Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia
Article Sidebar
Main Article Content
Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and indentify the type of wound, treatment and visual outcomes.
Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012.
Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge.
Conclusions: The ocular trauma related to a landmine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.
Weichel ED, Colyer MH. Combat ocular trauma and systemic injury. Curr Opin Ophthalmol. 2008 Nov,19(6):519–25
Weichel ED, Colyer MH, Ludlow SE, Bower KS, Eiseman AS. Combat ocular trauma visual outcomes during operations iraqi and enduring freedom. Ophthalmology. 2008 Dec;115(12):2235–45
Colyer MH, Chun DW, Bower KS, Dick JSB, Weichel ED. Perforating globe injuries during operation Iraqi Freedom. Ophthalmology. 2008 Nov;115(11):2087–93
Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am. 2002 Jun;15(2):163–5, vi
Schmidt GW, Broman a T, Hindman HB, Grant MP. Vision survival after open globe injury predicted by classification and regression tree analysis. Ophthalmology. 2008 Jan;115(1):202–9
Abrames E, Folio L. CT severity spectrum of penetrating eye injuries from blasts. Mil Med. 2012 Feb;177(2):169–73
Kuhn F, Morris R, Witherspoon CD. Birmingham Eye Trauma Terminology (BETT): terminology and classification of mechanical eye injuries. Ophthalmol Clin North Am. 2002 Jun;15(2):139–43, v
Lima-Gómez V, Razo Blanco-Hernández DM R-DJ. Ocular trauma score para la evaluación inicial del trauma ocular. Cir Cir. 2010;78(3):209–13
Restrepo AC, Lópe JA. Clinical and microbiological profiles of anti-personnel mine injuries in the Medellín area of northwestern Colombia. Biomédica. 2010;30(3):338–44
Vicipresidencia de la República (Colombia). Situación por MAP y MUSE. Colombia: Derechos Humanos y DIH; 2008. Available from: http://www.derechoshumanos.gov.co/Prensa/destacados/documents/2010/eventos.pdf
Barak A, Elhalel A, Pikkel J, Krauss E, Miller B. Incidence and severity of ocular and adnexal injuries during the Second Lebanon War among Israeli soldiers and civilians. Graefes Arch Clin Exp Ophthalmol. 2011 Dec;249(12):1771–4
Janković S, Zuljan I, Sapunar D, Buća A, Plestina-Borjan I. Clinical and radiological management of wartime eye and orbit injuries. Mil Med.; 1998 Jun;163(6):423–6
Nguyen QD, Kruger EF, Kim AJ, Lashkari MH, Lashkari K. Combat eye trauma: intraocular foreign body injuries during the Iran-Iraq war (1980-1988). Int Ophthalmol Clin. 2002 Jan;42(3):167–77
Plestina-Borjan I, Medvidovic-Grubisic M, Zuljan I, Lakos V, Miljak S, Markovic I, et al. Wartime open globe eye injuries. Graefes Arch Clin Exp Ophthalmo. 2010 Mar;248(3):305–12
Sobaci G, Mutlu FM, Bayer a, Karagül S, Yildirim E. Deadly weapon-related open-globe injuries: outcome assessment by the ocular trauma classification system. Am J Ophthalmol. 2000 Jan;129(1):47–53
Sobaci G, Akýn T, Mutlu FM, Karagül S, Bayraktar MZ. Terror-related open-globe injuries: a 10-year review. Am J Ophthalmol. 2005 May;139(5):937–9
Coupland RM, Korver a. Injuries from antipersonnel mines: the experience of the International Committee of the Red Cross. BMJ. 1991 Dec 14;303(6816):1509–12
Colyer MH, Weber ED, Weichel ED, Dick JSB, Bower KS, Ward TP, et al. Delayed intraocular foreign body removal without endophthalmitis during Operations Iraqi Freedom and Enduring Freedom. Ophthalmology. 2007 Aug;114(8):1439–47
Thach AB, Ward TP, Dick JSB, Bauman WC, Madigan WP, Goff MJ, et al. Intraocular foreign body injuries during Operation Iraqi Freedom. Ophthalmology. 2005 Oct;112(10):1829–33
Ehlers JP, Kunimoto DY, Ittoop S, Maguire JI, Ho AC, Regillo CD. Metallic intraocular foreign bodies: characteristics, interventions, and prognostic factors for visual outcome and globe survival. Am J Ophthalmol. 2008 Sep;146(3):427–33
Sobaci G, Akin T, Erdem U, Uysal Y, Karagül S. Ocular trauma score in deadly weapon-related open-globe injuries. Am J Ophthalmol. 2006 Apr;141(4):760–1
Parke DW, Pathengay A, Flynn HW, Albini T, Schwartz SG. Risk factors for endophthalmitis and retinal detachment with retained intraocular foreign bodies. J Ophthalmol. 2012 Jan;2012:758526
Savar A, Andreoli MT, Kloek CE, Andreoli CM. Enucleation for open globe injury. Am J Ophthalmol. 2009 Apr;147(4):595–600.e1.
Downloads
- Margarita María Suárez, Mussatyé Elorza, Jorge Hernando Donado, Luis Alfredo Londoño, David Andrés Espinal, Clinical and epidemiological characteristics of pediatric patients with positive serology for Mycoplasma pneumoniae, treated in the third level hospital from 2006 to 2008 , Colombia Medica: Vol. 42 No. 2 (2011)
- Carlos Andrés Molina, Jorge Hernando Donado, Liliana María Vélez, Natalia Andrea Martínez, Ana Isabel Rivera, Uveitis in patients with diagnosis of seronegative spondyloarthropathies. Hospital Pablo Tobón Uribe, Medellín, Colombia. , Colombia Medica: Vol. 38 No. 4 (2007)
Accepted 2013-11-05
Published 2013-12-31
The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use