A new approach to categorization of ocular injury among U.S. Armed Forces

This report describes a new approach to categorizing ocular injury using Military Health System data, the application of an algorithm to a dataset, and the verification of the results using an audit of clinical data. Based on health care encounter data, an algorithm was developed to systematically document the occurrence of specific complications and medical procedures in the 12 months following initial ocular injuries. The injuries were classified into 1 of 2 groups: "uncomplicated injury" with no complications or medical procedures and "complicated injury" with complications and/or medical procedures. Injuries in the latter group were further classified by severity into low, moderate, and high strata based on a ranking of complications and medical procedures. From 2016 through 2019, 12,664 complicated ocular injuries and 49,016 uncomplicated injuries were identified among active duty U.S. military members. The vast majority (84%) of complications were concurrent or occurred within 30 days following the injury. The 3 most common complications (orbital floor fracture, iridocyclitis and recurrent corneal erosion) accounted for 52% of complications. These findings underscore the importance of accurate classification of complex ocular injuries to inform studies in multiple areas including injury prevention, the development of clinical guidelines, and health services research.