Eye Injuries in the Iraq and Afghanistan Conflicts
Ophthalmology, April 2020
In an effort to inform future military surgical training requirements and medical planning, Breeze et al. compared incidences, ocular injury types, and treatment performed on U.S. and U.K. military service members and host nation civilians within the Iraq and Afghanistan conflicts. They found that eye injuries were more likely to have been treated definitively in U.S. deployed military treatment facilities, reflecting the absence of ophthalmologists in their U.K. counterparts.
For this retrospective cohort study, the authors evaluated data on 67,586 patients in the U.S. and U.K. military trauma registries who were treated at deployed military treatment facilities between March 2003 and October 2011. An adjusted multiple logistic regression model was performed using the main outcome measures of enucleation or evisceration and primary open globe repair as dependent variables and casualty nationality, location, and the presence of an ophthalmic surgeon as independent variables.
Of the 67,586 patients, 5,719 (8%) had sustained eye injuries. Of these, the most common were open globe injury without intraocular foreign body (3,201; 56%). Adnexal injuries were recorded in 1,265 patients (22%). The odds of undergoing evisceration or enucleation for open globe injury was highest in Iraqi and Afghani civilians (odds ratio [OR], 9.23; p < 0.001), but there was no evidence of a difference between U.S. and U.K. military service member casualties (p = 0.38). Primary repair of open globe injury was more commonly undertaken at U.S. medical facilities (OR 5.71; p < 0.0001), reflecting the presence of an ophthalmic surgeon at the U.S. facilities.
The authors emphasized that their findings support the inclusion of ophthalmologists in deployed coalition treatment facilities during future conflicts.
The original article can be found here.