OCULAR AND OCULAR ADNEXAL INJURIES TREATED BY UNITED-STATES MILITARY OPHTHALMOLOGISTS DURING OPERATIONS DESERT SHIELD AND DESERT-STORM

Background. Ocular and ocular adnexal injuries, both combat-related an d accidental, are common during wartime. In a combat setting, the eye is particularly vulnerable to serious injury from tiny flying particle s that might minimally affect other parts of the body. The purpose of this study is to examine the incidence of serious ocular and ocular ad nexal injuries that occurred during Operations Desert Shield and Deser t Storm. Methods: The authors retrospectively reviewed serious ocular and ocular adnexal injuries treated by United States Army and Navy oph thalmologists that occurred during Operations Desert Shield and Desert Storm. Only those injuries that resulted in, or would have resulted i n, hospital admission because of the ocular or ocular adnexal injury a lone are presented. Results: During Desert Shield, 20 patients (23 eye s) suffered serious ocular or ocular adnexal injuries compared with 16 0 patients (1 98 eyes) in Desert Storm. During Desert Storm, 78% of al l serious injuries were caused by blast fragmentation from munitions. More than one third of the 98 globe lacerations reported in this artic le were 10 mm or less in size. Of 35 enucleations performed during Des ert Storm, 94% were the result of munitions fragments. Conclusions: Du ring Operation Desert Storm, fragmentation wounds from munitions were the most common cause of ocular and ocular adnexal morbidity. The auth ors' findings indicate that polycarbonate ballistic protective eyewear could have prevented many of the ocular injuries that they report.