Sunglasses are widely sold for visual comfort in bright sunlight and for cosmetic purposes. Few people select sunglasses with any thought of protection of their eyes and vision. Nevertheless, standards organizations attempt to provide certain optical requirements to minimize risk from excessive UV exposure. Many sunglass manufacturers claim certain benefits of UV protection. However, these standards focus on the spectral properties of the filter lenses and generally ignore the frame. Recent research has shown that the design of the sunglass frame plays an important role in solar protection of the eyes.
An indication of the level of uncertainty in laser injury studies relates to the slope of the transformed dose-response curve, or the "probit plot" of the data. The most cited threshold in a laser injury experiment is the point on the probit plot that represents a 50 % probability of injury: the ED-50. This value is frequently referred to as the "threshold," even though some experimental damage points exist below this "threshold." An analysis of any number of example data sets reveals that the slope in most experiments could not be explained by biological variation alone. The optical, thermophysical and biological factors influencing the probit plot are critically analyzed. By theoretically modelling an experiment, small errors in focus are shown to produce a substantial change in the ED-50 and the slope of the probit plot. The implications of plotting spot-size dependence with ED-50 values are shown to be significant, and can lead to erroneous conclusions regarding the apparent spot-size dependence.
In laser safety, dose-response curves describe the probability for ocular injury as a function of ocular energy, and are often used to quantify the risk for ocular injury given a certain level of exposure to laser radiation. In principal, a dose-response curve describes the biological variation of the individual thresholds in a population. In laser safety, a log-normal cumulative distribution is generally assumed for the dose-response curve, for instance when Probit analysis is performed. The lognormal distribution is defined by two parameters, the median, called ED50, and the slope. When animal experiments are performed to obtain dose-response curves for laser induced injury, experimental uncertainty such as focussing errors as well as variability within the group of experimental animals, such as inter-individual variability of absorption of the ocular media, can influence the shape of the dose-response curve. We present simulations of uncertainties and variabilities that show that the log-normal dose-response curve as obtained in a animal experiments can grossly overestimate the probability for ocular damage for small doses. It is argued that the intrinsic slope for an individual’s dose-response curve is rather steep, even for retinal injury, however, the dose-response curve for a group or population can be broader when there is inter-individual variability of parameters which influence the threshold. The quantitative results of the simulation of the grouping of individual dose-response curves can serve as basis to correct potentially biased dose-response curves as well as to characterize the uncertainty associated with the ED50 and the slope of the dose-response curve. A probabilistic risk analysis model, which accounts for these uncertainties by using Monte-Carlo simulation, was developed for retinal laser injuries from pulsed lasers with wavelengths from 200 nm to 20 µm, and the interpretation of the results are discussed on the basis of example calculations.
For more than 35 years, a wide range of biomedical research has been conducted in order to understand the biophysical factors which influence laser induced retinal injury. Although the optical effects which influence retinal imaging and the initial physical events which lead to the absorption and dissipation of the laser energy are well understood, the stages of biological damage which take pace after the deposition of energy are not so well understood. The greatest body of research was initial centered on the interaction of laser energy with ocular tissues. Much of the research was to derive occupational health and safety standards that provide maximum permissible exposure limits. These limits are based both upon the theoretical understanding and the large body of experimental data. Current laser safety research has recently focused almost exclusively on deriving retinal injury thresholds for sub- nanosecond exposures. Setting limits in this temporal region has been difficult, since there have been conflicting data sets and there are limited data to extrapolate to other spectral regions. Because of the transparency of some ocular tissues, the ocular injury studies offer an opportunity to study all interaction mechanism with greater ease of viewing the effects directly with greater clarity than working with other biological tissues.
With the easy attainability of hand-held laser devices and burgeoning Light Emitting Diode (LED) technology, safety standards for long-term viewing of continuous light sources are being scrutinized. One concern is with formalizing the effect of head and eye movements on smearing energy from a small optical source over the retina. This experiment describes target motion over the retina as a result of head and eye movements during a deliberate fixation task. Volunteers fixated, with (fettered) and without (unfettered) head and chin rest support, on an LED and laser source that subtended 0.1 minutes of arc visual angle. A dual Purkinje Eye-Tracker measured eye position during each 100-second fixation trial. The data showed a non-uniform retinal energy distribution with an elliptical footprint. The major axis was 2 times greater than the minor axis and oriented along the temporal/nasal retinal axis. The average half-maximum diameter measured along the major axis was 42 microns for the fettered and 108 microns for the unfettered condition. Although the eye is not a stable platform, the `smear' of energy over the retina from head and eye movements does not grossly affect spot size. The data suggest that the time dependent spot size correction of the current laser safety standards be more restrictive.
Unlike radiofrequency and ionizing radiation which can penetrate deeply into biological tissues, optical radiation is generally absorbed very superficially. Except for the relatively narrow band of visible and near-infrared (IR-A) radiation from approximately 400 - 1400 nm, skin and other biological tissues are nearly opaque to optical radiation. For this reason, the volumetric or mass-based concepts of absorbed dose (i.e., J/cm3 or J/gm) used in other areas of radiation biology are of little value. Additionally, the absorbed radiant energy is conducted out of the absorbing site and for this reason thermal effects depend largely upon the size and location of the absorbing site as well as exposure and exposure rate. Concepts of surface exposure dose are therefore most useful and practical. The concepts of fluence and fluence rate are shown to be useful for volume scattering in the visible spectral region where photochemical reactions are to be described.
