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.