Eye care for artisans: welding, grinding and dust

If you work with metal, wood, cement or chemicals, your eyes are exposed to more risk in a week than most people's are in a year. This is written for that work specifically.

Welding

The arc emits intense ultraviolet. It burns the surface of the cornea, and because the cornea's pain nerves take hours to respond, you feel nothing at the time. Six to twelve hours later — usually in the middle of the night — the eyes become intensely painful, streaming, and unable to tolerate light.

Arc eye heals in a day or two. What it tells you is that the exposure was real, and repeated exposure over years contributes to cataract and to pterygium.

The shield must match the process. A shade too light passes too much UV; too dark and you cannot see the weld, so you lift the shield. An auto-darkening helmet is worth the money precisely because it removes the temptation to work with it up.

Bystanders get burned too. The apprentice holding the workpiece, the person at the next bench, the customer waiting. Screens around the work area protect them, and are the most commonly skipped precaution on a Lagos welding site.

Grinding is a separate hazard from welding and needs separate protection — impact spectacles or a face shield, not the welding helmet.

Grinding, chiselling and hammering metal

The characteristic injury is a small high-velocity fragment. It can enter the eye through a tiny self-sealing wound, cause little pain, and leave the person to carry on working. Metal fragments left inside the eye cause progressive damage, and iron in particular is toxic to the retina over months.

Anything that felt like it hit your eye during grinding or hammering should be examined, even if it feels fine now. This is the single most important sentence in this article. An examination takes minutes and can identify a penetrating injury that would otherwise be found far too late.

Impact-rated safety spectacles with side protection, worn every time. Ordinary prescription spectacles are not impact-rated and a shattered lens makes the injury worse.

Cement, lime and chemicals

Alkali burns are the worst category. Cement, lime and caustic cleaning agents penetrate tissue and keep damaging it for as long as they remain in contact — unlike acids, which tend to coagulate and self-limit.

Irrigate immediately. Clean water, a large volume, for at least twenty minutes, holding the lids open and rolling the eye around. Do not stop to look for a specialised eye wash. Do not stop to find transport first. The volume and the speed determine the outcome more than anything a hospital does afterwards, and every minute counts.

Then go to hospital, continuing to irrigate on the way if you can. Take the container or the product name with you.

Sealed chemical goggles when handling liquids. Ordinary safety spectacles do not stop a splash arriving from below or from the side.

Wood and dust

Sawdust and site dust cause corneal abrasions and conjunctivitis, and organic material carries a higher risk of fungal infection than metal does. Wood fragments should be removed properly rather than rubbed at.

Chronic dust exposure also contributes to pterygium — the fleshy growth across the surface of the eye that is so common among people who work outdoors here. Wraparound safety spectacles address dust, wind and UV in one piece of equipment.

What not to do

Do not let anyone remove a foreign body with a pin, a matchstick, a piece of cloth or the corner of a handkerchief. This turns a superficial speck into a corneal abrasion and introduces infection.

Do not apply herbal preparations, breast milk, sugar water or urine. These are common and they are the reason a proportion of minor injuries become corneal ulcers.

Do not use someone else's leftover drops, particularly steroid drops, which can cause devastating progression of an infection.

Do not rub. Rubbing an eye with a fragment in it grinds it further in.

What to do

Foreign body that will not come out with blinking and clean water: see an optometrist. It takes a few minutes to remove under magnification.

Chemical splash: irrigate for twenty minutes, then hospital.

Suspected penetrating injury: cover with a rigid shield without pressing, go to hospital, do not eat or drink in case surgery is needed.

Arc eye: rest in a dark room, see someone if it has not settled in a day.

And have a baseline eye examination. Knowing what your vision was before an incident matters, and the examination finds the uncorrected prescriptions that themselves cause accidents.