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2017 HCHB_digital

Sun Care: Eye Protection

Sun Care: Eye Protection Protecting eyes against the sun is just as important as protecting skin. While most people are aware of the link between ultraviolet (UV) radiation and skin cancer (see also Sun Care), few realise the connection between UV radiation (UVR) exposure and eye damage. Particles in the atmosphere scatter UVR so even staying out of direct sunlight does not eliminate this hazard. UV damage to the surface tissues and internal structures of the eye (such as the cornea and lens) can occur from either natural sunlight or artificial UV rays. In the short term, excessive exposure to UV radiation from daily activities can burn the surface of the eye, similar to a sunburn on the skin. Exposure is exacerbated by reflections off snow, concrete, water, or other shiny or white surfaces. Acute effects Acute effects of UV radiation on the eye include inflammation of the cornea and the iris, photoconjunctivitis (an inflammation of the conjunctiva, the membrane that lines the inside of the eyelids), and photokeratitis (snow blindness: a temporary but painful burn to the cornea). Long term risks Long-term exposure to UV radiation can lead to, or increase the risk of: • age-related macular degeneration: a deterioration in macular tissue that causes loss of central vision • cataracts: a clouding of the eye’s lens that can blur vision • pterygiums: a white or creamy opaque growth attached to the cornea (white of the eye). These are usually non-cancerous, but may grow over the cornea, partially blocking vision, and may require surgery to be removed • skin cancer around the eyelids: basal cell carcinoma is the most common. In order to reduce the risk of eye damage, sunglasses should always be worn outside, particularly when it's sunny, at the beach or near water, when driving or outside at high elevations or participating in snow sports. Anybody with an eye disease, who has had cataract surgery, or is taking photosensitising medicines should always wear sunglasses outside. Choosing sunglasses While more expensive sunglasses may use slightly dearer materials for both the frame and the lens, sunglass cost has more to do with the brand name than a reflection of UVR protection. Pharmacies should choose to only stock sunglasses that comply with the Australian/NZ standard (AS/NZS)1067:2003, or another internationally recognised standard. Note that this standard is only voluntary in New Zealand, although it is mandatory in Australia. Initial assessment Help customers select sunglasses that best suit the main activity for which they will be worn. For example, polarised sunglasses are best for fishing and driving; nylon blended frames are resistant to hot and cold, and easily moulded into wrap-around styles so are ideal for high-intensity sports; and purple or rose tints offer the best contrast of objects against a green or blue background so are perfect for hunting or water-skiing. Importantly, the customer likes and feels comfortable in the sunglasses, which makes them more likely to be worn. People who wear corrective lenses may consider having a UV protective coating added to their prescription lenses, investing in a pair of prescription sunglasses or buying protective shades that can be worn over their vision-correcting glasses. About the Australian/NZ standards (AS/NZS) The AS/NZS: 1067:2003 sets limits on the allowed transmittances of fashion spectacles and sunglasses for adults and children. Sunglasses that are allowed to be worn while driving must comply with the colouration limits of AS/NZS 1067. Colours, in particular traffic signals, must still be recognisable when viewed through the lenses. The standard defines five categories of lenses – see below. LENS DESCRIPTION CATEGORY 0 Fashion spectacles with very low sunglare reduction. Some UVR protection 1 Fashion spectacles – not sunglasses. Limited sunglare reduction. Some UVR protection 2 Sunglasses – medium sunglare reduction and good UV protection 3 Sunglasses – high sunglare reduction and good UV protection 4 Special purpose sunglasses – very high sunglare reduction. Good UV protection ADDITIONAL ENDORSEMENTS None Not suitable for driving at night None None Must not be used when driving Several other markings may be found on sunglasses including the Eye Protection Factor (EPF) rating. This takes into account the frame coverage, UV protection, blue light and infrared protection (ability to shield the eyes from heat). Sunglasses labelled EPF 10 actually exceed the requirements of AS/NZS 1067:2003. Sunglasses may also be labelled “Absorbs 100% UVR”. According to the New Zealand Association of Optometrists, the claim "UV400" is little more than a marketing spin as there is no accepted definition. TREATMENT OPTIONS Category Examples Comments Sunglasses eg, Bill Bass, North Beach, Zoya sunglasses Sunglass suppliers offer a wide range of popular branded sunglasses of varying specifications. READY, SET, LEARN! Page 146 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