In earth orbit, the ambient optical radiation environment provided by the sun is not the same as on the surface of the earth. The atmosphere provides a protective layer that is not present in space. The American Conference of Governmental Industrial Hygienists (ACGIH) has published guidelines for exposure to broad-band optical radiation. These guidelines are called threshold limit values (TLV). Potential hazards include photochemical and thermal effects on the eye and skin. These guidelines are intended to be used with artificial sources such as arc lamps, however, they may be applied to solar exposure during extravehicular activity so that recommendations may be made to limit the risk of astronauts who are spending more and more time outside the space shuttle. Protective filters are discussed that will limit exposure to optical radiation. Permissible exposure times are calculated based on the ACGIH TLVs. Although thermal TLVs may be exceeded, exposures are well below injury thresholds.
Ocular injuries resulting from exposure to laser beams are relatively uncommon since there is normally a low probability of a relatively small-diameter laser beam entering the pupil of an eye. This has been the accident experience to date with lasers used in the research laboratory and in industry. A review of the accident data suggests that at least one type of laser is responsible for the majority of accidental injuries that result in a visual loss in the exposed eye. This is the q-switched neodymium:YAG laser. Although a continuous-wave laser causes a thermal coagulation of tissue, a q-switched laser having a pulse of only nanoseconds duration disrupts tissue. A visible or near-infrared laser can be focused on the retina, resulting in a vitreous hemorrhage. Examples of laser ocular injuries will be presented. Despite macular injuries and an initially serious visual loss, the vision of many patients recovers surprisingly well. Others may have severe vision loss. Corneal injuries resulting from exposure to reflected laser energy in the far-infrared account for surprisingly few reported laser accidents. The explanation for this accident statistic is not really clear. However, with the increasing use of lasers operating at many new wavelengths in the ultraviolet, visible and infrared, the ophthalmologist may see more accidental injuries from lasers.
With the increasing use of both pulsed and CW lasers in the spectral region between 1100 nm and 3000 nm, biological research studies were performed in several laboratories to better define threshold effects. From this research both national committees (e.g., ANSI Z136 in the USA) and international committees (IEC TC76) have recommended increased occupational exposure limits (ELs) for lasers in this spectral region during the last year. Within the retinal hazard region, at wavelengths between 1200 and 1400 nm, ELs were increased by 8, and at wavelengths between 1400 nm and 2600 nm the ELs were raised as much as 100 times for short-pulse exposure, depending upon corneal penetration depth for each wavelength. The measuring aperture has also been modified so that some low-power optical-fiber diode laser sources are no longer considered potentially hazardous. Some of the research that led to these EL revisions also has implications for corneal refractive surgery.
The eye is exposed daily to UVR from skylight and ground reflections when outdoors in sunlight. Additional exposure occurs daily from artificial sources such as fluorescent lamps. Some workers, notably welders, are exposed to industrial sources of UVR. The geometry of exposure critically influences the actual UVR dose to the cornea and lens. When exposed to bright light, squinting reduces UVR exposure. the optical properties of the eye and behavioral responses to bright light both contribute to limiting actual UVR exposure. The actual daily dos of UVR is considerably less than what many previous investigators have assumed. The geometrical, as well as temporal and spectral, aspects of ocular dosimetry will be reviewed in order to allow participants a better insight into the practical impact of many laboratory studies of UVR effects upon ocular tissues.
Excimer lasers are now being used in surgical applications in the clinical environment. The laser safety measures developed for excimer laser use in the industrial and research setting may not be sufficient for use in the intense, time-urgent environment of the operating room. It is shown that the only major safety concern relates to handing of the compressed halogen gasses.
Historically many different agencies and standards organizations have proposed laser occupational exposure limits (EL1s) or maximum permissible exposure (MPE) levels. Although some safety standards have been limited in scope to manufacturer system safety performance standards or to codes of practice most have included occupational EL''s. Initially in the 1960''s attention was drawn to setting EL''s however as greater experience accumulated in the use of lasers and some accident experience had been gained safety procedures were developed. It became clear by 1971 after the first decade of laser use that detailed hazard evaluation of each laser environment was too complex for most users and a scheme of hazard classification evolved. Today most countries follow a scheme of four major hazard classifications as defined in Document WS 825 of the International Electrotechnical Commission (IEC). The classifications and the associated accessible emission limits (AEL''s) were based upon the EL''s. The EL and AEL values today are in surprisingly good agreement worldwide. There exists a greater range of safety requirements for the user for each class of laser. The current MPE''s (i. e. EL''s) and their basis are highlighted in this presentation. 2. 0
Unlike penetrating ionizing radiation, optical radiation is generally absorbed very superficially. Ex- cept for a narrow band of visible and near-infrared (IR-A) radiation from approximately 400-1400 nm, skin and other biological tissues are nearly opaque to optical radiation. For this reason, volumetric or mass based concepts of absorbed dose are of little value. Additionally, the abosorbed radiant energy is conducted out of the absorbing site and for this reason thermal effects depend largely upon the size and location of the absorbing site as well as exposure and exposure rate. Con- cepts of exposure dose are therefore most useful and practical.
Prof. Milner has nicely introduced the interrelationship of laser radiation parameters, environmen- tal parameters and tissue parameters which influence the biological tissue result. His analogy of a black box is quite appropriate.
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