Abstract

The light output of ten operating microscope illuminators used for eye surgery was measured. The spectral output characteristics of each source were compared to optical radiation safety standards. Exposure of sensitive ocular structures of the patient is discussed. The light sources tested were found to be safe for momentary viewing, and almost all devices sufficiently filtered IR wavelengths to preclude acute thermal bioeffects. The permissible occupational exposure duration was found to range from 2 min to 1 h. Interpretations of these findings to the clinical setting are provided. Light exposure of the retina should be minimized by using the lowest light setting commensurate with the surgical task and making maximal use of off-axis illumination to minimize central retinal (macular) exposure. It is also recommended to use eyecups to shield the retina during final suturing.

© 1986 Optical Society of America

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References

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    [PubMed]
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    [PubMed]
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    [CrossRef]
  5. D. Fuller, R. Machemer, R. W. Knighton, “Retinal Damage Produced by Intraocular Fiber Optic Light,” Am. J. Ophthalmol. 85, 519 (1978).
    [PubMed]
  6. G. A. Griess, M. F. Blankenstein, “Additivity and Repair of Actinic Retinal Lesions,” Invest. Ophthalmol. Vis. Sci. 20, 803 (1981).
    [PubMed]
  7. W. T. Ham, H. A. Mueller, D. H. Sliney, “Retinal Sensitivity to Damage from Short Wavelength Light,” Nature London 260, 153 (1976).
    [CrossRef] [PubMed]
  8. W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
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  9. W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
    [PubMed]
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  27. S. M. Meyers, R. F. Bonner, “Yellow Filter to Decrease the Risk of Light Damage to the Retina During Vitrectomy,” Am. J. Ophthalmol. 94, 577 (1982).
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    [PubMed]
  32. D. H. Sliney, “Eye Protective Techniques for Bright Light,” Ophthalmology 90, 937 (1983).
    [PubMed]
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    [CrossRef] [PubMed]
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    [CrossRef] [PubMed]
  36. H. G. Sperling, “Are Ophthalmologists Exposing their Patients to Dangerous Light Levels?” Invest. Ophthalmol. Vis. Sci. 19, 989 (1980).
    [PubMed]
  37. M. O. M. Tso, B. J. Woodward, “Effect of Photic Injury on the Retinal Tissue,” Ophthalmology 9, 952 (1983).
  38. M. O. M. Tso, F. G. La Piana, “The Human Fovea after Sun-Gazing,” Trans. Am. Acad. Ophthalmol. Otolaryngol. 79, 788 (1975).
  39. M. O. M. Tso, B. S. Fine, L. E. Zimmerman, “Photic Maculopathy Produced by the Indirect Ophthalmoscope. I. Clinical and Histopathologic Study,” Am. J. Ophthalmol. 73, 686 (1972).
  40. M. L. Wolbarsht, M. B. Landers, J. A. C. Wadsworth, W. B. Anderson, “Retinitis Pigmentosa. Clinical Management Based on Current Concepts,” in Retinitis Pigmentosa, Clinical Implications of Current Research, M. B. Landers, M. L. Wolbarsht, J. E. Dowling, A. M. Laites, Eds. (Plenum, New York, 1977).
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  43. M. Yanoff, F. Kurata, M. Lamensdorf, “Inexpensive Device to Reduce Surgical Light Exposure,” Ophthalmology Inst. Book Suppl. 90 (Suppl), 137 (1983).

1984 (1)

E. E. Boldrey, B. T. Ho, R. D. Griffeth, “Retinal Burns Occurring at Cataract Extraction,” Ophthalmology 91, 1297 (1984).
[PubMed]

1983 (10)

D. K. Berler, R. Peyser, “Light Intensity and Visual Acuity Following Cataract Surgery,” Ophthalmology 90, 933 (1983).
[PubMed]

J. Kossol, C. Cold, P. Dahaw-Barker, “Spectral Irradiances of and Maximal Permissible Exposures to Two Indirect Ophthalmoscopes,” Am. J. Optom. Physiol. Opt. 60, 616 (1983).
[CrossRef] [PubMed]

H. R. MacDonald, A. R. Irvine, “Light-Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intra-ocular Lens Implantation,” Ophthalmology 90, 945 (1983).

L. M. Parver, C. R. Auker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Am. J. Ophthalmol. 90, 964 (1983).

M. A. Mainster, W. T. Ham, F. C. Delori, “Potential Retinal Hazards,” Ophthalmology 90, 927 (1983).
[PubMed]

R. H. McDonald, A. R. Irvine, “Light Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intraocular Lens Implantation,” Ophthalmology 90, 945 (1983).
[PubMed]

L. M. Parver, C. R. Aucker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Ophthalmology 90, 964 (1983).
[PubMed]

D. H. Sliney, “Eye Protective Techniques for Bright Light,” Ophthalmology 90, 937 (1983).
[PubMed]

M. O. M. Tso, B. J. Woodward, “Effect of Photic Injury on the Retinal Tissue,” Ophthalmology 9, 952 (1983).

M. Yanoff, F. Kurata, M. Lamensdorf, “Inexpensive Device to Reduce Surgical Light Exposure,” Ophthalmology Inst. Book Suppl. 90 (Suppl), 137 (1983).

