Screens are being incorporated into operating rooms with greater regularity. They provide the view of the patient during minimally invasive procedures and access to important information during open procedures. Unfortunately, traditional white supplemental surgical lighting in operating rooms can compromise the surgeon’s ability to clearly view images on a screen, so it has become common practice to turn those overhead lights off, leaving surgical staff to fumble around in the dark.
White supplemental surgical lighting can interfere with a surgeon’s view of an image on a screen in many ways. Reflected glare occurs when the bright surface of a light source is reflected off of the screen, creating a hot spot that obstructs the image. Even without a bright spot, white supplemental surgical lighting can negatively affect the image on the screen by washing it out and making it less crisp.
The common practice of turning overhead lights off during a procedure is not an optimal OR solution. When the light level in a room falls to less than 0.1 lux, the eye’s sensitivity shifts from fine detail detection to light detection, making it more sensitive to the available low light levels, but less able to see details and colors. This means that while the low light level may minimize reflected glare and image wash out, it may also negatively impact the surgeon’s visual acuity.
Surprisingly, the answer to this life-impacting OR hack is green lighting. Using green supplemental surgical lighting in an OR addresses many of the issues caused by white supplemental lighting.
Minimize reflected glare. Green light reduces the occurrence of reflected glare on the monitors. Even if the monitor is positioned in such a way that the surface of the supplemental lighting fixtures can be detected on the screen, the green light does not create a blinding hot spot that obstructs the surgeon’s view of the procedure.
Improve contrast of the image. The presence of ambient green lighting, and its reflection off of a monitor, improves the depth and contrast of the image on the screen.
Increase perimeter lighting levels. Green lighting can provide enough illumination for support staff to perform their jobs and safely move around the space without compromising the surgeon’s operating line of sight.
Improve visual acuity and comfort of the surgeon. Green supplemental lighting enables surgeons to benefit from higher levels of light, which allows the human eye to see in greater level of detail and reduces the disparity between bright and dimly lit areas that can cause eyestrain.
Reduce afterimage. Green supplemental lighting combats the experience of afterimage during an open procedure. When a surgeon looks up from the surgical site, the room has a green hue, which immediately engages the rested blue and green photoreceptors that would typically create the afterimage in a white light environment. The green ambient lighting allows the red photoreceptors to rest until the surgeon looks back down to the surgical site.
If you are interested in diving deeper into this topic, specification-grade lighting manufacturer Kurtzon created an AIA-accredited course, “How to Avoid Common Visual Issues in an Operating Room with the Right Light.” This 1.0 LU/HSW course details the many ways that white supplemental surgical light interferes with a surgeon’s view of the patient and the advantages of using narrow spectrum green lighting fixtures to bring green light into an OR.