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Oculoplastic surgeon shares key lessons learned in combat ophthalmology
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KIAWAH ISLAND, S.C. — One oculoplastic surgeon who has been serving at Walter Reed hospital shared several essential lessons he has learned while treating troops with severe ocular injuries received in battle.
Upon working with a soldier transported to Walter Reed National Military Medical Center after being treated for an open globe injury from an improvised explosive device (IED) in the battle zone in Afghanistan, Andrew S. Eiseman, MD, stressed in a presentation here at Kiawah Eye 2012 the importance of attempting to close every open globe injury no matter how complex.
Even in the most complex and devastating open globe injuries, Dr. Eiseman said that temporary tarsorrhaphy has been beneficial, especially if the patient needed to travel for definitive care.
“Several eyes that started out with no light perception have achieved some vision after endoscopic vitrectomy and anterior segment reconstruction,” Dr. Eiseman said.
However, in cases in which enucleation is necessary, it is important to do the best job possible in minimizing postoperative complications and improving cosmesis, he said. Many soldiers have dealt extraordinarily well with their injuries, but a methodical reconstruction will reap the greatest benefits in the end for the soldiers.
One of the greatest lessons Dr. Eiseman said he learned was that eye protection worked but only if solders were convinced to wear it. Once soldiers were shown the effectiveness of over-the-counter eye protection worn during IED blasts, they were moved to wear protection, even if it was uncomfortable or troops felt it did not look “cool,” he said. He said that many devastating eye injuries from shrapnel from IED blasts were avoided because of eye protection.
- Disclosure: Dr. Eiseman had no relevant financial disclosures. The opinions he expressed as an active duty military officer were his own and neither those of the military nor Walter Reed National Military Medical Center.