Combat ocular trauma and systemic injury.

Area of Science:

• Ophthalmology
• Military Medicine
• Trauma Surgery

Background:

• Combat ocular trauma presents unique challenges in modern warfare.
• Operations Iraqi Freedom and Enduring Freedom have provided insights into the nature of these injuries.

Purpose of the Study:

• Review recent literature on combat ocular trauma.
• Classify combat-related eye injuries.
• Propose management strategies for eye injuries sustained in conflict.

Main Methods:

• Literature review of combat ocular trauma from recent military operations.
• Analysis of injury patterns, causes, and outcomes.
• Discussion of classification systems and management approaches.

Main Results:

• Unconventional fragmentary munitions are the primary cause of combat ocular injuries, often resulting in blast trauma.
• High rates of concomitant injuries, including traumatic brain injury and amputations, are observed.
• Open-globe and adnexal lacerations are frequent; severe globe injuries lead to high rates of enucleation and retained intraocular foreign bodies.
• Delayed removal of intraocular foreign bodies did not impact visual outcomes or lead to endophthalmitis.
• Significant vision loss persists in perforating globe injuries and posterior segment trauma.

Conclusions:

• Recent literature highlights the severity of ocular and systemic injuries from Operations Iraqi and Enduring Freedom.
• Classification and understanding of outcome measures are essential for managing combat eye trauma.
• Despite advances, severe vision loss remains a challenge in complex combat-related eye injuries.