Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T23:07:01.907Z Has data issue: false hasContentIssue false
  • English
  • Français

Blast Eye Injuries: A Review for First Responders

Published online by Cambridge University Press:  08 April 2013

Michael G. Morley ,
Jackie K. Nguyen ,
Jeffrey S. Heier ,
Bradford J. Shingleton ,
Joseph F. Pasternak  and
Kraig S. Bower
Get access Rights & Permissions [Opens in a new window]

Abstract

As the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.

(Disaster Med Public Health Preparedness. 2010;4:154-160)

Keywords

eye injurieswarfareblast injuriesterrorismtraumawounds and injuriesforeign bodiesreview articles
Type
Review Articles
Information
Disaster Medicine and Public Health Preparedness , Volume 4 , Issue 2 , June 2010 , pp. 154 - 160
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.US Department of State, Office of the Coordinator for Counterterrorism. Country Reports on Terrorism 2005: United States Department of State. Publication 11324. http://www.state.gov/documents/organization/65462.pdf. Published April 2006. Accessed February 20, 2007.Google Scholar
2.Kapur, GB, Hutson, HR, Davis, MA, Rice, PL.The United States twenty-year experience with bombing incidents: implications for terrorism preparedness and medical response. J Trauma. 2005;59 (6):1436–1444.Google Scholar
3.DePalma, RG, Burris, DG, Champion, HR, Hodgson, MJ.Blast injuries. N Engl J Med. 2005;352 (13):1335–1342.Google Scholar
4.Wightman, JM, Gladish, SL.Explosions and blast injuries. Ann Emerg Med. 2001;37 (6):664–678.Google Scholar
5.Centers for Disease Control and Prevention. Explosions and blast injuries: a primer for clinicians. CDC Emergency Preparedness & Response Web site. http://www.bt.cdc.gov/masscasualties/explosions.asp. Published June 14, 2006. Accessed February 20, 2007.Google Scholar
6.Pennardt, A, Lavonas, E.Blast injuries. eMedicine Web site. http://www.emedicine.com/emerg/topic63.htm. Published January 17, 2006. Accessed February 20, 2007.Google Scholar
7.Frykberg, ER.Medical management of disasters and mass casualties from terrorist bombings: how can we cope? J Trauma. 2002;53 (2):201–212.Google Scholar
8.Mines, M, Thach, A, Mallonee, S, Hildebrand, L, Shariat, S.Ocular injuries sustained by survivors of the Oklahoma City bombing. Ophthalmology. 2000;107 (5):837–843.Google Scholar
9.Odhiambo, WA, Guthua, SW, Macigo, FG, Akama, MK.Maxillofacial injuries caused by terrorist bomb attack in Nairobi, Kenya. Int J Oral Maxillofac Surg. 2002;31 (4):374–377.CrossRefGoogle ScholarPubMed
10.Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center–New York City, September 2001. MMWR Morb Mortal Wkly Rep. 2002;51:1–5.Google Scholar
11.Carley, SD, Mackway-Jones, K.The casualty profile from the Manchester bombing 1996: a proposal for the construction and dissemination of casualty profiles from major incidents. J Accid Emerg Med. 1997;14 (2):76–80.CrossRefGoogle ScholarPubMed
12.Thach, AB, Ward, TP, Hollifield, RD, Cockerham, K, Birdsong, R, Kramer, KK.Eye injuries in a terrorist bombing: Dhahran, Saudi Arabia, June 25, 1996. Ophthalmology. 2000;107 (5):844–847.Google Scholar
13.Heier, JS, Enzenauer, RW, Wintermeyer, SF, Delaney, M, LaPiana, FP.Ocular injuries and diseases at a combat support hospital in support of Operations Desert Shield and Desert Storm. Arch Ophthalmol. 1993;111 (6):795–798.CrossRefGoogle Scholar
14.Mader, TH, Aragones, JV, Chandler, AC.Ocular and ocular adnexal injuries treated by United States military ophthalmologists during Operations Desert Shield and Desert Storm. Ophthalmology. 1993;100 (10):1462–1467.Google Scholar
15.Mader, TH, Carroll, RD, Slade, CS, George, RK, Ritchey, JP, Neville, SP.Ocular war injuries of the Iraqi Insurgency, January-September 2004. Ophthalmology. 2006;113 (1):97–104.CrossRefGoogle ScholarPubMed
16.Beiran, I, Miller, B.Pure ocular blast injury. Am J Ophthalmol. 1992;114 (4):504–505.Google Scholar
17.Feeney, JM, Goldberg, R, Blumenthal, JA, Wallack, MK.September 11, 2001, revisited: a review of the data. Arch Surg. 2005;140 (11):1068–1073.Google Scholar
18.Muzaffar, W, Khan, MD, Akbar, MK, Malik, AM, Durrani, OM.Mine blast injuries: ocular and social aspects. Br J Ophthalmol. 2000;84 (6):626–630.Google Scholar
19.Wong, TY, Seet, MB, Ang, CL.Eye injuries in twentieth century warfare: a historical perspective. Surv Ophthalmol. 1997;41 (6):433–459.Google Scholar
20.Shingleton, BJ, Hersh, PS.Traumatic hyphema. In: Shingleton BJ, Hersh PS, Kenyon KR, eds. Eye Trauma. St Louis: Mosby-Year Book; 1991:104-116.Google Scholar
21.Sobaci, G, Akyn, T, Mutlu, FM, Karagul, S, Bayraktar, MZ.Terror-related open globe injuries: a 10-year review. Am J Ophthalmol. 2005;139 (5):937–939.CrossRefGoogle Scholar
22.Holmes, S, Coombes, A, Rice, S, Wilson, ABarts and the London NHS Trust. The role of the maxillofacial surgeon in the initial 48 h following a terrorist attack. Br J Oral Maxillofac Surg. 2005;43 (5):375–382.Google Scholar
23.Colyer, MH, Weber, ED, Weichel, ED.Delayed intraocular foreign body removal without endophthalmitis during Operations Iraqi Freedom and Enduring Freedom. Ophthalmology. 2007;114 (8):1439–1447.Google Scholar
24.Vachon, CA, Warner, DO, Bacon, DR.Succinylcholine and the open globe. Tracing the teaching. Anesthesiology. 2003;99 (1):220–223.CrossRefGoogle ScholarPubMed
25.Hamill, MB.Clinical evaluation. In: Shingleton BJ, Hersh PS, Kenyon KR, eds. Eye Trauma. St Louis: Mosby-Year Book; 1991:3-24.Google Scholar
26.Levin, MR, D'Amico, DJ.Traumatic endophthalmitis. In: Shingleton BJ, Hersh PS, Kenyon KR, eds. Eye Trauma. St Louis: Mosby-Year Book; 1991:242-251.Google Scholar
27.Sternberg, P JrPrognosis and outcomes for penetrating ocular trauma. In: Shingleton BJ, Hersh PS, Kenyon KR, eds. Eye Trauma. St Louis: Mosby-Year Book; 1991:238-241.Google Scholar
28.Khouri, AS.Civilian eye injuries in warfare. Surv Ophthalmol. 1998;42 (4):390–391.Google ScholarPubMed
29.Quere, MA, Bouchat, J, Cornand, G.Ocular blast injuries. Am J Ophthalmol. 1969;67 (1):64–69.Google Scholar
30.Wong, TY, Smith, GS, Lincoln, AE, Tielsch, JM.Ocular trauma in the United States Army: hospitalization records from 1985 through 1994. Am J Ophthalmol. 2000;129 (5):645–650.Google Scholar