Retinal phototoxicity: a review of standard methodology for evaluating retinal optical radiation hazards

Optical radiation (light) safety standards can be difficult to use for the evaluation of light hazards to the retina, even for persons experienced in radiometry and photometry. This paper reviews terminology and methodology for evaluating optical radiation hazards to the retina in accordance with international standard ISO 15004-2 Ophthalmic instruments-Fundamental requirements and test methods, Part 2: Light hazard protection (2007). All optical radiation safety standards use similar methods. Specifically, this paper illustrates how to evaluate the retinal hazards from various ophthalmic instruments including the following: diffuse illumination of the cornea; incident light diverging at the cornea (direct ophthalmoscope, operation microscope, fixation lamp); and incident light converging at the cornea (indirect ophthalmoscope, fundus camera, slit lamp biomicroscope). A brief review of radiometry and the use of certified optical components by manufacturers as specified by the ISO standard is also provided. Finally, the authors provide examples of the use of photometric measurements in hazard evaluation.