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    Changing nature of combat brings new set of ocular injuries

    San Diego—When military personnel are injured in combat situations, the primary concern of saving lives supersedes saving sight, said Col. Anthony J. Johnson, MD, Fort Sam Houston, Antonio, TX.

    In combat situations, the use of fragmentation weapons has been “the lion’s share” of damage to the ocular surface.

    Related: The future of glaucoma therapies

    In the past 12 years, the U.S. Army and its Coalition Partners have had more than 1.2 million soldiers entering combat operations. Of those soldiers, slightly fewer than 60,000 have been injured, and of those, 2,800 have suffered “significant ocular injuries,” said Dr. Johnson, speaking here during World Cornea Congress.

    Consistent with other recent conflicts, during the peak of operations, ocular injuries accounted for more than 15% of all evacuations out of combat theater.

    If a wounded soldier is still alive upon arrival at a level 3-combat hospital, there is a 98% chance of surviving, Dr. Johnson said.

    The number of terrorist activities outside of combat situations has “skyrocketed” since 2010, with terrorists preferring large-scale blasts that will deliver the most devastating damage to the largest number of people.

    In today’s world, terrorist attacks have been ballistic in nature, bringing with them a slew of additional ocular, brain, and skin injuries.

    According to the National Consortium for the Study of Terrorism and Reponses to Terrorism, in 2012 there were more than 8,400 terrorist attacks worldwide and more than 15,400 casualties, with the incidence increasing monthly. By 2013, there was an average of over 900 attacks per month.

    The Oklahoma City Bombing, Boston Marathon attack, and the West Texas Industrial Plant explosion have all recently illustrated the fact that traumatic explosive injuries are no longer purely a construct of war and are a growing experience for urban ophthalmic providers, and ballistic weapons are the preferred weapons of choice because of the amount of damage they can inflict, he explained.

    Next: Understanding traumatic brain injury

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