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Marcus H. Colyer, Michael J. Mines, Farhad Safi, Dal Chun, Michael Smith; Ocular Injuries Treated at Walter Reed Army Medical Center: March 2003 - March 2009. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5582.
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© ARVO (1962-2015); The Authors (2016-present)
To report the injury patterns and visual outcomes of patients evaluated by the Walter Reed Army Medical Center Ophthalmology Service between 2003 and 2009
Retrospective, non-comparative case series of 783 eyes of 574 military healthcare beneficiaries who were evaluated by the Walter Reed Army Medical Center Ophthalmology Service from January 2002 through March 2009 with a diagnosis of ocular trauma. Injury characteristics, specific surgical techniques employed, and postoperative visual and anatomic outcomes at 6 months and final follow-up were evaluated.
The average age was 27.2±7.3 years (range 17-57 years). The median ocular trauma score was 80±26 (range 12-100). Closed globe injuries comprised 347 eyes (44%) while open globe injuries occurred in 289 eyes (37%). Of eyes sustaining closed globe injuries, zone 1 and 2 injuries occurred in 158 eyes (20%), while zone 3 injuries occurred in 199 eyes (25%). Intraocular foreign bodies were present in 118 eyes with open globe injuries (15%), while perforating injuries occurred in 74 eyes (9.5%). Simple penetrating injuries occurred in 41 eyes (5%), while blunt-force globe ruptures occurred in 54 eyes (6.9%). Orbital or eyelid injuries were present in 421 eyes (54%) while neuro-ophthalmic injuries occurred in 176 eyes (23%). In total, 336 surgical procedures were performed on 237 patients. The average initial logMAR acuity was 0.75 ± 1.0, while at 6 months average best corrected visual acuity was 0.39 ± 0.74. At final follow-up, 425 patients (54%) achieved 20/40 or better visual acuity. Eighty-nine eyes (11%) were enucleated at final follow-up, and 19 patients (3%) were bilaterally legally blind at final follow-up.
Nearly 10% of all casualties sustained ocular injury; nearly half of those patients have been treated at the Walter Reed Army Medical Center. Fortunately, the majority of patients retained excellent vision, yet devastating ocular injuries still occur. Improved tracking and longer followup is essential to measure long-term effects of these injuries and improve outcomes for patients.
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