Arrière-plan Copy


The OHS Act and Regulations, Act No. 85 of 1993 and Mine Health and Safety Act, (discussed in Chapter 4) requires that all hazards in the working environment must be identified, monitored, and controlled. Despite legislative requirements requiring the identification of potential hazards, and other measures to reduce risks and prevent these injuries, the use of safe machinery and proper protective devices is generally inadequate and therefore ocular accidents in the workplace still occur. Accident rates remain higher than necessary, and the health and lives of workers continue to be at risk3. and eye trauma is still the leading cause of unilateral blindness and visual impairment across the world1.

Ocular trauma is known to be an important preventable cause of visual impairment. Ocular trauma rates appear higher in newly established factories, particularly small-scale industries in developing countries, due to poor working conditions, long hours at work and poor organisational safety measures3. Most injuries in developed countries are accidental, work-related injuries, while assaults are the predominant cause in developing countries1. Most studies in this area have been done in countries outside the African continent. A limited number of general surveys in eye trauma appear in the ophthalmic literature in South Africa2. Knowledge about the epidemiology of workplace injuries is an essential tool in the formulation of workplace safety measures. Reduction of exposures and targeted intervention among high-risk workers will reduce the incidence of work-related ocular injuries and illnesses.

Velibanti Nhlanhla Sukati conducted a quantitative retrospective study on eye injuries presenting at specific hospitals in KZN over a 4-year period. The data indicated that 660 patients presented with ocular injuries to four selected provincial eye care clinics in KZN between January 2005 – December 2008. There were 440 patients from rural hospitals and 220 at urban hospitals. Males were more likely than females to have an eye injury (72.3% versus 27.7%, respectively) and urban males were more likely than rural males to incur an eye injury (79.1% versus 68.9%, respectively). The Black population had a higher prevalence of ocular injuries than other race groups.

Islam SS et al, cited in an article “Epidemiology of compensable work-related ocular injuries and illnesses: incidence and risk factors”4, that the incidence rates of work-related compensable ocular injuries/illnesses and associated risk factors using a state-managed workers’ compensation database estimated the annual incidence rate to be 537 per 100,000 employees. The majority of the ocular injuries and illnesses were caused by foreign bodies in the external eye (incidence rate 194 per 100,000 employees). The incidence rates for superficial eye injury, atopic conjunctivitis, burn, keratitis, chronic conjunctivitis, and contusion were 168.3, 30.9, 28.0, 23.4, 17.9, and 15.3 per 100,000 employees, respectively. The highest incidence rate was observed in the agricultural sector, with male employees having higher rates than female employees. Cooks, housekeepers, and food service workers had higher risk of atopic conjunctivitis (relative risk, 3.2 to 7.3) compared with other workers. The majority of the atopic conjunctivitis illnesses and burn injuries were associated with chemical exposures.

Employee vision assessments (vision screenings and physical eye examinations), taking account of the specific person’s job specifications and occupational risk exposure profiles should be conducted on pre-employment and then periodically to ensure the minimum level of visual functioning or fitness needed to accomplish visual tasks and ensure eye safety. Conducting workplace surveys that include visual risks should be included in all health risk assessments and hygiene surveys as required by law.

The occupational health team which includes the occupational medicine practitioner, occupational health nurse, vision screening technician and in some instances the optometrists are required to have the appropriate skills to conduct visual examinations and eye screening should contribute to appropriate eye safety policies and procedures.

The purpose of this course is to understand and carry out the various procedures when conducting vision screenings and physical eye examinations to produce a valid vision screening result. In some instances, workers will not be able to produce accurate results on fully automated vision screeners, furthermore, vision screeners cannot perform the physical examination of the eye which forms part of the assessment. For these reasons, the non-automated assessment of the eye and vision screening methods are taught during this course. The automated assessment will be demonstrated (and is significantly easier) during the clinical practice and forms part of the portfolio of evidence.