Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;35(8):2155-2163.
doi: 10.1038/s41433-020-01316-w. Epub 2021 Feb 12.

The epidemiology and outcomes of combat ocular trauma among local nationals managed at a deployed military hospital in Afghanistan

William G Gensheimer  1   2 , Michael T Kerber  3 , Richard J Blanch  4   5   6   7
Affiliations

The epidemiology and outcomes of combat ocular trauma among local nationals managed at a deployed military hospital in Afghanistan

William G Gensheimer et al. Eye (Lond). 2021 Aug.

Abstract

Background/objectives: There is limited published data on combat ocular trauma (COT) among local nationals managed at deployed United States (US) and United Kingdom (UK) military hospitals in recent conflicts. We report the epidemiology and outcomes of COT from a deployed military hospital in Afghanistan.

Subjects/methods: In this retrospective case series, consecutive injuries requiring ophthalmic surgery at a military hospital in Afghanistan where the sole US and UK ophthalmologist(s) were deployed between January 2017 and September 2019 were reviewed. The main outcomes were mean post-operative visual acuity (VA) in open and closed globe injury and the incidence of retinal detachment after open globe repair.

Results: There were 102 eyes of 84 patients who had ocular injuries and underwent ophthalmic surgery at the military hospital. Most patients were male (81 [96%]) and were local nationals (71 [85%]). Blast exposure (82 [80%]) was the most common mechanism of injury. Mean post-operative VA was 1.24 ± 2.29 logMAR (20/348 Snellen equivalent) in open globe injury and 1.59 ± 1.17 logMAR (20/778 Snellen equivalent) in closed globe injury. After open globe repair, retinal detachment developed in 8 of 18 (44%) eyes.

Conclusions: COT injuries often resulted in poor post-operative VA and retinal detachment after open globe repair was common. The high incidence and severity of COT sustained by local civilians and combatants in this study may support programs to increase the availability and wear of combat eye protection among local nationals partnered with US and coalition troops.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1. Post-operative LogMAR visual acuity in 54 of 85 cases with open or closed globe injury where post-operative visual acuity was able to be assessed and recorded.
Injuries are classified according to the Birmingham Eye Trauma Terminology System (BETTS) [16]. Mean, standard deviation (SD), and number (N) displayed.
See this image and copyright information in PMC

Comment in

References

    1. Wild H, Stewart BT, LeBoa C, Stave CD, Wren SM. Epidemiology of injuries sustained by civilians and local combatants in contemporary armed conflict: an appeal for a shared trauma registry among humanitarian actors. World J Surg. 2020;44:1863–73. doi: 10.1007/s00268-020-05428-y. - DOI - PMC - PubMed
    1. Tapp C, Burkle FM, Wilson K, et al. Iraq War mortality estimates: a systematic review. Confl Health. 2008;2:1. doi: 10.1186/1752-1505-2-1. - DOI - PMC - PubMed
    1. Iraq Family Health Survey Study Group, Alkhuzai AH, Ahmad IJ, et al. Violence-related mortality in Iraq from 2002 to 2006. N Engl J Med. 2008;358:484–93. 10.1056/NEJMsa0707782. - PubMed
    1. Colyer MH, Chun DW, Bower KS, Dick JSB, Weichel ED. Perforating globe injuries during operation Iraqi Freedom. Ophthalmology. 2008;115:2087–93. doi: 10.1016/j.ophtha.2008.05.013. - DOI - PubMed
    1. Blanch RJ, Bindra MS, Jacks AS, Scott RAH. Ophthalmic injuries in British Armed Forces in Iraq and Afghanistan. Eye (Lond) 2011;25:218–23. doi: 10.1038/eye.2010.190. - DOI - PMC - PubMed