title: Ocular injuries sustained by survivors of the Oklahoma City bombing.
abstract: OBJECTIVE
  The purpose of this study is to provide a review of the ocular injuries sustained by survivors of the April 19, 1995, bombing of the Alfred P. Murrah Federal Building in Oklahoma City.
  
  
  METHODS
  Retrospective, noncomparative case series.
  
  
  METHODS
  The authors retrospectively evaluated data collected on all surviving persons receiving ocular injuries during the bombing and on all at-risk occupants of the federal building and four adjacent buildings.
  
  
  METHODS
  Injury data from survivors were collected from multiple sources to include hospital medical records, a physician survey, emergency medical services run reports, written survivor accounts, building occupant survey, telephone interviews, and mail surveys.
  
  
  METHODS
  The types of ocular injuries, the associated systemic injuries, and the location of the injured at the time of the blast were evaluated.
  
  
  RESULTS
  Fifty-five (8%) of the 684 injured bombing survivors sustained an ocular injury. Persons injured in the Murrah building were more than three times more likely to sustain an ocular injury than other injured persons. Seventy-one percent of ocular injuries occurred within 300 feet of the point of detonation. The most common serious ocular injuries included lid/brow lacerations (20 patients, 23 eyes), open globe injuries (12 eyes), orbital fractures (6 eyes), and retinal detachment (5 eyes). A retained intraocular foreign body accounted for only two of the injuries (4%). Glass accounted for nearly two thirds of the ocular injuries.
  
  
  CONCLUSIONS
  Blasts involving explosions inflict severe ocular injury, mostly as a result of secondary blast effects from glass, debris, etc. Eye injuries in bombings can probably be prevented by increasing the distance from and orientation away from windows (i.e., by facing desks away from windows). Use of such products as laminated glass, toughened window glazing, and Mylar curtains may reduce glass projectiles in the blast vicinity.
authors.affiliation: Ophthalmology Service, Walter Reed Army Medical Center, Washington, DC, USA.
authors.forename: M
authors.initials: M
authors.lastname: Mines
authors.forename: A
authors.initials: A
authors.lastname: Thach
authors.forename: S
authors.initials: S
authors.lastname: Mallonee
authors.forename: L
authors.initials: L
authors.lastname: Hildebrand
authors.forename: S
authors.initials: S
authors.lastname: Shariat
mesh_terms: D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D019548:Crime Victims; D005107:Explosions; D005129:Eye Foreign Bodies / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D015807:Eye Injuries, Penetrating / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D005138:Eyebrows / Q000293:injuries*; D005143:Eyelids / Q000293:injuries*; D005260:Female; D005898:Glass; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D009915:Orbit / Q000293:injuries*; D009917:Orbital Fractures / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D012189:Retrospective Studies; D017741:Survivors