1982 (3)

S. M. Meyers, R. F. Bonner, “Retinal Irradiance from Vitrectomy Endoilluminators,” Am. J. Ophthalmol. 94, 26 (1982).
[PubMed]

S. M. Meyers, R. F. Bonner, “Yellow Filter to Decrease the Risk of Light Damage to the Retina During Vitrectomy,” Am. J. Ophthalmol. 94, 577 (1982).

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

1981 (3)

M. M. Henry, L. M. Henry, L. M. Henry, Carl Zeiss Bull. (11May1981).

G. A. Griess, M. F. Blankenstein, “Additivity and Repair of Actinic Retinal Lesions,” Invest. Ophthalmol. Vis. Sci. 20, 803 (1981).
[PubMed]

D. G. Pitts, A. P. Cullen, “Determination of Infrared Radiation Levels for Acute Ocular Cataractogenesis,” A Von Graefe Arch. Klin. Ophthalmol. 217, 285 (1981).

1980 (6)

D. H. Sliney, M. L. Wolbarsht, “Safety Standards and Measurement Techniques for High Intensity Light Sources,” Vision Res. 20, 1133 (1980).
[CrossRef] [PubMed]

H. G. Sperling, “Are Ophthalmologists Exposing their Patients to Dangerous Light Levels?” Invest. Ophthalmol. Vis. Sci. 19, 989 (1980).
[PubMed]

W. Noell, “Possible Mechanisms of Photoreceptor Damage by Light in Mammalian Eyes,” Vision Res. 20, 1163 (1980).
[CrossRef] [PubMed]

M. J. Mannis, B. Becker, “Retinal Light Exposure and Cystoid Macular Edema,” Arch. Ophthalmol. 98, 1133 (1980).
[CrossRef] [PubMed]

J. L. Calkins, B. F. Hochheimer, S. A. D’Anna, “Potential Hazards from Specific Ophthalmic Devices,” Vision Res. 20, 1039 (1980).
[CrossRef] [PubMed]

T. Lawwill, R. S. Crockett, G. Currier, R. B. Rosenberg, “Review of the Macaque Model of Light Damage with Implications for the Use of Ophthalmic Instrumentation,” Vision Res. 20, 1113 (1980).
[CrossRef] [PubMed]

1979 (2)

B. F. Hochheimer, S. A. D’Anna, J. L. Calkins, “Retinal Damage from Light,” Am. J. Ophthalmol. 88, 1039 (1979).
[PubMed]

W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
[CrossRef] [PubMed]

1978 (3)

J. L. Calkins, B. G. Hochheimer, “Retinal Light Exposure from Operation Microscopes,” Arch. Ophthalmol. 97, 2363 (1978).
[CrossRef]

D. Fuller, R. Machemer, R. W. Knighton, “Retinal Damage Produced by Intraocular Fiber Optic Light,” Am. J. Ophthalmol. 85, 519 (1978).
[PubMed]

M. A. Mainster, “Spectral Transmittance of Intraocular Lenses and Retinal Damage from Intense Light Sources,” Am. J. Ophthalmol. 85, 167 (1978).
[PubMed]

1977 (2)

M. M. Henry, L. M. Henry, L. M. Henry, “A Possible Cause of Chronic Cystic Maculopathy,” Ann. Ophthalmol. 9, 455 (1977).
[PubMed]

T. Lawwill, S. Crockett, G. Currier, “Retinal Damage Secondary to Chronic Light Exposure. Thresholds and Mechanisms,” Doc. Ophthalmol. 44, 379 (1977).
[CrossRef] [PubMed]

1976 (1)

W. T. Ham, H. A. Mueller, D. H. Sliney, “Retinal Sensitivity to Damage from Short Wavelength Light,” Nature London 260, 153 (1976).
[CrossRef] [PubMed]

1975 (1)

M. O. M. Tso, F. G. La Piana, “The Human Fovea after Sun-Gazing,” Trans. Am. Acad. Ophthalmol. Otolaryngol. 79, 788 (1975).

1973 (1)

D. H. Sliney, B. C. Freasier, “Evaluation of Optical Radiation Hazards,” Appl. Opt. 12, (1973).
[CrossRef] [PubMed]

1972 (1)

M. O. M. Tso, B. S. Fine, L. E. Zimmerman, “Photic Maculopathy Produced by the Indirect Ophthalmoscope. I. Clinical and Histopathologic Study,” Am. J. Ophthalmol. 73, 686 (1972).

1969 (1)

O. Pomerantzeff, J. Giovignon, C. L. Schepens, “Indirect Ophthalmoscope: is the Illumination Level Dangerous?Trans. Am. Acad. Ophthalmol. Otolaryngol. 73, 246 (1969).
[PubMed]

1968 (2)

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 79, 69 (1968).
[CrossRef] [PubMed]

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 70, 187 (1968).

Aaberg, T.

R. Machemer, T. Aaberg, Vitrectomy (Grune & Stratton, New York, 1979).

Anderson, W. B.

