Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter
XXIV: Wounds and Injuries of the Eye
Introduction
United States Department of Defense
Under battlefield conditions, the casualty with an injured eye is usually seen first by
nonspecialized personnel at a facility that has little or no specialized equipment. If his
injury is minor, the soldier is treated and sent back to his unit. If it is not, he should
be promptly evacuated. The distinction between minor and serious ocular injuries is not
always easy to make The most trivialappearing injury may prove to be very serious indeed.
If an injury of the eye is properly managed, a good result (or at least some salvage of
vision) is often secured even in serious injuries. If improperly managed, a trivial
penetrating ocular wound may be converted into a serious one; a large majority of these
may result in blindness. All care providers must know how to detect, assess, and initially
manage patients with eye injuries. The mandatory principles of initial management are
presented in this chapter. In ophthalmic surgery, the first opportunity to repair an
injury is usually the only opportunity. There is an inordinately high rate of ocular
injury relative to the amount of surface area exposed to injury. Although comprising as
little as 0.10% of total body surface and only 0.27% of the erect frontal silhouette, the
eye is injured in nearly 10% of nonfatal casualties. The likelihood of ocular injury is
further increased by various postures assumed in warfare. For example, although 25% of the
projected body surface is exposed in the prone position, the eye comprises a considerable
proportion of the prone silhouette. The recent introduction of laser technology to the
battlefield will lead to a new class of ocular injury. These injuries are most likely to
fall into two categories. The first category is that of thermal burns of the eyelids and
cornea. The second category constitutes injury to the retina and vitreous body, leading to
intraocular hemorrhage. Laser injuries of the eye are covered separately.
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Operational Medicine 2001
Health Care in Military Settings
Bureau of Medicine and Surgery
Department of the Navy
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Washington, D.C
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Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
United States Special Operations Command
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MacDill AFB, Florida
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