Verma Sudheer, Waikar S, Sharma Vivek, Bhatkoti B, Chauhan R
Classified Specialist (Ophthalmology), Command Hospital (Central Command), Lucknow, India.
Senior Advisor (Ophthalmology), INHS Asvini, Colaba, Mumbai, India.
Med J Armed Forces India. 2021 Oct;77(4):390-396. doi: 10.1016/j.mjafi.2020.02.001. Epub 2020 Jul 27.
To analyze the epidemiology of hospitalized ocular injuries occurring in counter insurgency and proxy war environment in a forward area of northern India over a period of 13 years.
Retrospective observational study of medical records was performed of 458 patients with ocular injuries primarily treated at zonal referral hospital of Indian Army between January 1992 and December 2004.
A total of 559 eyes with ocular injuries were studied. The average age of the victims was 30 years. In 77% cases, injuries were sustained by army personnel and remaining by paramilitary forces. Of all cases, 86.5% cases were due to combat-related (militant action), of which 93.9% cases were caused by splinters from munitions. Among the eyes injured due to militant action, 60.36% were open globe injuries, 31.19% were closed globe injuries and 8.45% were isolated adnexal injuries. Among the eyes injured, 76.33% of the eyes with open globe injuries owing to militant action had perforating injuries, whereas in closed globe injuries, 47.74% eyes had corneal foreign body. Among eyes with open globe injuries, Corneo-scleral, scleral and corneal lacerations were seen in 45%, 28% and 27% eyes respectively. 15.75% of eyes with ocular injuries underwent eviscerations.
The study reveals that splinter eye injuries from munitions were the most common cause of ocular morbidity in counter insurgency and proxy war. Implementation of use of protective glasses by the personnel deployed in such hostile environment and strict compliance of preventive measures would be effective in saving eyes and also medical and economic resources.
分析印度北部前沿地区13年间在反叛乱和代理战争环境中发生的住院眼外伤的流行病学情况。
对1992年1月至2004年12月期间在印度陆军区域转诊医院接受主要治疗的458例眼外伤患者的病历进行回顾性观察研究。
共研究了559只眼外伤眼睛。受害者的平均年龄为30岁。在77%的病例中，受伤者为军队人员，其余为准军事部队人员。在所有病例中，86.5%的病例与战斗相关（军事行动），其中93.9%的病例是由弹药碎片造成的。在因军事行动受伤的眼睛中，60.36%为开放性眼球损伤，31.19%为闭合性眼球损伤，8.45%为单纯附属器损伤。在受伤的眼睛中，因军事行动导致的开放性眼球损伤中，76.33%为穿孔伤，而在闭合性眼球损伤中，47.74%的眼睛有角膜异物。在开放性眼球损伤的眼睛中，角膜巩膜、巩膜和角膜裂伤分别见于45%、28%和27%的眼睛。15.75%的眼外伤眼睛接受了眼球摘除术。
该研究表明，弹药碎片导致的眼外伤是反叛乱和代理战争中眼部发病的最常见原因。在这种敌对环境中部署的人员使用防护眼镜并严格遵守预防措施，将有效地挽救眼睛以及医疗和经济资源。