M. L. Wolbarsht, M. B. Landers, J. A. C. Wadsworth, W. B. Anderson, “Retinitis Pigmentosa. Clinical Management Based on Current Concepts,” in Retinitis Pigmentosa, Clinical Implications of Current Research, M. B. Landers, M. L. Wolbarsht, J. E. Dowling, A. M. Laites, Eds. (Plenum, New York, 1977).

Aucker, C. R.

L. M. Parver, C. R. Aucker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Ophthalmology 90, 964 (1983).
[PubMed]

Auker, C. R.

L. M. Parver, C. R. Auker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Am. J. Ophthalmol. 90, 964 (1983).

Becker, B.

M. J. Mannis, B. Becker, “Retinal Light Exposure and Cystoid Macular Edema,” Arch. Ophthalmol. 98, 1133 (1980).
[CrossRef] [PubMed]

Berler, D. K.

D. K. Berler, R. Peyser, “Light Intensity and Visual Acuity Following Cataract Surgery,” Ophthalmology 90, 933 (1983).
[PubMed]

Blankenstein, M. F.

G. A. Griess, M. F. Blankenstein, “Additivity and Repair of Actinic Retinal Lesions,” Invest. Ophthalmol. Vis. Sci. 20, 803 (1981).
[PubMed]

Boldrey, E. E.

E. E. Boldrey, B. T. Ho, R. D. Griffeth, “Retinal Burns Occurring at Cataract Extraction,” Ophthalmology 91, 1297 (1984).
[PubMed]

Bonner, R. F.

S. M. Meyers, R. F. Bonner, “Yellow Filter to Decrease the Risk of Light Damage to the Retina During Vitrectomy,” Am. J. Ophthalmol. 94, 577 (1982).

S. M. Meyers, R. F. Bonner, “Retinal Irradiance from Vitrectomy Endoilluminators,” Am. J. Ophthalmol. 94, 26 (1982).
[PubMed]

Calkins, J. L.

J. L. Calkins, B. F. Hochheimer, S. A. D’Anna, “Potential Hazards from Specific Ophthalmic Devices,” Vision Res. 20, 1039 (1980).
[CrossRef] [PubMed]

B. F. Hochheimer, S. A. D’Anna, J. L. Calkins, “Retinal Damage from Light,” Am. J. Ophthalmol. 88, 1039 (1979).
[PubMed]

J. L. Calkins, B. G. Hochheimer, “Retinal Light Exposure from Operation Microscopes,” Arch. Ophthalmol. 97, 2363 (1978).
[CrossRef]

Clarke, A. M.

W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
[CrossRef] [PubMed]

Cold, C.

J. Kossol, C. Cold, P. Dahaw-Barker, “Spectral Irradiances of and Maximal Permissible Exposures to Two Indirect Ophthalmoscopes,” Am. J. Optom. Physiol. Opt. 60, 616 (1983).
[CrossRef] [PubMed]

Crockett, R. S.

T. Lawwill, R. S. Crockett, G. Currier, R. B. Rosenberg, “Review of the Macaque Model of Light Damage with Implications for the Use of Ophthalmic Instrumentation,” Vision Res. 20, 1113 (1980).
[CrossRef] [PubMed]

Crockett, S.

T. Lawwill, S. Crockett, G. Currier, “Retinal Damage Secondary to Chronic Light Exposure. Thresholds and Mechanisms,” Doc. Ophthalmol. 44, 379 (1977).
[CrossRef] [PubMed]

Cullen, A. P.

D. G. Pitts, A. P. Cullen, “Determination of Infrared Radiation Levels for Acute Ocular Cataractogenesis,” A Von Graefe Arch. Klin. Ophthalmol. 217, 285 (1981).

Currier, G.

T. Lawwill, R. S. Crockett, G. Currier, R. B. Rosenberg, “Review of the Macaque Model of Light Damage with Implications for the Use of Ophthalmic Instrumentation,” Vision Res. 20, 1113 (1980).
[CrossRef] [PubMed]

T. Lawwill, S. Crockett, G. Currier, “Retinal Damage Secondary to Chronic Light Exposure. Thresholds and Mechanisms,” Doc. Ophthalmol. 44, 379 (1977).
[CrossRef] [PubMed]

D’Anna, S. A.

J. L. Calkins, B. F. Hochheimer, S. A. D’Anna, “Potential Hazards from Specific Ophthalmic Devices,” Vision Res. 20, 1039 (1980).
[CrossRef] [PubMed]

B. F. Hochheimer, S. A. D’Anna, J. L. Calkins, “Retinal Damage from Light,” Am. J. Ophthalmol. 88, 1039 (1979).
[PubMed]

Dahaw-Barker, P.

J. Kossol, C. Cold, P. Dahaw-Barker, “Spectral Irradiances of and Maximal Permissible Exposures to Two Indirect Ophthalmoscopes,” Am. J. Optom. Physiol. Opt. 60, 616 (1983).
[CrossRef] [PubMed]

Delori, F. C.

M. A. Mainster, W. T. Ham, F. C. Delori, “Potential Retinal Hazards,” Ophthalmology 90, 927 (1983).
[PubMed]

Fine, B. S.

