POSTERIOR SEGMENT INJURIES IN OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM: 2001 to 2011

Area of Science:

• Ophthalmology
• Trauma Surgery
• Military Medicine

Background:

• Combat trauma presents unique challenges for ocular injury management.
• Posterior segment injuries are a significant concern in combat eye trauma.
• Understanding injury patterns is crucial for improving patient outcomes.

Purpose of the Study:

• To characterize the nature and patterns of posterior segment ocular injuries resulting from combat trauma.
• To compare visual outcomes and injury types between open-globe and closed-globe injuries in combat casualties.
• To assess the impact of injury zones on visual prognosis in combat-related eye trauma.

Main Methods:

• Retrospective analysis of ocular injuries within the Walter Reed Ocular Trauma Database.
• Evaluation of posterior segment injuries in relation to globe integrity (open vs. closed).
• Assessment of visual outcomes based on injury zone (I, II, III) and injury type.

Main Results:

• Over half of combat-related eye injuries (50.8%) involved the posterior segment.
• Improvised explosive devices were the most frequent cause of injury (62.0%).
• Zone I injuries were associated with better visual acuity outcomes compared to Zone II and III injuries. Closed-globe injuries had better visual outcomes than open-globe injuries, with lower risks of vitreous hemorrhage, proliferative vitreoretinopathy, and retinal detachment, but higher risks of chorioretinal rupture and macular hole.

Conclusions:

• Posterior segment injury patterns in combat trauma are comparable to civilian injuries.
• Ocular trauma zones II and III are linked to poorer visual prognoses.
• Effective management strategies for combat eye injuries require consideration of globe integrity and injury zone.