CONTINUING OTC EDUCATION COMPONENT MATERIALS INFORMATION Frame Moulded plastic polymer Plastic injected into a desired mould. Cost-effective but frames cannot be reheated or generally take a prescription lens. Cellulose acetate Nylon Metal (eg, titanium, beryllium, stainless steel, aluminium)/monel Frames are cut from solid sheets of acetate. Retain their shape and do not shrink. Hypoallergenic and easily coloured. Nylon blends make superior sports and performance frames and are resistant to hot and cold, flexible and readily moulded into wraparound styles. Lighter than plastic and easy to adjust. Less obtrusive to the field of vision. More expensive and less durable than other types and not for high-impact activities. Can get hot. Titanium is a hypoallergenic metal that is lightweight, strong, durable and corrosion resistant. Produced in a variety of colours. Beryllium is less expensive than titanium. Resists corrosion and tarnish – good for people with high skin acidity or around salt water. Stainless steel is light weight and strong and provides excellent resistance to corrosion, abrasion and heat. Usually hypoallergenic. Aluminium is lightweight and corrosion resistant and usually combined with silicon and iron to increase strength. Monel is a rust-proof metal alloy, composed of nickel and copper with some traces of iron. Good malleability. Lens Polycarbonate Expensive, virtually unbreakable thermoplastic that is 1/3rd the weight of acrylic and 1/6th as heavy as glass. Usually made from bisphenol A. Excellent transparency, durability, and high refractive index. Can be made thinner than glass or conventional plastic. Polarising filters can be incorporated. High impact resistance. Easily shaped but more likely to scratch. Can discolour over time. CR39 Patented plastic polymer. Reasonably cheap. Same optical qualities and visual acuity as glass but more lightweight and impact resistant. Optically superior to polycarbonate. High glossy surface finish. Plastic Light and impact resistant. Naturally UVR resistant. Acrylic Synthetic cast lens. Same optical qualities and visual acuity as glass but more lightweight and 20 times more impact resistant. Can crack when exposed to extreme temperatures. More easily scratched than other lenses since softer. Good optical qualities at a low price. Glass Excellent optical quality and scratch resistant. Heavy. Can shatter on impact. No UVR protection unless coated. Lens effects Mirrored Reduce glare by reflecting light off the lens surface. Scratch easily as coating applied last. Photochromatic/ photochromic Polarised Tinted Become darker when exposed to UV radiation. Can take up to two minutes for adjustment to happen, and may not darken inside vehicles with glass that blocks UV light. Block polarised light reflected off horizontal surfaces and reduce light intensity. Enhance visual acuity. Recommended for water sports and driving but not as effective against snow glare as snow reflects light equally in all directions, rather than just horizontally.Test if truly polarised by holding lens up to a reflective surface (eg, car bonnet) and slowly rotating 90 degrees. Polarised sunglasses will show a significant diminishing of glare. Cost and optical quality depends on polarising method used and includes external film coating (cheapest), sandwiching polarising filter between layers of the lens (more durable and expensive), combining the polarising filter with the lens material while in liquid form (best optical quality). Tint reduces visible light but does not provide protection from UVR. May affect ability to drive at night. Various tints are available: –grey, grey-green, smoke: good all-purpose tint. Reduces brightness while preserving 100% colour recognition. SPORTS: all outdoor sports in bright light conditions. –green: heightens contrast (mildly) while preserving colour balance. SPORTS: golf, baseball. –dark amber, copper, brown: good for blocking blue light (ie, on a cloudy day). Contains a red element to enhance depth perception. Useful to improve contrast on grass and against blue skies. SPORTS: fishing, cycling, golf, hunting, skiing, watersports. –yellow, orange: less glare protection but perfect for moderate-to-low level light conditions. Excellent depth perception and contrast enhancement in flat-light conditions. SPORTS: skiing, snowboarding, hunting, indoor sports. –amber, rose, red: heightens contrast in partly cloudy and sunny conditions but causes significant colour imbalances. SPORTS: cycling, fishing, hunting, skiing, snowboarding, water sports. Hydrophobic coatings repel water. Anti-scratch coatings improve durability. Anti-fog coatings good for high-energy activities. Other Other Reduce fogging “Air dams” direct the flow of air over the inside of the lenses. Small ventilator holes can also reduce fogging. Hinges Metal are more durable than plastic. Grips Rubber nose or ear pieces help keep sunglasses from sliding down nose. Side protection Wide plastic temples and wraparound lenses give more protection from dust, snow, wind, rain and glare that may come in from the side. Stock display and marketing • Keep a good selection of each brand on display and ensure the eyewear and display cabinet is thoroughly dusted, clean and tidy. • Keep the best selling styles at eye level. • Know your product and be aware of different features and benefits. »» Ask your supplier for more information if you need it. • Ask customers what style they prefer (ie, large, rimless, metal, plastic) »» Allow them to try on several pairs and listen to their feedback. Locate this icon throughout the Healthcare Handbook. Then find the corresponding Pharmacy Today and ELearning articles. Read all three to unleash learning prizes and giveaways! Page 147

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