When spectacles pose a risk of injury

Excerpted from page 53 of the October 2015 edition of AOA Focus.

"You probably wouldn't wear high heels to go canoeing," says Karl Citek, O.D., Ph.D., chair of the Commission on Ophthalmic Standards, "so you definitely shouldn't wear the wrong type of eye protection for activities like sports or work."

This appropriate analogy is Dr. Citek's response to new research on the prevalence of injuries related to eyeglasses. In "Spectacle-related eye injuries, spectacle-impact performance and eye projection," published in Clinical and Experimental Optometry, researchers performed an extensive literature review and identified 695 individual ocular traumas in which spectacles were either the main reason or a contributing factor.

The causes of those traumas are noteworthy not only for patients but also for the doctors of optometry who treat—and, ideally, educate—them. For instance, in some cases lenses were shattered by projectiles (a badminton shuttlecock or cricket ball, for example) during sports.

"Prescription glasses are not an adequate substitute for protective eyewear," the authors note. And indeed, because their review covers a multidecade timespan, they also note that safety measures, such as states requiring children who wear spectacles to use specially issued protection for sports, have curbed the rate of injuries. The same is true of occupational legislation for workers in jobs with eye hazards.

Dr. Citek says there's still plenty of room for patient education, though. For instance, as shown in the study, shattered lenses aren't the only cause of ocular trauma.

"For frames with a hinge, an impact to the side can suddenly create two sharp objects very near the eyes," Dr. Citek says. "That's why I recommend eyewear without a hinge for active patients, for example."

Similarly, the study authors note the importance of analyzing patient needs and balancing them against factors such as frame type and lens material. For example, polycarbonate may have drawbacks related to expense and visual clarity, but it's the most impact-resistant option.

"Many of the disadvantages of polycarbonate are outweighed by the cost of eye injury and the long-term consequences of vision loss," the authors write.