Abstract
Purpose :
Combat ocular trauma represents a significant and increasing proportion of wartime injuries. As weaponry and body armor continue to advance, the eyes remain relatively unprotected, especially when ocular personal protective equipment is not worn. The purpose of this study is to provide an update to the epidemiology of ocular injuries in US soldiers from 2001-2011 after sustaining combat injuries in OIF and OEF.
Methods :
This study analyzes 890 consecutive globe and/or adnexal combat injuries sustained by 651 soldiers. Outcome measures included sources and types of ocular and extra-ocular injuries, types of surgeries performed, visual outcomes, and use of eye protection.
Results :
The average age was 27.2 years (range, 18-53). Of the patients, 96.9% were male, and 27.30% had documented use of eye protection. The most common mechanisms of injury were improvised explosive devices (62.5%) and rocket propelled grenades (11.6%). Of the affected eyes, 26.6% were found to have ocular trauma scores (OTS) grades 1-2 (0-65), 47.6% had OTS grades 3-5 (66-100), 9.3% had adnexal injuries, and 5.3% had neuro-ophthalmic injuries. The majority of patients (62.0%) had final visual acuity (VA) grades of 1-2 (20/15 – 20/200), while 29.9% of patients had final VA grades of 3-5 (less than 20/200), and 8.1% had unknown final VA grades. Common injuries included orbital fracture (33.0%), corneal laceration (14.3%), scleral laceration (14.4%), traumatic cataract (22.3%), vitreous hemorrhage (37.3%), retinal detachment (16.1%) and traumatic brain injury (40.3%). Common surgeries included pars plana vitrectomy (22.1%), pars plana lensectomy (13.4%), and cataract extraction (7.5%).
Conclusions :
Despite advancements in body armor preventing previously fatal wounds, combat trauma results in complicated ocular injuries causing 30% of patients to be left blind in their injured eye.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.