Ocular trauma under the shadow of terror.
OBJECTIVE
To determine the prevalence and severity of penetrating eye trauma (PET) in victims of terror attacks in Jerusalem and to determine their specific in-hospital needs; and to evaluate the role of the ophthalmic nurse in helping to treat these patients in wards other than the ophthalmology ward and to determine how the ophthalmic nurse can coordinate care of the patients with other hospital personnel.


BACKGROUND
PET is a common cause of significant visual loss. Early treatment is mandatory if maximum vision is to be restored. From January 2000 through February 2003, 468 victims of terror were examined in one of two major hospitals in Jerusalem that treat ocular injuries; 40 (8.5%) of these patients suffered from PET.


METHODS
We conducted in our hospital a retrospective chart review of 109 consecutive patients with PET from January 2000 to February 2003; 40 (36.7%) cases were caused by terrorism. Data were collected on demographic characteristics; type, cause and extent of injury; and visual acuity (VA) on admission and at discharge. The terror victims were hospitalized in intensive care, surgical, and ophthalmology wards.


RESULTS
Of the patients admitted after terrorist attacks, 64% were male. Arab patients comprised 20% of those admitted. Ninety-five percent of the terror victims with PET required surgery (20% for enucleation, 30% for retinal detachment, and the remaining 45% for other causes). Eighty-two percent of these victims presented with a visual acuity > or = 20/200 in the injured eye (versus 63% in patients admitted with ocular trauma from other causes), and 44% remained blind at discharge (versus 28% from other causes).


CONCLUSIONS
Terror victims have more severe ocular injuries than do other patients with PET Ophthalmic nurses must make a special effort to attend to these patients in wards other than the ophthalmology wards and to coordinate their in-hospital care and follow-up treatments with hospital personnel in intensive care and surgical wards.
Mimran
Sheila
S
Hadassah University Hospital, Ein Kerem, Jerusalem, Israel. Sheila@hadassah.org.il
Rotem
Ruth
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005131:Eye Injuries / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D024802:Nurse's Role; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D023481:Terrorism; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing