title: Quantitative assessment of the blue-light hazard during indirect ophthalmoscopy and the increase in the "safe" operating period achieved using a yellow lens.
abstract: OBJECTIVE
  The indirect ophthalmoscope presents a blue-light hazard with the potential for causing photochemical injury to the retina. In this study, this hazard was assessed with respect to the threshold limit values (TLVs) recently adopted by the American Conference of Governmental Industrial Hygienists.
  
  
  METHODS
  Spectral radiometric measurements were made from a standard indirect ophthalmoscope headset used in conjunction with either a clear or a yellow lens. The results were weighted spectrally with the published blue-light hazard function.
  
  
  RESULTS
  When the clear lens was used, the TLV was exceeded after approximately 2.5 minutes. The yellow lens filtered out the more hazardous blue wavelengths of light and this increased the "safe" operating period by a factor of approximately 20.
  
  
  CONCLUSIONS
  In clinical practice, with a clear lens, the TLV could be exceeded easily if the patient is subjected to prolonged or repeated examination because the blue-light hazard is additive in a linear manner for periods as long as 3 hours with a potential for a cumulative effect over longer periods. Furthermore, some ophthalmic patients, such as those with aphakia, are less tolerant of blue-light than healthy subjects. In the interests of patient safety, it is recommended that yellow lenses are considered for use for routine indirect ophthalmoscopy.
authors.affiliation: West of Scotland Health Boards' Department of Clinical Physics and Bio-Engineering, Glasgow.
authors.forename: M S
authors.initials: MS
authors.lastname: Bradnam
authors.forename: D M
authors.initials: DM
authors.lastname: Montgomery
authors.forename: H
authors.initials: H
authors.lastname: Moseley
authors.forename: G N
authors.initials: GN
authors.lastname: Dutton
mesh_terms: D004869:Equipment Safety / Q000379:methods; D006801:Humans; D007909:Lenses; D008027:Light / Q000009:adverse effects; D008433:Mathematics; D008452:Maximum Allowable Concentration; D019721:Ophthalmoscopes; D009887:Ophthalmoscopy / Q000009:adverse effects; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D012160:Retina / Q000528:radiation effects