TY - JOUR PY - 1975// TI - New hazards in penetrating wounds of the eye JO - Proceedings: American Association for Automotive Medicine Annual Conference A1 - Keeney, A. H. A1 - Moore, WE SP - 226 EP - 233 VL - 19 IS - N2 - Since the mid 1960's phototropic spectacles and sunglasses have been widely sold. These contain highly active and photo reactive silver halides. In additions to silver chloride, fluoride and bromide, some of these lenses contain small percentages of copper and cobalt. These active and toxic elements significantly increase the x-ray density of such lenses or their fragments and slightly increase the specific gravity of the glass. Infrequently patients complain of added weight of such lenses. Skiers on bright, sunny slopes and particularly cold days are enthusiastic concerning such lenses especially when skiing mogul courses. Market place popularity has also placed millions of such lenses before the eyes of warm weather wearers and others hoping for some advantage inside automobiles on bright days. Inherently slow clearing, compounded by the further delaying effect of high ambient temperature makes these lenses an impediment to twilight and night driving. Maximum clearing requires shielding from all light for many hours. Filters such as these worn under mesopic conditions as in night driving reduce needed incident light on the retina and are progressively more severe impediments with advancing age of the wearer. MacFarland has demonstrated a need for essentially doubled ambient light every thirteen years of adult life to maintain recognition capabilities under mesopic illumination. Drivers with tinted windshields face compounded reduction of necessary luminous cues when wearing such lenses for mesopic driving tasks. When fragmented, these lenses, like lead glass, are easier to identify by x-ray even when less than 2 mm in size. Conventional crown glass fragments must be larger than 2 mm in size for usual x-ray identification. Active silver and cobalt ions are leached from this glass. Chronic experiment with glass fragments implanted into the vitreous of albino rabbits over 6-8 months shows a tri-phasic reaction consisting of a few days of post insertional inflammation followed by 7-14 days of relative inflammatory quietude and then progressive low grade inflammation over months. This is complicated by vitreous strands and localized hemorrhage about the fragments particularly when they are in contact with the retina. Fragments suspended in mid vitreous evoke lesser localized reaction. Established concepts of minimal extraction efforts for glass fragments may now need to be revised toward more prompt or heroic efforts to remove phototropic elements.

LA - SN - 0892-6484 UR - http://dx.doi.org/ ID - ref1 ER -