L. M. Parver, C. R. Auker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Am. J. Ophthalmol. 90, 964 (1983).

L. M. Parver, C. R. Aucker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Ophthalmology 90, 964 (1983).
[PubMed]

M. O. M. Tso, B. S. Fine, L. E. Zimmerman, “Photic Maculopathy Produced by the Indirect Ophthalmoscope. I. Clinical and Histopathologic Study,” Am. J. Ophthalmol. 73, 686 (1972).

Freasier, B. C.

D. H. Sliney, B. C. Freasier, “Evaluation of Optical Radiation Hazards,” Appl. Opt. 12, (1973).
[CrossRef] [PubMed]

Fuller, D.

D. Fuller, R. Machemer, R. W. Knighton, “Retinal Damage Produced by Intraocular Fiber Optic Light,” Am. J. Ophthalmol. 85, 519 (1978).
[PubMed]

Giovignon, J.

O. Pomerantzeff, J. Giovignon, C. L. Schepens, “Indirect Ophthalmoscope: is the Illumination Level Dangerous?Trans. Am. Acad. Ophthalmol. Otolaryngol. 73, 246 (1969).
[PubMed]

Gorn, R. A.

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 70, 187 (1968).

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 79, 69 (1968).
[CrossRef] [PubMed]

Griess, G. A.

G. A. Griess, M. F. Blankenstein, “Additivity and Repair of Actinic Retinal Lesions,” Invest. Ophthalmol. Vis. Sci. 20, 803 (1981).
[PubMed]

Griffeth, R. D.

E. E. Boldrey, B. T. Ho, R. D. Griffeth, “Retinal Burns Occurring at Cataract Extraction,” Ophthalmology 91, 1297 (1984).
[PubMed]

Guerry, D.

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

Guerry, R. K.

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

Ham, W. T.

M. A. Mainster, W. T. Ham, F. C. Delori, “Potential Retinal Hazards,” Ophthalmology 90, 927 (1983).
[PubMed]

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
[CrossRef] [PubMed]

W. T. Ham, H. A. Mueller, D. H. Sliney, “Retinal Sensitivity to Damage from Short Wavelength Light,” Nature London 260, 153 (1976).
[CrossRef] [PubMed]

Henry, L. M.

M. M. Henry, L. M. Henry, L. M. Henry, Carl Zeiss Bull. (11May1981).

M. M. Henry, L. M. Henry, L. M. Henry, Carl Zeiss Bull. (11May1981).

M. M. Henry, L. M. Henry, L. M. Henry, “A Possible Cause of Chronic Cystic Maculopathy,” Ann. Ophthalmol. 9, 455 (1977).
[PubMed]

M. M. Henry, L. M. Henry, L. M. Henry, “A Possible Cause of Chronic Cystic Maculopathy,” Ann. Ophthalmol. 9, 455 (1977).
[PubMed]

Henry, M. M.

M. M. Henry, L. M. Henry, L. M. Henry, Carl Zeiss Bull. (11May1981).

M. M. Henry, L. M. Henry, L. M. Henry, “A Possible Cause of Chronic Cystic Maculopathy,” Ann. Ophthalmol. 9, 455 (1977).
[PubMed]

Ho, B. T.

E. E. Boldrey, B. T. Ho, R. D. Griffeth, “Retinal Burns Occurring at Cataract Extraction,” Ophthalmology 91, 1297 (1984).
[PubMed]

Hochheimer, B. F.

J. L. Calkins, B. F. Hochheimer, S. A. D’Anna, “Potential Hazards from Specific Ophthalmic Devices,” Vision Res. 20, 1039 (1980).
[CrossRef] [PubMed]

B. F. Hochheimer, S. A. D’Anna, J. L. Calkins, “Retinal Damage from Light,” Am. J. Ophthalmol. 88, 1039 (1979).
[PubMed]

Hochheimer, B. G.

J. L. Calkins, B. G. Hochheimer, “Retinal Light Exposure from Operation Microscopes,” Arch. Ophthalmol. 97, 2363 (1978).
[CrossRef]

Irvine, A. R.

R. H. McDonald, A. R. Irvine, “Light Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intraocular Lens Implantation,” Ophthalmology 90, 945 (1983).
[PubMed]

H. R. MacDonald, A. R. Irvine, “Light-Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intra-ocular Lens Implantation,” Ophthalmology 90, 945 (1983).

Knighton, R. W.

D. Fuller, R. Machemer, R. W. Knighton, “Retinal Damage Produced by Intraocular Fiber Optic Light,” Am. J. Ophthalmol. 85, 519 (1978).
[PubMed]

Kossol, J.

J. Kossol, C. Cold, P. Dahaw-Barker, “Spectral Irradiances of and Maximal Permissible Exposures to Two Indirect Ophthalmoscopes,” Am. J. Optom. Physiol. Opt. 60, 616 (1983).
[CrossRef] [PubMed]

Kurata, F.

M. Yanoff, F. Kurata, M. Lamensdorf, “Inexpensive Device to Reduce Surgical Light Exposure,” Ophthalmology Inst. Book Suppl. 90 (Suppl), 137 (1983).

Kuwabara, T.

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 79, 69 (1968).
[CrossRef] [PubMed]

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 70, 187 (1968).

