Temporary Keratoprosthesis and Primary Corneal Graft for Ocular Trauma: A Systematic Review and Meta-Analysis.

Purpose: When severe retinal and corneal injury occur together, a temporary keratoprosthesis (TKP) is often a last resort to allow posterior segment visualization to enable vitreoretinal surgery, followed by a penetrating keratoplasty (PKP) which can restore corneal clarity in a single operation. We aimed to assess visual outcomes following combined PKP and vitreoretinal surgery with the use of a TKP for cases of ocular trauma.

Design: A systematic literature review was performed following PRISMA guidelines (PROSPERO registration number: CRD42023423518).

The Risk of Sympathetic Ophthalmia Associated with Open-Globe Injury Management Strategies: A Meta-analysis.

Topic: Sympathetic ophthalmia (SO) is a sight-threatening granulomatous panuveitis caused by a sensitizing event. Primary enucleation or primary evisceration, versus primary repair, as a risk management strategy after open-globe injury (OGI) remains controversial.

Clinical Relevance: This systematic review was conducted to report the incidence of SO after primary repair compared with that of after primary enucleation or primary evisceration.

The Use of Preoperative Prophylactic Systemic Antibiotics for the Prevention of Endopthalmitis in Open Globe Injuries: A Meta-Analysis.

Topic: This study reports the effect of systemic prophylactic antibiotics (and their route) on the risk of endophthalmitis after open globe injury (OGI).

Clinical Relevance: Endophthalmitis is a major complication of OGI; it can lead to rapid sight loss in the affected eye. The administration of systemic antibiotic prophylaxis is common practice in some health care systems, although there is no consensus on their use.

Teleophthalmology in the United States Army: A Review From 2004 Through 2018.

Introduction: We describe results of the U.S. Army Ocular Teleconsultation program from 2004 through 2018 as well as the current condition, benefits, barriers, and future opportunities for teleophthalmology in the clinical settings and disease areas specific to the U.

Traumatic brain injury and sight loss in military and veteran populations- a review.

War and combat exposure pose great risks to the vision system. More recently, vision related deficiencies and impairments have become common with the increased use of powerful explosive devices and the subsequent rise in incidence of traumatic brain injury (TBI). Studies have looked at the effects of injury severity, aetiology of injury and the stage at which visual problems become apparent.

A Sub-Analysis of U.S. Africa Command Area of Operations Transportations for Ophthalmic Concerns, 2008-2018.

Introduction: American military personnel in U.S. Africa Command (AFRICOM) operate in a continent triple the size of the USA without mature medical facilities, requiring a substantial transportation network for medical evacuation.

The ABCs of Ocular Trauma: Adapting a Familiar Mnemonic for Rapid Eye Exam in the Pre-Ophthalmic Zone of Care.

Evaluation and management of eye trauma is daunting to many practitioners. For general medical emergencies, the familiar ABCs mnemonic serves to both recompose the provider as well as provide a logical order for evaluation and action. We recently adapted an ABCs mnemonic to provide non-ophthalmologists with a familiar method for systematically evaluating and managing eye trauma.

The Joint Pathology Center/Vision Center of Excellence Approach to Analyzing Intra-Ocular "Foreign Bodies".

Background: The Military Health System recognizes the importance of analyzing "foreign bodies" removed from US service members through several policy documents. This activity focuses on detecting potentially toxic metals. Intra-ocular "foreign bodies" (IOFBs) represent a small, clinically important subset.

Ocular Manifestations of Mosquito-Transmitted Diseases.

Of the 3,548 known mosquito species, about 100 transmit human diseases. Mosquitoes are distributed globally throughout tropical and temperate regions where standing water sources are available for egg laying and the maturation of larva. Female mosquitoes require blood meals for egg production.

Simplified Method for Rapid Field Assessment of Visual Acuity by First Responders After Ocular Injury.

Objective: Initial visual acuity after ocular injury is an important measure, as it is an accurate predictor of final visual outcome and gives a rapid estimation of the overall severity of the injury, thereby aiding evacuation prioritization. We devised a simple method for rapidly assessing visual acuity in the field without having to rely on formal screening cards.

