Ocular injuries sustained by survivors of the Oklahoma City bombing

Objective: The purpose of this study is to provide a review of the ocular i njuries sustained by survivors of the April 19, 1995, bombing of the Alfred P. Murrah Federal Building in Oklahoma City. Design: Retrospective, noncomparative case series. Participants: The authors retrospectively evaluated data collected on all s urviving persons receiving ocular injuries during the bombing and on all at -risk occupants of the federal building and four adjacent buildings. Methods: Injury data from survivors were collected from multiple sources to include hospital medical records, a physician survey, emergency medical se rvices run reports, written survivor accounts, building occupant survey, te lephone interviews, and mail surveys. Main Outcome Measures: The types of ocular injuries, the associated systemi c injuries, and the location of the injured at the time of the blast were e valuated. Results: Fifty-five (8%) of the 684 injured bombing survivors sustained an ocular injury. Persons injured in the Murrah building were more than three times more likely to sustain an ocular injury than other injured persons. S eventy-one percent of ocular injuries occurred within 300 feet of the point of detonation. The most common serious ocular injuries included lid/brow l acerations (20 patients, 23 eyes), open globe injuries (12 eyes), orbital f ractures (6 eyes), and retinal detachment (5 eyes). A retained intraocular foreign body accounted for only two of the injuries (4%). Glass accounted f or nearly two thirds of the ocular injuries. Conclusions Blasts involving explosions inflict severe ocular injury, mostl y as a result of secondary blast effects from glass, debris, etc. Eye injur ies in bombings can probably be prevented by increasing the distance from a nd orientation away from windows (i.e., by facing desks away from windows). Use of such products as laminated glass, toughened window glazing, and Myl ar curtains may reduce glass projectiles in the blast vicinity. (C) 2000 by the American Academy of Ophthalmology.