La Piana, F. G.

M. O. M. Tso, F. G. La Piana, “The Human Fovea after Sun-Gazing,” Trans. Am. Acad. Ophthalmol. Otolaryngol. 79, 788 (1975).

Lamensdorf, M.

M. Yanoff, F. Kurata, M. Lamensdorf, “Inexpensive Device to Reduce Surgical Light Exposure,” Ophthalmology Inst. Book Suppl. 90 (Suppl), 137 (1983).

Landers, M. B.

M. L. Wolbarsht, M. B. Landers, J. A. C. Wadsworth, W. B. Anderson, “Retinitis Pigmentosa. Clinical Management Based on Current Concepts,” in Retinitis Pigmentosa, Clinical Implications of Current Research, M. B. Landers, M. L. Wolbarsht, J. E. Dowling, A. M. Laites, Eds. (Plenum, New York, 1977).

Lawwill, T.

T. Lawwill, R. S. Crockett, G. Currier, R. B. Rosenberg, “Review of the Macaque Model of Light Damage with Implications for the Use of Ophthalmic Instrumentation,” Vision Res. 20, 1113 (1980).
[CrossRef] [PubMed]

T. Lawwill, S. Crockett, G. Currier, “Retinal Damage Secondary to Chronic Light Exposure. Thresholds and Mechanisms,” Doc. Ophthalmol. 44, 379 (1977).
[CrossRef] [PubMed]

MacDonald, H. R.

H. R. MacDonald, A. R. Irvine, “Light-Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intra-ocular Lens Implantation,” Ophthalmology 90, 945 (1983).

Machemer, R.

D. Fuller, R. Machemer, R. W. Knighton, “Retinal Damage Produced by Intraocular Fiber Optic Light,” Am. J. Ophthalmol. 85, 519 (1978).
[PubMed]

R. Machemer, T. Aaberg, Vitrectomy (Grune & Stratton, New York, 1979).

Mainster, M. A.

M. A. Mainster, W. T. Ham, F. C. Delori, “Potential Retinal Hazards,” Ophthalmology 90, 927 (1983).
[PubMed]

M. A. Mainster, “Spectral Transmittance of Intraocular Lenses and Retinal Damage from Intense Light Sources,” Am. J. Ophthalmol. 85, 167 (1978).
[PubMed]

Mannis, M. J.

M. J. Mannis, B. Becker, “Retinal Light Exposure and Cystoid Macular Edema,” Arch. Ophthalmol. 98, 1133 (1980).
[CrossRef] [PubMed]

Marshall, W. J.

W. J. Marshall, D. H. Sliney, “Hazard Analysis of Broad Band Optical Sources,” Technical Guide TG 085, U.S. Army Environmental Hygiene Agency, Aberdeen Proving Ground, MD (Oct.1981).

McDonald, R. H.

R. H. McDonald, A. R. Irvine, “Light Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intraocular Lens Implantation,” Ophthalmology 90, 945 (1983).
[PubMed]

Meyers, S. M.

S. M. Meyers, R. F. Bonner, “Retinal Irradiance from Vitrectomy Endoilluminators,” Am. J. Ophthalmol. 94, 26 (1982).
[PubMed]

S. M. Meyers, R. F. Bonner, “Yellow Filter to Decrease the Risk of Light Damage to the Retina During Vitrectomy,” Am. J. Ophthalmol. 94, 577 (1982).

Mueller, H. A.

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
[CrossRef] [PubMed]

W. T. Ham, H. A. Mueller, D. H. Sliney, “Retinal Sensitivity to Damage from Short Wavelength Light,” Nature London 260, 153 (1976).
[CrossRef] [PubMed]

Noell, W.

W. Noell, “Possible Mechanisms of Photoreceptor Damage by Light in Mammalian Eyes,” Vision Res. 20, 1163 (1980).
[CrossRef] [PubMed]

Parver, L. M.

L. M. Parver, C. R. Auker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Am. J. Ophthalmol. 90, 964 (1983).

L. M. Parver, C. R. Aucker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Ophthalmology 90, 964 (1983).
[PubMed]

Peyser, R.

D. K. Berler, R. Peyser, “Light Intensity and Visual Acuity Following Cataract Surgery,” Ophthalmology 90, 933 (1983).
[PubMed]

Pitts, D. G.

D. G. Pitts, A. P. Cullen, “Determination of Infrared Radiation Levels for Acute Ocular Cataractogenesis,” A Von Graefe Arch. Klin. Ophthalmol. 217, 285 (1981).

Pomerantzeff, O.

O. Pomerantzeff, J. Giovignon, C. L. Schepens, “Indirect Ophthalmoscope: is the Illumination Level Dangerous?Trans. Am. Acad. Ophthalmol. Otolaryngol. 73, 246 (1969).
[PubMed]

Rosenberg, R. B.

T. Lawwill, R. S. Crockett, G. Currier, R. B. Rosenberg, “Review of the Macaque Model of Light Damage with Implications for the Use of Ophthalmic Instrumentation,” Vision Res. 20, 1113 (1980).
[CrossRef] [PubMed]

Ruffolo, J. J.

