Specific health surveillance as a preventive tool in dry eye syndrome
It is common for common diseases to manifest or worsen after exposure to certain risk factors present in the workplace. Of the various eye diseases that can affect workers, SOS is the most common.
Law 31/95, on Occupational Risk Prevention (LPRL) 23 and its implementing regulations, determine which are the functions to be carried out by the occupational physician of the prevention service to achieve adequate care for workers: health promotion, prevention of work-related diseases, specific health surveillance, care work, expert function, management, and research and training. It is also included in its Art. 22 the obligation of employers to watch over workers avoiding damage.
Specific health surveillance (VSE) is the basic preventive tool from the perspective of occupational medicine and is determined by a specific strategy, that is, based on the risks inherent to the job and stipulated for each type of risk factor. To which the worker is exposed and adjusted to protocols24. Highlight the double aspect of this work: individual and collective.
In art. 37 of RD 39/199725, which approves the Regulation of Prevention Services, it is stated: specific health examinations must be carried out in the following cases:
to) Initial evaluation of workers' health after incorporation to work or after assigning tasks that involve new risks. b) Periodic health examinations are based on the specific risk to which the worker is exposed. c) A new evaluation of workers who resume work after prolonged absences from it for health reasons, to detect the possible professional origin of such absences and recommend an appropriate action to protect the worker.
The specific protocols (PVSE) necessary at all times are used, depending on the risk or risks of your activity. Adjusting specifically to the prevention of SOS and some of the labor factors most frequently related to its appearance, those published by the Ministry are taken as a reference, which will serve as a guide to the occupational doctor when carrying out health surveillance, in this specific case: PVD, ionizing radiation, chemical agents.
Due to its greater implication in this disease, outstanding among these protocols is the one applicable to PVD users, defined by Royal Decree 488/199726 as any worker who habitually and during a relevant part of their normal working day uses a computer with a display screen. Display. The risks associated with the effective use of such equipment are mainly musculoskeletal disorders, visual problems, and mental fatigue.
In those positions in which there is greater exposure to risk factors related to the development of SOS, the occupational physician must carry out a complete ocular evaluation and screening for the syndrome. Depending on the results of the examinations and tests indicated, the severity of the condition27 is determined: mild, moderate, and severe and, based on this, the preventive behavior to be followed and the care coordination and referral, if deemed necessary, to the primary care or family doctor and ophthalmology specialist.
To carry out complete surveillance of workers’ health, it is necessary to epidemiologically study the results of individual examinations and assess the impact of working conditions on all workers. The detection of multiple cases of a disease in workers who perform similar tasks serves as an alert to study whether there are labor factors related to this increase in incidence and determine the necessary preventive actions to be carried out in coordination with the prevention service technicians.
Article 25 of Law 31/1995, relating to the protection of workers especially sensitive to certain risks, states that “the employer will specifically guarantee the protection of workers who, due to their characteristics or known biological status, including those who have recognized the situation of physical, mental or sensory disability, they can be especially sensitive to the risks derived from work. It must, within the technical possibilities of the company, guarantee a new position under these limitations.
When the occupational doctor detects or has knowledge of a worker with SOS, he must confront this diagnosis with the requirements of the job and determine if she can continue doing it or if, provisionally or definitively and depending on the cause of dry eyes, the performance of some tasks must be restricted or a change of position is necessary.
Finally, make a brief reference to the care functions of the occupational doctor, which include the detection and treatment of work-related illnesses developed by the people in their charge. The diagnosis of SOS within the framework of occupational medicine is carried out through directed anamnesis, symptom questionnaires, eye examination, and basic diagnostic techniques, such as the Fluotest or the Schirmer test. If a disease situation is detected in the initial stages, early treatment can stop the natural evolution of the disease and act in secondary prevention.
Pulsed Light Treatment for Dry Eye
In addition to the procedures mentioned above, at Oftalvist’s Dry Eye Unit, we have taken a step towards new pulsed light technologies that offer much more truthful and useful data to establish a more effective, safe, long-lasting treatment.
For this reason, we have non-invasive and painless high-frequency pulsed light laser technologies that serve to stimulate the meibomian glands without the need to enter the operating room.
The pulsed light helps stimulate circulation and acts on nerve endings to control the production and secretion of fats, improving the visual quality of the patient with excellent results.
For more information about our procedure for pulsed light treatment, click here.
Dry eye prevention
Those most susceptible to dry eye can find relief by incorporating omega-3 fatty acids into their diet that can be found in foods such as oily fish, salmon, sardines, tuna, mackerel, or trout, as well as shellfish, like crab, prawns, or mussels.
Foods with Omega 3
Plant foods such as flax seeds or chia seeds are also recommended, as well as dried fruits such as walnuts and drinking plenty of fluids.
Recent studies affirm that diets low in omega-3 and antioxidants but rich in omega-6 produce oxidative stress that generates inflammatory effects on the meibomian glands, the cornea, and the conjunctiva.
In addition, it is also recommended to be away from dry environments, drafts, tobacco smoke, and air conditioners that can greatly irritate our eyes as they promote the evaporation of tears. It is also advisable to use a humidifier and even protective sunglasses in winter every month of the year.
On the other hand, it is advisable to blink frequently, clean the eyelashes (where the lacrimal glands are located) with hot compresses, or use artificial tears from time to time to compensate for the lack of natural tears.