Ocular trauma in counter insurgency and proxy war environment: Epidemiological study, 1992-2004

To analyze the epidemiology of hospitalized ocular injuries occurring in counter insurgency and proxy war environment in a forward area of northern India over a period of 13 years.

Retrospective observational study of medical records was performed of 458 patients with ocular injuries primarily treated at zonal referral hospital of Indian Army between January 1992 and December 2004.

A total of 559 eyes with ocular injuries were studied. The average age of the victims was 30 years. In 77% cases, injuries were sustained by army personnel and remaining by paramilitary forces. Of all cases, 86.5% cases were due to combat-related (militant action), of which 93.9% cases were caused by splinters from munitions. Among the eyes injured due to militant action, 60.36% were open globe injuries, 31.19% were closed globe injuries and 8.45% were isolated adnexal injuries. Among the eyes injured, 76.33% of the eyes with open globe injuries owing to militant action had perforating injuries, whereas in closed globe injuries, 47.74% eyes had corneal foreign body. Among eyes with open globe injuries, Corneo-scleral, scleral and corneal lacerations were seen in 45%, 28% and 27% eyes respectively. 15.75% of eyes with ocular injuries underwent eviscerations.

The study reveals that splinter eye injuries from munitions were the most common cause of ocular morbidity in counter insurgency and proxy war. Implementation of use of protective glasses by the personnel deployed in such hostile environment and strict compliance of preventive measures would be effective in saving eyes and also medical and economic resources.