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
[CrossRef] [PubMed]

Schepens, C. L.

O. Pomerantzeff, J. Giovignon, C. L. Schepens, “Indirect Ophthalmoscope: is the Illumination Level Dangerous?Trans. Am. Acad. Ophthalmol. Otolaryngol. 73, 246 (1969).
[PubMed]

Sliney, D. H.

D. H. Sliney, “Eye Protective Techniques for Bright Light,” Ophthalmology 90, 937 (1983).
[PubMed]

D. H. Sliney, M. L. Wolbarsht, “Safety Standards and Measurement Techniques for High Intensity Light Sources,” Vision Res. 20, 1133 (1980).
[CrossRef] [PubMed]

W. T. Ham, H. A. Mueller, D. H. Sliney, “Retinal Sensitivity to Damage from Short Wavelength Light,” Nature London 260, 153 (1976).
[CrossRef] [PubMed]

D. H. Sliney, B. C. Freasier, “Evaluation of Optical Radiation Hazards,” Appl. Opt. 12, (1973).
[CrossRef] [PubMed]

D. H. Sliney, M. L. Wolbarsht, Safety with Lasers and Other Optical Sources (Plenum, New York, 1980).

W. J. Marshall, D. H. Sliney, “Hazard Analysis of Broad Band Optical Sources,” Technical Guide TG 085, U.S. Army Environmental Hygiene Agency, Aberdeen Proving Ground, MD (Oct.1981).

Sperling, H. G.

H. G. Sperling, “Are Ophthalmologists Exposing their Patients to Dangerous Light Levels?” Invest. Ophthalmol. Vis. Sci. 19, 989 (1980).
[PubMed]

Tso, M. O. M.

M. O. M. Tso, B. J. Woodward, “Effect of Photic Injury on the Retinal Tissue,” Ophthalmology 9, 952 (1983).

M. O. M. Tso, F. G. La Piana, “The Human Fovea after Sun-Gazing,” Trans. Am. Acad. Ophthalmol. Otolaryngol. 79, 788 (1975).

M. O. M. Tso, B. S. Fine, L. E. Zimmerman, “Photic Maculopathy Produced by the Indirect Ophthalmoscope. I. Clinical and Histopathologic Study,” Am. J. Ophthalmol. 73, 686 (1972).

Wadsworth, J. A. C.

M. L. Wolbarsht, M. B. Landers, J. A. C. Wadsworth, W. B. Anderson, “Retinitis Pigmentosa. Clinical Management Based on Current Concepts,” in Retinitis Pigmentosa, Clinical Implications of Current Research, M. B. Landers, M. L. Wolbarsht, J. E. Dowling, A. M. Laites, Eds. (Plenum, New York, 1977).

Wolbarsht, M. L.

D. H. Sliney, M. L. Wolbarsht, “Safety Standards and Measurement Techniques for High Intensity Light Sources,” Vision Res. 20, 1133 (1980).
[CrossRef] [PubMed]

M. L. Wolbarsht, M. B. Landers, J. A. C. Wadsworth, W. B. Anderson, “Retinitis Pigmentosa. Clinical Management Based on Current Concepts,” in Retinitis Pigmentosa, Clinical Implications of Current Research, M. B. Landers, M. L. Wolbarsht, J. E. Dowling, A. M. Laites, Eds. (Plenum, New York, 1977).

D. H. Sliney, M. L. Wolbarsht, Safety with Lasers and Other Optical Sources (Plenum, New York, 1980).

Woodward, B. J.

M. O. M. Tso, B. J. Woodward, “Effect of Photic Injury on the Retinal Tissue,” Ophthalmology 9, 952 (1983).

Yanoff, M.

M. Yanoff, F. Kurata, M. Lamensdorf, “Inexpensive Device to Reduce Surgical Light Exposure,” Ophthalmology Inst. Book Suppl. 90 (Suppl), 137 (1983).

Zimmerman, L. E.

M. O. M. Tso, B. S. Fine, L. E. Zimmerman, “Photic Maculopathy Produced by the Indirect Ophthalmoscope. I. Clinical and Histopathologic Study,” Am. J. Ophthalmol. 73, 686 (1972).

A Von Graefe Arch. Klin. Ophthalmol. (1)

D. G. Pitts, A. P. Cullen, “Determination of Infrared Radiation Levels for Acute Ocular Cataractogenesis,” A Von Graefe Arch. Klin. Ophthalmol. 217, 285 (1981).

Am. J. Ophthalmol. (8)

M. A. Mainster, “Spectral Transmittance of Intraocular Lenses and Retinal Damage from Intense Light Sources,” Am. J. Ophthalmol. 85, 167 (1978).
[PubMed]

S. M. Meyers, R. F. Bonner, “Retinal Irradiance from Vitrectomy Endoilluminators,” Am. J. Ophthalmol. 94, 26 (1982).
[PubMed]

S. M. Meyers, R. F. Bonner, “Yellow Filter to Decrease the Risk of Light Damage to the Retina During Vitrectomy,” Am. J. Ophthalmol. 94, 577 (1982).

