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3.  Protection of Employees with Defective Vision 
An employer has a special duty towards a one-eyed man (Paris v. Stepney Borough Council, 1951) but does not have a special duty to a man with normal sight because employment could normally continue with good monocular vision. Clearly, a man with very defective vision in one eye needs the same consideration as a one-eyed man so we examined the level of visual acuity which should alert the employer to giving a man special consideration.
Two consultant oculists examined a chemist with Leber's syndrome and found 6/24 vision in each eye. One consultant advised taking greater care of the man's eyes because if one eye was lost, or became further damaged, he would have difficulty in continuing laboratory work. His colleague advised that the loss to the man would be of binocular vision and a no greater proportional loss than to the man with normal sight.
Loss of binocular vision is considered greater in a man with poor eyesight because his visual acuity might, as in the present case, go from 6/18 using both eyes to 6/24 using one. We consider that wherever an employee's (corrected) sight is 6/18 or less in either eye then his case should be given special consideration which may then indicate the need for the provision of extra eye protection.
PMCID: PMC1008586  PMID: 4961507
4.  Phosphorus Necrosis of the Jaw: A Present-day Study 
A historical note on the aetiology of phossy jaw shows that present-day knowledge is little greater than it was a century ago. The varied clinical course of the disease is described together with a report of 10 classical cases not previously reported. Six cases, not amounting to true necrosis but in which healing after dental extraction was delayed, and described, and mention is made of the noticeable differences in the oral state and appearances of tartar of healthy workmen exposed to phosphorus compared with healthy workmen not exposed. But no systematic differences of any kind were found in the incidence of general infections, fractures of bones, haematological findings, and biochemical studies of blood and urine in two groups of healthy men most exposed and least exposed to phosphorous in the same factory. An intensive study in hospital of a case of classical necrosis showed no departure from normal, except delayed healing following bone biopsy from the iliac crest, and a reversed polymorphonuclear/lymphocyte ratio.
In the discussion the time of onset of necrosis after first exposure to phosphorus, clinical and radiological diagnosis, the organisms present, personal susceptibility, the appearance of the sequestra, and regeneration of bone are considered. An up-to-date note on prevention of the disease is given, although this has met with only partial success. Some persons are highly susceptible and, whilst complete protection is impossible in the light of our present knowledge, early diagnosis and modern treatment have robbed the disease of its terrible manifestations of Victorian times and turned it into a minor, although often uncomfortable complaint, with little or no resulting disability.
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PMCID: PMC1038164  PMID: 14449812

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