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Wartime ocular injuries increasing ‘exponentially,’ surgeon says
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ROME — The incidence of eye injuries during military operations has increased exponentially over the past decades, according to a collection of data presented at the International Society of Ocular Trauma meeting.
Compared with World War I and World War II, more recent conflicts, such as the Gulf and Croatian wars, reported five to six times the number of ocular injuries. Statistically, the eye is one of the most frequent targets of wartime injuries, said one speaker here.
“Provided that the profile surface of the eyeball constitutes only 0.1% of the frontal body silhouette, the incidence of ocular injuries in warfare is about 20 to 50 times higher than could be expected,” said Giorgio Romani, MD, head of the Ophthalmology Department at the Military Hospital in Rome.
Lateral curvature of the orbital margin extends the exposed surface of the eye laterally and increases the risk of injury from the lateral side, he said. More sophisticated war techniques and weapons have also contributed to the increase in ocular injuries.
“Improved munitions, which create increasingly smaller fragments, and also non-conventional or unknown munitions like those used in terrorist explosions, have multiplied the number of blast injuries and fragment injuries in the eye apparatus,” Dr. Romani said.
Fragment injuries are particularly common in trench warfare, where artillery inflict wounds not only through bomb fragments and shrapnel, but also from stones, cement and sand turned into projectiles from the explosion.
The use of anti-personnel mines also accounts for a high number of eye injuries in some geographic areas, he said. In warfare in general, mines represents 9% to 15% of all munitions-related causes of ocular injuries.
“On the whole, blast wave contusions and blast fragmentation account for 68% to 78% of warfare ocular trauma,” Dr. Romani said.
A different type of damage to the eye is related to the laser, which is used routinely in modern battlefields for target designators, rangefinders and radar warning. In the future, the incidence of laser-induced eye injuries might significantly grow, as the threat of the use of lasers as antipersonnel devices by enemy forces is “a real and increasing threat,” Dr. Romani said.
Protection of the eye during military operations is mandatory, he concluded. He recommended shock-resistant eyewear that would protect the lateral side of the orbit be made mandatory.