D. Fuller, R. Machemer, R. W. Knighton, “Retinal Damage Produced by Intraocular Fiber Optic Light,” Am. J. Ophthalmol. 85, 519 (1978).
[PubMed]

W. T. Ham, H. A. Mueller, J. J. Ruffolo, D. Guerry, R. K. Guerry, “Action Spectrum for Retinal Injury from Near-Ultraviolet Radiation in the Aphakic Monkey Eye,” Am. J. Ophthalmol. 93, 299 (1982).
[PubMed]

B. F. Hochheimer, S. A. D’Anna, J. L. Calkins, “Retinal Damage from Light,” Am. J. Ophthalmol. 88, 1039 (1979).
[PubMed]

L. M. Parver, C. R. Auker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Am. J. Ophthalmol. 90, 964 (1983).

M. O. M. Tso, B. S. Fine, L. E. Zimmerman, “Photic Maculopathy Produced by the Indirect Ophthalmoscope. I. Clinical and Histopathologic Study,” Am. J. Ophthalmol. 73, 686 (1972).

Am. J. Optom. Physiol. Opt. (1)

J. Kossol, C. Cold, P. Dahaw-Barker, “Spectral Irradiances of and Maximal Permissible Exposures to Two Indirect Ophthalmoscopes,” Am. J. Optom. Physiol. Opt. 60, 616 (1983).
[CrossRef] [PubMed]

Ann. Ophthalmol. (1)

M. M. Henry, L. M. Henry, L. M. Henry, “A Possible Cause of Chronic Cystic Maculopathy,” Ann. Ophthalmol. 9, 455 (1977).
[PubMed]

Appl. Opt. (1)

D. H. Sliney, B. C. Freasier, “Evaluation of Optical Radiation Hazards,” Appl. Opt. 12, (1973).
[CrossRef] [PubMed]

Arch. Ophthalmol. (4)

J. L. Calkins, B. G. Hochheimer, “Retinal Light Exposure from Operation Microscopes,” Arch. Ophthalmol. 97, 2363 (1978).
[CrossRef]

M. J. Mannis, B. Becker, “Retinal Light Exposure and Cystoid Macular Edema,” Arch. Ophthalmol. 98, 1133 (1980).
[CrossRef] [PubMed]

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 79, 69 (1968).
[CrossRef] [PubMed]

T. Kuwabara, R. A. Gorn, “Retinal Damage by Visible Light; An Electron Microscopic Study,” Arch. Ophthalmol. 70, 187 (1968).

Carl Zeiss Bull. (1)

M. M. Henry, L. M. Henry, L. M. Henry, Carl Zeiss Bull. (11May1981).

Doc. Ophthalmol. (1)

T. Lawwill, S. Crockett, G. Currier, “Retinal Damage Secondary to Chronic Light Exposure. Thresholds and Mechanisms,” Doc. Ophthalmol. 44, 379 (1977).
[CrossRef] [PubMed]

Invest. Ophthalmol. Vis. Sci. (2)

G. A. Griess, M. F. Blankenstein, “Additivity and Repair of Actinic Retinal Lesions,” Invest. Ophthalmol. Vis. Sci. 20, 803 (1981).
[PubMed]

H. G. Sperling, “Are Ophthalmologists Exposing their Patients to Dangerous Light Levels?” Invest. Ophthalmol. Vis. Sci. 19, 989 (1980).
[PubMed]

Nature London (1)

W. T. Ham, H. A. Mueller, D. H. Sliney, “Retinal Sensitivity to Damage from Short Wavelength Light,” Nature London 260, 153 (1976).
[CrossRef] [PubMed]

Ophthalmology (8)

D. K. Berler, R. Peyser, “Light Intensity and Visual Acuity Following Cataract Surgery,” Ophthalmology 90, 933 (1983).
[PubMed]

E. E. Boldrey, B. T. Ho, R. D. Griffeth, “Retinal Burns Occurring at Cataract Extraction,” Ophthalmology 91, 1297 (1984).
[PubMed]

H. R. MacDonald, A. R. Irvine, “Light-Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intra-ocular Lens Implantation,” Ophthalmology 90, 945 (1983).

M. O. M. Tso, B. J. Woodward, “Effect of Photic Injury on the Retinal Tissue,” Ophthalmology 9, 952 (1983).

D. H. Sliney, “Eye Protective Techniques for Bright Light,” Ophthalmology 90, 937 (1983).
[PubMed]

M. A. Mainster, W. T. Ham, F. C. Delori, “Potential Retinal Hazards,” Ophthalmology 90, 927 (1983).
[PubMed]

R. H. McDonald, A. R. Irvine, “Light Induced Maculopathy from the Operating Microscope in Extracapsular Cataract Extraction and Intraocular Lens Implantation,” Ophthalmology 90, 945 (1983).
[PubMed]

L. M. Parver, C. R. Aucker, B. S. Fine, “Observations on Monkey Eyes Exposed to Light from an Operating Microscope,” Ophthalmology 90, 964 (1983).
[PubMed]

Ophthalmology Inst. Book Suppl. (1)

M. Yanoff, F. Kurata, M. Lamensdorf, “Inexpensive Device to Reduce Surgical Light Exposure,” Ophthalmology Inst. Book Suppl. 90 (Suppl), 137 (1983).

