Therefore, early diagnosis of these diseases of the central retina and optic nerve appears essential, and previous reports have demonstrated its benefits in preserving patient’s vision. Unfortunately, at this late stage, often lesions are permanent and the possibility of visual recovery is marginal. These diseases are completely asymptomatic in early stages and slowly progress to greater stages when symptoms developed and diagnosis is made. In modern societies, in the developed world, the diseases of the central retina and glaucoma are the most frequent cause of severe visual loss. These scarce publications support the need for periodic ocular reviews and highlight the value of vision and the importance of visual health prevention, especially in elderly patients. There is a literature lack about the role of ophthalmology in these routine occupational health checkups, and only few studies have been reported.
Although no data or extensive studies on the general prevalence of injuries are available, previous studies have reported a positive impact of these reviews on certain aspects, such as enhancing respiration, improving diet, assessing low back pain, or providing economic data that demonstrate absenteeism reduction in companies with these types of examinations. Similar checkups are carried out in other countries of the European Union and North America as a previous assessment to start a job. In some cases, other tests such as radiology studies may be included.
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Routinely, other complementary tests are often included in the reviews such as a control of the best corrected visual acuity, an audiometry, a spirometry, an electrocardiogram, and blood and urine analysis with standard profiles (i.e., full blood count, glucose, U&E, etc.). A routine occupational health examination usually consists of a general past medical history of the worker’s health status and a structured general physical examination. Medical revisions should be carried out by qualified personnel and should always be supervised by a medical specialist in occupational health. In Spain, the regulation of Occupational Risk Prevention Services arranges medical checkups before starting work (for the first time or after a long time off) and periodically, normally once a year. Regulations differ between countries, being mandatory or voluntary depending on the framework, except in certain sectors such as the chemical industry or other industries where the job itself implies a specific risk for the workers. Routine occupational health checkups for employees are commonly organized in a periodical basis by employers and companies in many countries. Mass screening of retinal and optic disc abnormalities during occupational health routine checkups is a feasible, quick, and efficient tool for early detection of potential vision-threatening disease markers. Men had more abnormalities in retinal fundus images than women (8.6 vs. The presence of abnormalities was associated with greater age, being 5%, 7.9%, 12.6%, and 19.7% in workers less than 40 years, from 40 to 49, 50–59, and ≥ 60 years ( p < 0.05), respectively. Of the workers, 7.8% presented abnormalities in retinal fundus images, being the main findings choroidal nevus (2.4%), macular pigment abnormalities (1.5%), glaucomatous optic disc (1.2%), and macular signs of high myopia (1.1%). Mean duration of the test was around 2 min. Mean age was 41.1 years old, 43.9% men and 56.1% women. ResultsĪ total of 19,881 workers were evaluated in 52 centers.
The main items evaluated were the detection of retinal abnormalities and the relationship between retinal findings and demographic data such as age and sex.
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A team of ophthalmologists, all retinal specialists, remotely read the images using a custom-made software and sent telematic reports of findings within 24–48 h. Retinal fundus images were captured by technicians, and images and data were anonymized and sent securely to a remote server. Participants were volunteers recruited from staff within work centers. MethodsĬross-sectional, first year screening program outcomes audit. To evaluate the first year outcomes of a remote screening program for detection of retinal diseases using handheld nonmydriatic cameras in occupational routine checkups performed onsite at work centers.
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