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System for Focal, Closed-System Central Nervous System Injury

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Closed globe macular injuries after blasts in combat.

Brandon N Phillips¹, Dal W Chun, Marcus Colyer

¹Ophthalmology Service, Department of Surgery, Walter Reed National Military Medical Center Bethesda, Bethesda, Maryland, USA. brandon.n.phillips@us.army.mil

Retina (Philadelphia, Pa.)

|October 2, 2012

Summary

Blast-related closed globe injuries can cause various macular issues, with inner segment/outer segment junction integrity crucial for vision. Long-term outcomes require ongoing ophthalmological monitoring.

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Area of Science:

Ophthalmology
Trauma Surgery
Military Medicine

Background:

Blast injuries pose significant risks to ocular health.
Understanding macular damage patterns is vital for prognosis.

Purpose of the Study:

To characterize macular findings in soldiers after closed globe ocular injuries from blasts.
To identify factors influencing visual outcomes.

Main Methods:

Retrospective chart review of soldiers with closed globe ocular injuries from February 2003 to March 2010.
Analysis of macular findings on examination.

Main Results:

36 eyes were analyzed; 86% of injuries resulted from improvised explosive devices.
22.2% developed macular holes, and 22.2% showed macular scarring.
Orbital fractures occurred in 42%, and optic neuropathy in 19%.

Conclusions:

Closed globe blast injuries present a diverse range of macular pathologies.
Inner segment/outer segment junction integrity is key for visual outcomes.
Long-term complications necessitate close patient follow-up by ophthalmologists.