Abstract
Purpose::
To report the number and causes of eye injuries treated in the Optometry section of the Fourth Infantry Division during the first year of Operation Iraqi Freedom.
Design::
Retrospective case series.
Participants::
169 consecutive United States military personnel, civilian contract workers, and enemy prisoners of war, presenting with eye injuries.
Methods::
We analyzed Department of the Army Eye Injury Reporting System (EIRS) data sheets for each patient treated April 1, 2003 through March 16, 2004.
Results::
The most common etiology was mechanical trauma (87%): dirt/sand (37%), metal (19%), and contact lens (8%). Corneal foreign body (32%), and corneal abrasion (25%), were the most frequent diagnoses. 85% of patients were treated within 20 minutes, (mean 18 minutes, standard deviation 20 minutes). Lost duty hours was a bimodal distribution, with peaks at 2 hours (30%), and 24 hours, (12%). 83% of patients wore no eyewear at the time of injury.
Main Outcome Measures::
Etiology, diagnosis, time to treatment, lost duty hours, and protective eyewear use.
Conclusions::
Eye injuries presenting to an optometry clinic in Iraq were almost uniformly treatable on-site, facilitating rapid return to duty and maximizing force strength. Many injuries were preventable through the proper use of military-issue safety eyewear, or the discontinuation of contact lens wear while deployed.Two articles recently described combat eye injuries in Iraq and their treatment with surgical interventioni,ii. The authors describe complex trauma involving systemic as well as ophthalmic injuries, which required valiant intervention to preserve sight and/or prevent infection. A third paper studied data from eye injuries in Iraq and Afghanistan which required medical evacuation out of the theater of combatiii. This paper describes another common category of eye injuries, those largely sustained during non-combat operations, and treatable without aeromedical evacuation. Optometric care at the division level allows for rapid intervention and return to duty of these patients, minimizing resource-draining, time-consuming transfer to facilities with ophthalmologic services. To our knowledge, there have been no such studies to date.Endnotesi Mader TH, Carroll RD, Slade CS, et al. Ocular War Injuries of the Iraqi Insurgency, January-September 2004. Ophthalmology 2006; 113:97-104.ii Thach AB, Ward TP, Dick JSB, et al. Intraocular Foreign Body Injuries during Operation Iraqi Freedom. Ophthalmology 2005; 112:1829-1833.iii Ari AB. Eye Injuries on the Battlefields of Iraq and Afghanistan: pulic health implications. Optometry 2006 Jul;77(7):329-39.