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R. Thomas, J. McManus; Trends of Ocular Injuries in the Conflicts in Iraq and Afghanistan. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5380.
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As the wars in Iraq and Afghanistan progress, the mechanisms of injury in the combat zones have changed. While initially firearms accounted for a large percentage of injuries, the forces opposing the United States and its allies in Iraq have adapted their tactics, almost exclusively utilizing explosive devices. The forces in Afghanistan still utilize firearms but to a lesser degree. As found in previous conflicts the human eye is exceedingly susceptible to fragmentary munitions, and ocular casualties tend to be more prevalent than would be expected from the surface area of the eye.
This IRB approved retrospective review examines 6589 charts in the Joint Theatre Trauma Registry (JTTR), which were gathered from military treatment facilities within the theatre of operations for Iraq and Afghanistan during the first three and a half years of the conflicts. The primary outcome measures were the percentage of eye injuries and the mechanisms of injury.
The overall number of eye injuries collected in the database during this period was 1246 compared to the overall casualty number of 6589 (18.9%). The percentage of eye injuries trended up significantly over the first five months from 10% to 26%. Further, the vast majority of eye casualties were Army soldiers at the E4 pay grade (corporal). Explosive injuries accounted for 1141 (92%) of the eye casualties, firearms accounted for 4% and other mechanisms accounted for the other 4%. Gunshot wounds were a more prevalent source of injury initially but became less common as the conflict progressed.
This study supports the previous body of research suggesting the percentages of eye injuries have increased in every major conflict that the US has been involved in. Previous authors have asserted that the increasing percentage of explosive and fragmentary weapons used in the modern conflicts have led to higher percentages of ocular injuries. The majority of the these injuries are sustained by lower ranking soldiers in the Army and steps should continue to be taken to protect these individuals from ocular injuries.
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