Clinical and radiological management of wartime eye and orbit injuries

The purpose of this study is to present our experience in treating 191 patients with eye and orbit injuries that occurred during the war in Croatia and Bosnia and Herzegovina.

The authors retrospectively reviewed the clinical and radiological management of wartime eye and orbit injuries in patients hospitalized at Clinical Hospital Split.

Seventy-nine percent of the war eye and orbit injuries were caused by fragments of explosive devices, 9.9% by high-velocity missiles, and 8.4% by other objects. Most of the patients were admitted to the hospital within 24 hours of injury. The total number of injured globes was 222; 48.2% of globes had intrabulbar (mostly magnetic) foreign bodies, and 13% had extrabulbar intraorbital foreign bodies. Extensive wounds (perforation, double perforation, rupture, and evisceration/ enucleation) were encountered in 74% of patients, and 26% of patients had slight trauma. There was a statistically significant correlation between admission within the first 12 hours and postoperative visual acuity (Chi 2 = 3.93; p = 0.0474).

Along with clinical examination, computed tomography is the most important diagnostic procedure in preoperative evaluation of various forms of globe and orbit injuries. The admission time is the most important factor in determining postoperative visual acuity.