Objectives <p>To evaluate the impact of a law amendment that reduced the eye lens dose limit on the use of personal dosimeters among radiation workers in medical settings.</p> Materials and methods <p>A repeated cross-sectional survey was conducted at medical institutions across three periods: before the law amendment (control) and during the promulgation and implementation periods. Surveyors (radiological technologists) at each participating medical institution recorded dosimeter-wearing status among radiation workers. Data were collected via mail or email and analysed. The observed workers included physicians, nurses, and radiological technologists.</p> Results <p>The surveys were collected from 1194 workers in the control period, 1374 in the promulgation period, and 1194 in the implementation period, totalling 3762 workers. Post-law amendment, the overall wearing rate of primary personal dosimeters significantly increased from 64.6% to 77.9% (<i>p</i> &lt; 0.001). Significant increases in wearing rates were observed among physicians and radiological technologists (<i>p</i> &lt; 0.001). Among occupations, physicians showed the lowest wearing rates across all periods (control: 35.8%, promulgation: 56.7%, implementation: 62.6%), whereas radiological technologists showed the highest (control: 92.7%, promulgation: 98.5%, implementation: 99.5%). Regarding physician specialities, orthopaedic surgery exhibited the lowest compliance (control: 11.3%, promulgation: 35.4%, implementation: 24.7%). The proportion of workers without provision of a personal dosimeter declined from 5.9% to 1.9% (<i>p</i> &lt; 0.001).</p> Conclusions <p>Despite overall improvement following the law amendment, low compliance among physicians, particularly in orthopaedics, indicates the need for targeted interventions.</p> Critical relevance statement <p>Although dosimeter-wearing rates improved after Japan’s eye dose limit revision, persistent low physician compliance—especially in orthopaedics—highlights the need for targeted strategies to strengthen radiation protection in clinical practice.</p> Key Points <p><UnorderedList Mark="Bullet"> <ItemContent> <p>The effect of reduced eye dose limits on dosimeter use remains unclear.</p> </ItemContent> <ItemContent> <p>Personal dosimeter usage increased significantly after the law amendment. Compliance remained low among orthopaedic physicians despite regulatory tightening.</p> </ItemContent> <ItemContent> <p>Targeted interventions are needed for low-compliance groups to ensure radiation protection.</p> </ItemContent> </UnorderedList></p> Graphical Abstract <p></p>