Traumatic brain injury associated with combat ocular trauma

Area of Science:

• Ophthalmology
• Neurology
• Military Medicine

Background:

• Combat ocular trauma (COT) is a significant concern for military personnel.
• Traumatic brain injury (TBI) is frequently observed in conjunction with COT.
• Understanding the relationship between TBI and ocular injury is crucial for effective treatment and rehabilitation.

Purpose of the Study:

• To investigate the impact of TBI on visual acuity in patients with COT.
• To determine the association between TBI severity and the types of ocular injuries sustained.
• To identify risk factors for TBI in combat-related eye injuries.

Main Methods:

• A retrospective cross-sectional study was conducted on 152 US service members with 207 combat ocular injuries.
• Data were collected from patients treated at Walter Reed Army Medical Center between August 2004 and October 2006.
• Best-corrected visual acuity (BCVA) was the primary outcome measure, with TBI screening and severity assessment as secondary measures.

Main Results:

• TBI was present in 66% of COT cases; 21% of all casualties had TBI with ocular trauma.
• Explosive fragmentary munitions were the cause in 79% of TBI-associated COT.
• Closed-globe injuries were more likely to be associated with TBI (OR: 2.17) than open-globe injuries, but TBI severity did not correlate with poorer visual outcomes (BCVA).

Conclusions:

• TBI is common in COT, particularly with closed-globe injuries.
• Despite the high incidence, TBI does not appear to worsen visual outcomes in COT patients.
• All COT patients require TBI screening, with positive cases needing referral to TBI rehabilitation specialists.