Purpose: To document the types and causes of ocular and ocular adnexal injuries treated by United States Army ophthalmologists serving in Iraq during the Iraqi Insurgency.
Design: Prospective hospital-based observational analysis of injuries.
Participants: All coalition troops, enemy prisoners of war, and civilians with severe ocular and ocular adnexal injuries.
Methods: We prospectively examined severe ocular and ocular adnexal injuries that were treated at the 31st Combat Support Hospital during the portion of the Iraqi Insurgency that took place from January 20 through September 12, 2004.
Main outcome measures: Incidences and characteristics of ocular and ocular adnexal injuries.
Results: During the time observed, 207 patients suffered severe ocular or ocular adnexal injuries, including 132 open globes. Blast fragmentation from munitions caused 82% of all injuries. The most common single cause of injury was the improvised explosive device (IED), which caused 51% of all injuries. Of 41 eye excisions, 24 were caused by IEDs.
Conclusions: During the portion of the Iraqi Insurgency covered in our report, munitions fragments were the most common cause of ocular and ocular adnexal injuries. The single most common cause of injury was the IED, which produced devastating ocular and ocular adnexal injuries. The authors' findings indicate that polycarbonate ballistic eyewear could have prevented many, but not all, of the ocular injuries we report.