Lasers
There are multiple laser systems at the CFN. Users who will work with the
following class 3b or 4 laser systems are required to complete the Laser
Safety (TQ-LASER) training and comply with OMC Laser Medical Surveillance:
- Createc Low Temperature Scanning Tunneling Microscope, Proximal
Probes Facility, Room 1L39, or
- Amplified Ti:Sapphire Laser System, Ultrafast Optical Facility, Room
1L01B
- Time Correlated Single Photon Counting (TCSPC) Spectroscopy and
Microscopy, Soft/Bio Materials Facility, Room 1L01B
Laser Medical Surveillance Form
The purpose of the Laser Medical
Surveillance form is to provide BNL-OMC with information necessary to
determine that an individual to be cleared as a laser user at BNL has met
the medical requirements of ANSI Standard Z136.1-2000 governing the
safe use of lasers.
This standard requires each Class 3b and 4 laser user to have a
pre-assignment eye examination by an ophthalmologist, which is recorded on
Part B of the Laser Medical Surveillance form.
Instructions to Laser User
- As soon as possible, contact one of the contracted local
ophthalmologists from the list below and request an appointment for a
“laser eye exam for Brookhaven Lab.” (Note: You may also obtain this
exam from a Board Certified ophthalmologist other than those listed.
However, for BNL employees, BNL cannot guarantee payment. Consult with
your BNL supervisor to discuss payment issues.)
- Complete Part A of the form. This provides BNL-OMC with needed
contact and medical information. The ophthalmologist will record his/her
examination on Part B.
- The ophthalmologist will then fax the form to BNL-OMC at
631-344-7366. This is a secure, clinic fax that can receive confidential
medical information. BNL-OMC’s voice number for problems or questions is
631-344-3670. If unable to fax, mail as soon as possible to BNL-OMC at
Brookhaven National Laboratory, Building 490, Upton, NY 11973.
- After receipt of the form, BNL-OMC will contact the user if
additional information or a skin examination is required.
A laser user who has already had a laser eye exam can submit this exam to
BNL-OMC in lieu of a new laser eye exam. BNL-OMC will then consider whether
the submitted exam is acceptable, or whether a new exam will still be
required. Generally, to be acceptable, the submitted exam must
- be performed by a Board Certified ophthalmologist;
- provide substantially the same information that is requested in Part
B of the attached form;
- have been performed within the last 3 years, with no laser eye
accidents or changes in vision subsequent to the exam.
The laser user who wishes to submit a recent laser eye exam for
consideration by BNL-OMC must do the following
- Fill in Part A of the form.
- Fax Part A of the form to BNL-OMC at 631-344-7366, along with the
written record of the laser eye exam. (If unable to fax, mail as soon as
possible to BNL C at Occupational Medicine Clinic, Brookhaven National
Laboratory, Bldg. 490, Upton, NY 11973-5000.)
- BNL-OMC will contact the laser user if additional information or
examinations are required.
Contracted Local Ophthalmologists
Dr. Charles Rothberg
331 East Main
Patchogue, NY 11772
631-758-5300
The Ophthalmic Center
Dr. Vincent Basilice
3400 Nesconset Highway
East Setauket, NY 11733
631-751-2020
East End Eye Associates
Dr. Lewis Roberts
669 Whiskey Road
Ridge, NY 11961
631-744-8020
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Last Modified: April 1, 2009 Please forward all questions about this site to:
Pam Ciufo.
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