War Yields Lessons in Preventing, Treating Eye Injuries

By Donna Miles
American Forces Press Service

WASHINGTON, Jan. 9, 2012 – Ten years of conflict has given rise, not only to the world’s best body armor and state-of-the-art battlefield technologies, but also a new understanding about ways to prevent eye injuries and treat those who suffer from them.

When the war in Afghanistan kicked off in 2002, ballistic goggles were hard to come by in the military supply system and combat troops rarely wore them, Army Col. (Dr.) Donald Gagliano, executive director of the Vision Center of Excellence, told American Forces Press Service.

As improvised explosive devices became the enemy’s weapons of choice, eye injuries soared, affecting as many as 29 percent of all battlefield casualties, Gagliano estimated. So as the military began introducing improved body and head protection, ensuring troops had and wore ballistic glasses also became a top priority.

Eye injuries initially dropped, Gagliano reported, but as IEDs and high-energy blast waves become increasingly powerful, eye injuries continued to take their toll. So as part of its charter, the Department of Defense and Department of Veterans Affairs Vision Center of Excellence is focusing on ways to prevent injuries and improve the care and rehabilitation for wounded warriors.

In addition to exploring these areas, the center is promoting research that could one day restore vision to those who have lost it, Gagliano reported.

Eye prosthetics are likely to be a decade or more away, but Gagliano said he’s optimistic that initiatives under way will bear fruit. In the meantime, Gagliano and his deputy, Dr. Mary Lawrence, offered several suggestions to help prevent battlefield eye injuries and ensure the best outcome when they occur:

-- Wear ballistic eye protection. While not completely eliminating eye injuries, they greatly reduce their occurrence, particularly against fragments. One of the programs at the Center of Excellence is exploring improvements to existing ballistic eye protection devices.

-- Avoid wearing contact lenses in combat environments, particularly in dirty, sandy areas. In addition to the high risk of infection, wearers risk exposure to flying fragments from explosions or weapons fire.

-- Consider refractive surgery to improve vision problems and eliminate the need for corrective glasses or contact lenses.

-- Don’t apply pressure to the eye area when providing battlefield care for a comrade suspected of having an eye injury. Pressure may be the appropriate treatment to some wounds, but in the case of eye injuries, it can cause severe complications and even blindness.

-- Apply a Fox Eye Shield, if available, over the eyes of any patient suspected of having an eye injury. Fox Eye Shields are now included in every Air Force and Marine Corps individual first aid kit, and the Army is expected to begin adding eye shields to its kits soon. If one of these metal devices isn’t immediately available, Lawrence recommended using another rigid surface such as the bottom of a coffee cup or even knee pads or elbow pads and taping it over the patient’s eyes.

Vision has a major impact on military readiness as well as quality of life, Gagliano emphasized.

“If you can’t see, you can’t fight,” he said. “And the bottom line is, that makes not only you, but also your entire unit, vulnerable.”

Brain Injury Awareness Month: Did You Know…

DCoE Strategic Communications

Today isn’t just the opening day for major league baseball, it’s the end of March—the month we’ve spent talking and sharing information about brain injury awareness. Brain injury awareness is an important topic not only for service members and veterans in combat situations, but also for those who play sports or most anyone—did you know that more than 35 percent of traumatic brain injuries (TBI) result from falls? Did you know…

…about these numbers?

■1.7 million estimated people sustain a TBI each year

■275,000 people are hospitalized annually because of a TBI

■30.5% of all injury-related deaths in the United States have TBI as the contributing factor

Click here for more TBI Stats.

…about these resources?

■Mild TBI Pocket Guide: it’s a quick reference, all-encompassing resource on the treatment and management of patients with mild TBI and related symptoms.

■Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health: this toolkit helps providers assess and manage patients with co-occurring mild TBI and psychological health disorders.

■ICD-9 TBI Coding Guidance Pocket Card: a very cool flashcard that helps providers quickly, accurately document and track diagnosis of a service member who has been treated, or is in the process of being treated, for a TBI.

■Mild TBI Web-Based Case Studies: these online tools include modules with real scenarios to help military and civilian health care professionals better understand mild TBI to include screening, diagnosis and management of symptoms in the non-deployed setting. The latest case study “Assessing the Individual with Persistent Headaches” is available now.

■TBI Family Caregiver Curriculum: because we know people with a TBI aren’t the only ones who live with it, this resource was created especially for families of service members and veterans. The guide provides support, education on TBI and guidance on symptom management.

■DCoE Outreach Center: this resource provides 24/7 customized support to service members, their families and providers who have questions and concerns related to traumatic brain injury or psychological health by phone at 866-966-1020 or email resources@dcoeoutreach.org. The center is operated by trained health resource consultants who work to get people to the right resources.

In case you’ve missed some of the valuable information we’ve shared during the month, don’t worry, you can find most of it on the DCoE Brain Injury Awareness page on the DCoE website. You can also download the resources mentioned above from the ‘For Health Professionals’ section of the DCoE website. Or, if you’d like hard copies, please contact the Defense and Veterans Brain Injury Center at info@dvbic.org or call 800-870-9244.

Living with a TBI is a challenge, but there are tips, resources and people available to help. Early detection is key to a better recovery, so stay informed about TBI signs and symptoms – this new DCoE information sheet on TBI may help.

Pop quiz!

OK history buffs, just to see if you’ve been paying attention, who patented the first steel helmets worn in World War I? If you don’t know, or perhaps simply forgot, check out DCoE’s “Helmets Throughout History” virtual timeline to learn fun facts about head protection that’s been worn in several different shapes, sizes and styles.

Brain Injury Awareness Month may be over, but DCoE will continue to share current and important information about traumatic brain injury, and we are always interested in your feedback, so please leave us a comment.