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ARTICLE
Year : 1968  |  Volume : 16  |  Issue : 4  |  Page : 240-242

Compensation of industrial injuries of the eye


India

Date of Web Publication24-Dec-2007

Correspondence Address:
Roland I Pritikin
India

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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Pritikin RI. Compensation of industrial injuries of the eye. Indian J Ophthalmol 1968;16:240-2

How to cite this URL:
Pritikin RI. Compensation of industrial injuries of the eye. Indian J Ophthalmol [serial online] 1968 [cited 2020 Aug 9];16:240-2. Available from: http://www.ijo.in/text.asp?1968/16/4/240/37564


  Introduction Top


Eye injuries in the industries of the nuclear age are varied and complex. Such injuries may be due to foreign bodies, contusions, concussions, rup­tures or tears, intense heat, illumi­nation and radiations of different kinds chemical agents, explosives and poisonous gases. Foreign bodies may become imbedded in the surface tis­sues of the eye, or imbedded in the eyeball and remain there, or pass into the surrounding tissues. The re­action of the tissues depends on the nature of the different foreign bodies and the length of time they remain in the eye. Blunt objects and instru­ments may produce concussions, con­tusions, ruptures and tears of the eye. Thermal injuries may be due to heat, electricity or radioactive substances. Excessive illumination, flash burns and especially radiation can be agents responsible for eye injuries. Chemi­cal injuries from acids and alkalies, explosions and poisonous gases may cause serious eye injury.

In a consideration of compensation for injuries to the eye not only must we consider the extent of damage to the eye by the injury but the presence or absence of infections and immuneallergic reactions following such in­juries.

Also important for consideration are pre-existing eye disturbances which may be responsible for an eye injury and falsely made a pretext for compensation. On the other hand the problem of aggravation of a pre-exist­ing ocular disturbance by an injury must be given a just consideration.

Estimation of visual loss:

There is still a great variance in the methods used for estimating visual loss after injuries of the eye. One of the more modern methods is to base the loss of ocular function on the following principles:­-

1. Loss of visual efficiency of the individual. Total permanent disabi­lity of both eyes renders the indivi­dual permanently disabled for all in­dustrial purposes and the ability to earn a livelihood, but this does not necessarily mean that the individual must have no light perception in either eye as, from the industrial standpoint, a 6/60 corrective vision in the better eye and a visual field of at least 30 degrees in each meridian separate the blind from the seeing.

2. Three primary elements enter­ing into visual efficiency, are central visual acuity, peripheral vision, and muscle function; and, secondary ele­ments entering into visual efficiency are depth perception, stereoscopic vi­sion, fusion sense, color perception, adaptation to light and dark, and ac­commodation. In establishing the amount of compensation, the factors to be measured normally are: central visual acuity, field of vision, and muscle function.

Central visual acuity is measured in percentages assigned to vision varying from 6/6 to 6/240 for dis­tance and from 100% to 2.5% for near vision. Central visual acuity is measured at a distance of 6 meters. For near vision it is measured at a test distance of 35 meters. However, since this would not be a true measurement of visual loss in monocular aphakia following the extraction of a traumatic lens, no difference of more than four diopters in the correction of the two eyes may be used in com­puting the visual efficiency loss for compensation.

A value of one weight is given to distance loss and a value of two weights is given to near vision loss.

The field of vision is measured on the basis of the following standards: outward, 85 degrees; down and out, 85 degrees; down 65 degrees; down and in, 50 degrees; inward, 60 deg­rees, in and up, 55 degrees; up, 45 degrees; and up and out, 55 degrees. In measuring a field of vision, not less than three foot candles illumination may be used with a standard perime­ter. 500 is the sum of the eight meri­dians of degrees of arc in the stan­dard that has been set. This is the basis upon which visual field loss is computed.

Muscle function is based on a ma­ximum standard in which there is an absence of diplopia in all parts of the field of binocular vision. The in­dustrial visual efficiency of one eye is the product of the efficiency values of central vision acuity, field of vision and muscle function. Thus if the central vision acuity efficiency is 50 per cent, visual field efficiency is 75 per cent and muscle function effi­ciency is 89 per cent, the resultant visual efficiency of the eye will be a multiplication of 0.50 x 0.75 x 0.89, and that would be 33.4 per cent. The loss of both eyes is without doubt a much more severe loss than twice the loss of one eye. In computing the visual efficiency, weight of three applied to a more efficient eye, and a weight of one to the less efficient eye, has been found the most equitable standard for industrial compensation. If the individual efficiency rating of the injured eye is 50 per cent and that of the fellow eye is 90 per cent, the visual efficiency of the individual will be found by the fol­lowing computation:



equals 80 per cent.

In this case then, compensation would be 20 per cent of the amount awarded for total permanent disabi­lity.

Most compensation laws today are interpreted to indicate that if any in­jury is inciting to the recurrence or occurrence of a pre-existing condition, then compensation must be consider­ed from the standpoint of the injury being totally responsible for the vi­sual loss. This has resulted in many unusual awards. Some of the con­ditions in which the injury has been held responsible for all the visual da­mage produced by a condition al­ready existing may be grouped as follows: Actinomycosis, blastomy­cosis, herpes simplex, herpes zoster ophthalmicus, dendritic ulcers of the cornea, Reiter's syndrome, (which includes inflammation of the conjunc­tiva of the eye along with arthritis, nonspecific urethritis and sometimes by other symptoms), Stevens-Johnson syndrome, (a severe form of erythe­ma multiforme characterized by con­stitutional symptoms and marked in­volvement of the conjunctive and oral mucosa), toxoplasmosis when ac­companied by an infection of the eye, foreign body in the eye believed to be the inciting agent in an eye con­dition due to hypertension which has caused ill effects to the vision, foreign bodies in another part of the eye be­ing held responsible for a malignant growth of the iris of the eye; and, diseases of the central nervous sys­tem producing optic -atrophy attri­buted to a minor eye injury when a systemic condition was responsible.


  Summary Top


A method of computing for com­pensation of eye injuries as used in the United States of America is ex­plained.




 

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