Methods: Using common objects, icons, and text found in the injury zone - for example, common military name tapes, rank insignias, patches, emblems, and helmet camouflage bands, which will be known collectively as the Army Combat Optotypes (ACOs) - a Snellen-equivalent method of assessing visual acuity was devised and correlated to the ocular trauma score (OTS).

The Biological Basis of Chronic Traumatic Encephalopathy following Blast Injury: A Literature Review.

The United States Department of Defense Blast Injury Research Program Coordinating Office organized the 2015 International State-of-the-Science meeting to explore links between blast-related head injury and the development of chronic traumatic encephalopathy (CTE). Before the meeting, the planning committee examined articles published between 2005 and October 2015 and prepared this literature review, which summarized broadly CTE research and addressed questions about the pathophysiological basis of CTE and its relationship to blast- and nonblast-related head injury. It served to inform participants objectively and help focus meeting discussion on identifying knowledge gaps and priority research areas.

Atropine Eye Drops: A Proposed Field Expedient Substitute in the Absence of Atropine Autoinjectors.

Nerve agents are a threat to military and civilian health. The antidote, atropine sulfate, is delivered by autoinjector, which is a limited resource. We propose the use of 1% atropine ophthalmic solution (supplied commercially in 5mL or 15 mL bottles) via oral, ocular, and intranasal administration as an expedient substitute in austere environments.

Self-Reported Visual Quality of Life After Combat Ocular Trauma.

Objectives: To describe the visual outlook and quality of life of service members after combat ocular trauma.

Methods: In a single-center, prospective observational study of service members sustaining ocular trauma, participants underwent a series of ocular examinations and noninvasive tests, including the National Eye Institute Visual Functioning Questionnaire (VFQ-25).

Results: Of the 165 enrolled participants, 137 completed the VFQ-25.

The use of rigid eye shields (Fox shields) at the point of injury for ocular trauma in Afghanistan.

Background: Unlike hemorrhagic injuries in which direct pressure is indicated, any pressure placed on the eye after penetrating trauma can significantly worsen the injury by expulsing intraocular contents. The accepted first response measure for obvious or suspected penetrating ocular injury is placement of a rigid shield that vaults the eye so as to prevent accidental iatrogenic aggravation during transport to the ophthalmologist. Patching and placing intervening gauze between the shield and the eye are both contraindicated.

Ocular blast injuries in mass-casualty incidents: the marathon bombing in Boston, Massachusetts, and the fertilizer plant explosion in West, Texas.

Purpose: To report the ocular injuries sustained by survivors of the April 15, 2013, Boston Marathon bombing and the April 17, 2013, fertilizer plant explosion in West, Texas.

Design: Multicenter, cross-sectional, retrospective, comparative case series.

Participants: Seventy-two eyes of 36 patients treated at 12 institutions were included in the study.

Subperiosteal hematoma in multiple settings.

Most reports of orbital hemorrhage do not distinguish among intraconal, extraconal, and subperiosteal hemorrhages, although several reports describe isolated subperiosteal hematomas as a separate entity. We report 3 cases of subperiosteal hematoma with different etiologies but similar progression of signs and symptoms. Each patient presented with spontaneous proptosis, rarely caused by orbital subperiosteal hematoma, measuring approximately 5 mm.

Pediatric PRK (PhotoRefractive Keratectomy) with Mitomycin C (MCC) for Persistent Anisometropic Amblyopia. A Case Report.

Purpose: To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with Mitomycin C (MMC) for the treatment of severe pediatric anisometropia and amblyopia resistant to more conservative treatment modalities.

Methods: A 3 year-old-child, who at 18 months old underwent unilateral diode laser treatment for threshold ROP, developed 11 diopters of anisometropic myopia and secondary dense amblyopia of the Right Eye. Only after all conservative treatment options failed was he treated with PRK and MMC.

The United States Army Ocular Teleconsultation program 2004 through 2009.

Purpose: To describe the United States Army Ocular Teleconsultation program and all consultations received from its inception in July 2004 through December 2009.

Design: Retrospective, noncomparative, consecutive case series.

Methods: All 301 consecutive ocular teleconsultations received were reviewed.