Eye injuries in twentieth century warfare: A historical perspective

• Published in: Survey of Ophthalmology Vol. 41; no. 6; pp. 433 - 459
• Main Authors: Wong, Tien Yin, Seet, Major Benjamin, Ang, Chong-Lye
• Format: Book Review Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.1997; Elsevier Science
• Subjects: Biological and medical sciences; chemical eye injury; combat eye injury; Eye Injuries - etiology; Eye Injuries - therapy; History of medicine; History, 20th Century; Humans; Incidence; Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents; laser eye injury; Medical sciences; Military Medicine; nuclear warfare; ocular war injury; protective eyewear; Traumas. Diseases due to physical agents; Warfare; chemical eye injury; laser eye injury; military medicine; warfare; protective eyewear; combat eye injury; nuclear warfare; ocular war injury; Human; Penetrating injury; Chemical compound; War; Laser irradiation; Trauma; Nuclear weapon; Eye; Prevention; Century 20th; Eye disease; Treatment; Classification; Complication; Foreign body; Military
• ISSN: 0039-6257; 1879-3304
• DOI: 10.1016/S0039-6257(97)00022-2

With successive wars in the twentieth century, there has been a relative 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 injuries accounting for 50–80% of cases. Penetrating and perforating injuries are most common, and injuries associated with intraocular foreign bodies pose special diagnostic and management problems. Injuries are bilateral in 15–25% of cases. Injuries associated with chemical, nuclear, and laser weapons have distinct characteristics and epidemiology. Enucleation was commonly performed at the turn of the century, but incidence has declined with better understanding of the pathophysiology of ocular trauma, improved surgical techniques and sepsis control with antibiotics. Sympathetic ophthalmia appears to be uncommon and earlier fears of this complication seem to have been exaggerated. Timely evacuation to a surgical facility is important for a good visual prognosis and preservation of the globe. However, prevention of injuries with eye armor is ultimately the best management, and the need for a comprehensive eye protection program in the military cannot be overemphasized, especially since eye injuries pose important socioeconomic, as well as medical, problems.