OCULAR INJURIES

Abstract

Introduction The preservation of the eyes and eyesight of service personnel is an extremely important goal. Although accepted medical priorities are described as “life, limb, and sight,” most casualties would reprioritize the list as “life, SIGHT, and limb.” Despite comprising as little as 0.1% of the total body surface area, eye injuries accounted for 6%–13% of all combat casualties in Operation Iraqi Freedom/Operation Enduring Freedom. Between 66% and 75% of eye casualties will be medically disqualified from service. In the Vietnam War, almost 50% of casualties with penetrating eye wounds lost the injured eye. The best outcomes are heavily predicated on proper early mitigation and treatment of the injury, as well as prompt transfer to ophthalmic surgical care. Nevertheless, 96% of eye casualties (or more) may be improperly treated at the point of injury. Although improvements in ophthalmic care in the last 30 years offer hope that blindness in combat casualties will be less common in future wars, the eye continues to demonstrate its notorious intolerance of injury—and error—underscoring the critical need for proper initial casualty care.