title: Ocular blast injuries related to explosive military ammunition.
abstract: OBJECTIVE
  To report the clinical features of ocular injuries associated with explosive military ammunition in insurgent attacks in Turkey.
  
  
  METHODS
  The medical records of 48 casualties who were treated for ocular injuries sustained in insurgent attacks at the Combat Region Hospitals in Turkey were retrospectively reviewed. The reviewed data included initial visual acuity, type of explosive military ammunition (ie, improvised explosive device, mine, hand grenade and rocket-propelled grenade), type of globe injury (open-globe vs closed-globe injury), traumatised globe zones, the presence/absence of an intraocular foreign body, medical interventions, status during the explosion and injuries to other parts of the body. The visual acuity differences between different explosive materials and between 'on-foot' and 'inside-vehicle' casualties were investigated.
  
  
  RESULTS
  A total of 83 injured eyes were analysed. The mean patient age was 24.5±6.6 years. The mean initial logarithm of the minimum angle of resolution visual acuity was 0.60±0.63. The injuries were due to improvised explosive devices in 28 cases (58.3%), land mines in 16 cases (33.3%), and hand grenades and rocket-propelled grenades in 2 cases each (4.2%). Forty-seven eyes (56.6%) had open-globe injuries. The most frequently involved zones were zone 1 (50.0%) in closed-globe injuries and all zones (31.9%) in open-globe injuries. Intraocular foreign bodies were present in 45/47 (95.7%) eyes with open-globe injuries. Twelve (14.4%) eyes with no light perception were enucleated, and two (2.4%) eviscerated. The difference in the visual acuities between the on-foot and inside-vehicle casualties and between the injuries that were caused by the different types of explosive ammunitions was also insignificant (p=0.271 and 0.394, respectively).
  
  
  CONCLUSIONS
  The clinical results for eye injuries caused by explosive military ammunition sustained during insurgent attacks in Turkey are disappointing irrespective of the explosive material. The use of protective eyeglasses might improve the outcomes and should be encouraged.
authors.affiliation: Department of Ophthalmology, GATA Medical School, Ankara, Turkey.
authors.forename: Fatih Cakir
authors.initials: FC
authors.lastname: Gundogan
authors.affiliation: Department of Ophthalmology, Izmir Military Hospital, Izmir, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Akay
authors.affiliation: Department of Ophthalmology, Sarıkamış Military Hospital, Siirt, Turkey.
authors.forename: U
authors.identifier: http://orcid.org/0000-0002-2605-3413
authors.initials: U
authors.lastname: Yolcu
authors.affiliation: Department of Ophthalmology, Etimesgut Military Hospital, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Uzun
authors.affiliation: Department of Ophthalmology, Erzurum Military Hospital, Erzurum, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Ilhan
authors.affiliation: Department of Ophthalmology, Izmir Military Hospital, Izmir, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Toyran
authors.affiliation: Department of Emergency Medicine, GATA Medical School, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Eyi
authors.affiliation: Department of Ophthalmology, GATA Medical School, Ankara, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Diner
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005107:Explosions; D005129:Eye Foreign Bodies / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D015807:Eye Injuries, Penetrating / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology; D005135:Eye Protective Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D012189:Retrospective Studies; D014421:Turkey; D014792:Visual Acuity; D014857:Warfare; D055815:Young Adult
keywords: ACCIDENT & EMERGENCY MEDICINE; TRAUMA MANAGEMENT