The main difficulty in implementing an intervention strategy in the informal sector is the geographical distribution of the workers and absence of organized fora to carry these out.
One of the professions that involves incurring a high risk of ocular trauma is of the lathe machinist, especially in the informal sector, due to non- or under-utilization of protective devices and unawareness of proper safety protocols.
Keeping this in mind a research protocol was designed to assess the incidence and causes of ocular trauma, the traditional modes of intervention and their economical burden. Furthermore, intervention in selected outlets chosen at random was made and its effect on the incidence studied. As part of the protocol a market survey was also conducted to identify the availability of various protective devices.
We expect this study to lead to formulation of low-cost participatory intervention strategies in the informal sectors that hopefully will reduce the incidence of trauma and its social and economic burden.