EYE INJURIES IN 20TH-CENTURY WARFARE - A HISTORICAL-PERSPECTIVE

With successive wars in the twentieth century, there has been a relati ve increase in injuries to the eye compared to injuries of other parts of the body. The main causes of eye injury have changed with advances in techniques and weaponry of warfare, with blast fragmentation injur ies accounting for 50-80% of cases. Penetrating and perforating injuri es are most common, and injuries associated with intraocular foreign b odies pose special diagnostic and management problems. Injuries are bi lateral in 15-25% of cases. Injuries associated with chemical, nuclear , and laser weapons have distinct characteristics and epidemiology. En ucleation was commonly performed at the turn of the century, but incid ence has declined with better understanding of the pathophysiology of ocular trauma, improved surgical techniques and sepsis control with an tibiotics. Sympathetic ophthalmia appears to be uncommon and earlier f ears of this complication seem to have been exaggerated. Timely evacua tion to a surgical facility is important for a good visual prognosis a nd preservation of the globe. However, prevention of injuries with eye armor is ultimately the best management, and the need for a comprehen sive eye protection program in the military cannot be overemphasized, especially since eye injuries pose important socioeconomic, as well as medical, problems. (C) 1997 by Elsevier Science Inc. All rights reser ved.