Intraocular Foreign Body Trauma in Operation Iraqi Freedom and Operation Enduring Freedom

Purpose We update the incidence of intraocular foreign bodies (IOFB) in soldiers admitted to Walter Reed Army Medical Center from 2001 to 2011 after sustaining combat injuries in Operation Iraqi Freedom and Operation Enduring Freedom. Design This consecutive retrospective case series included 890 eyes of 652 patients. Methods Data were collected in the Walter Reed Ocular Trauma Database. Inclusion criteria were any American soldier or Department of Defense civilian with an IOFB injured in Operation Iraqi Freedom/Operation Enduring Freedom. Closed globe injuries with orbital foreign bodies, injury outside of a combat zone, or non–Department of Defense civilian trauma were the exclusion criteria. Main Outcome Measures Primary outcome measures were final visual outcome and the number, size, and location of IOFBs. Secondary outcome measures included surgical procedures, use of eye protection, associated complications, source of injury and Ocular Trauma Score. Results There were 890 eye injuries in 652 patients evacuated to Walter Reed Army Medical Center between 2001 and 2011. IOFBs were found in 166 eyes of 149 patients (18.6%; 95% confidence interval [CI], 16.2%–21.3%). Most patients had a single IOFB (80.7%). An IOFB was positively associated with Ocular Trauma Score grade 1 or 2 (0–65) injuries (odds ratio [OR], 1.58; 95% CI, 1.07–2.38; P = 0.01). There were 130 eyes (78.33%) that had recorded time from initial visual acuity to final visual acuity and it ranged from 8 to 2421 days (mean, 433.24 days). Thirty-eight (25.16%; 95% CI, 18.89%–32.67%) eyes had no change in visual acuity, 98 (64.90%; 95% CI, 57.00%–72.07%) had improved visual acuity, and 15 (9.93%; 95% CI, 6.01%–15.84%) had decreased visual acuity. IOFB was not found to predict final visual acuity of Conclusions IOFBs occur frequently in combat ocular trauma and are significantly associated with more severe injuries. However, IOFBs were not found to be a significant risk factor for visual acuity of