Photochem. Photobiol. (1)

W. T. Ham, H. A. Mueller, J. J. Ruffolo, A. M. Clarke, “Sensitivity of the Retina to Radiation Damage as a Function of Wavelength,” Photochem. Photobiol. 29, 735 (1979).
[CrossRef] [PubMed]

Trans. Am. Acad. Ophthalmol. Otolaryngol. (2)

M. O. M. Tso, F. G. La Piana, “The Human Fovea after Sun-Gazing,” Trans. Am. Acad. Ophthalmol. Otolaryngol. 79, 788 (1975).

O. Pomerantzeff, J. Giovignon, C. L. Schepens, “Indirect Ophthalmoscope: is the Illumination Level Dangerous?Trans. Am. Acad. Ophthalmol. Otolaryngol. 73, 246 (1969).
[PubMed]

Vision Res. (4)

D. H. Sliney, M. L. Wolbarsht, “Safety Standards and Measurement Techniques for High Intensity Light Sources,” Vision Res. 20, 1133 (1980).
[CrossRef] [PubMed]

W. Noell, “Possible Mechanisms of Photoreceptor Damage by Light in Mammalian Eyes,” Vision Res. 20, 1163 (1980).
[CrossRef] [PubMed]

J. L. Calkins, B. F. Hochheimer, S. A. D’Anna, “Potential Hazards from Specific Ophthalmic Devices,” Vision Res. 20, 1039 (1980).
[CrossRef] [PubMed]

T. Lawwill, R. S. Crockett, G. Currier, R. B. Rosenberg, “Review of the Macaque Model of Light Damage with Implications for the Use of Ophthalmic Instrumentation,” Vision Res. 20, 1113 (1980).
[CrossRef] [PubMed]

Other (6)

R. Machemer, T. Aaberg, Vitrectomy (Grune & Stratton, New York, 1979).

W. J. Marshall, D. H. Sliney, “Hazard Analysis of Broad Band Optical Sources,” Technical Guide TG 085, U.S. Army Environmental Hygiene Agency, Aberdeen Proving Ground, MD (Oct.1981).

D. H. Sliney, M. L. Wolbarsht, Safety with Lasers and Other Optical Sources (Plenum, New York, 1980).

M. L. Wolbarsht, M. B. Landers, J. A. C. Wadsworth, W. B. Anderson, “Retinitis Pigmentosa. Clinical Management Based on Current Concepts,” in Retinitis Pigmentosa, Clinical Implications of Current Research, M. B. Landers, M. L. Wolbarsht, J. E. Dowling, A. M. Laites, Eds. (Plenum, New York, 1977).

American National Standards Institute Standard Z-136. 1-1980, Safe Use of Lasers (ANSI, New York, 1980).

American Conference of Industrial Hygienists Threshold Limit Values for Chemical Substances and Physical Agents in the Workroom Environment with Intended Changes for 1984 (ACGIH, Cincinnati, 1984).

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Figures (4)

Fig. 1
Fig. 1

Example of a free-standing surgical microscope with fiber-optic illumination system.

Fig. 2
Fig. 2

Spectral irradiance of two Carl Zeiss OPMI-6 (SN 23678) light sources. Note that the infrared absorbing filter of one must be more effective than the other. The right-hand-side scale applies to the dashed-line spectrum.

Fig. 3
Fig. 3

Spectral irradiance of the Applied Fiber Optics 0592 (SN 76-025) light source.

Fig. 4
Fig. 4

Intrabeam photographs of a direct filament source (left) and fiber-optic source (right) as would be seen by the patient.

Tables (3)

Tables Icon

Table I Sources Measured

Tables Icon

Table II Summary of Radiometric Values and Hazard Calculations

Tables Icon

Table III Spectral Weighing Functions for Assessing Retinal Hazards from Broadband Optical Sources

Equations (13)

Equations on this page are rendered with MathJax. Learn more.

L = E / Ω s and Ω s = A s / r 2 .
E r = 0.27 L s · τ · d e 2 .
τ eff = Σ L λ · α · τ · Δ λ / Σ L λ · Δ λ .
L v = 683 Σ V λ · L λ · Δ λ .
E v = 683 Σ V λ · E λ · Δ λ .
L ( HAZ ) = 1 / ( α t 1 / 2 ) ,
L p ( HAZ ) = 100 J / ( cm 2 · sr ) for t < 10 4 s , L ( HAZ ) = 10 mW / ( cm 2 · sr ) for t > 10 4 s .
t max = 100 J / ( cm 2 · sr ) / L ( blue ) .
400 1400 E λ · t · B λ · Δ λ 10 mJ / cm 2 ( t 10 4 s ) ,
400 1400 E λ · B λ · Δ λ 1 μ W / cm 2 ( t 10 4 s ) .
t mex = 10 mJ · cm - 2 / E ( bule ) .
770 1400 E λ Δ λ = 0.6 / α
sun : 1.3 W / ( cm 2 · sr · nm ) , snow : 2.6 × 10 - 5 W / ( cm 2 · sr · nm ) , sky : 7 × 10 - 6 W / ( cm 2 · sr · nm ) .

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