Eye injury surveillance in the U.S. Department of Defense, 1996-2005

Abstract

Background: Consistent with the public health approach to prevention, surveillance analyses are needed to fully understand a health problem. U.S. military eye injury rates have not been fully described using medical surveillance data.

Methods: Medical visit data on active duty personnel, 1996-2005, and causes of eye injury hospitalizations (identified by Standard NATO Agreement injury cause codes) were obtained from the Defense Medical Surveillance System. Eye injury-related ICD-9-CM codes beyond the traditional 800-999 injury code set were included. Rates by age and gender are reported for 1996-2005, along with the frequency of causes of injury hospitalizations and leading eye injury diagnoses for 2005.

Results: Eye injury rates among active duty military personnel increased from 1996 to 2005 among both men and women (p<0.001), with the highest rates in 2004 (26/1000 person-years and 21/1000 person-years, women and men, respectively). Women consistently had 7%-21% higher rates than men (rate ratios=1.07; 95% CI=1.04, 1.11) to 1.21 (95% CI= 1.17, 1.25). From 1996-2005, eye injury rates increased among all age groups (p<0.001). From 2002-2005, rates were highest for those aged > or =40 years compared to those aged 17-19 years (rate ratios=1.17 [95% CI=1.11, 1.24] to 1.24 [95% CI=1.18, 1.31]). Leading causes of eye injury hospitalizations were ordnance handling (16.9%), enemy action (13.1%), and fighting (11.9%).

Conclusions: Medical surveillance data enable the assessment and monitoring of overall active duty eye injury rates, trends, and causes. Outpatient data could be improved with the addition of cause of injury codes and eye protection use. Current data suggest that continued use of eye protection during ordnance handling, combat, motor vehicle use, and sports could help reduce eye injury rates.