gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Eye Injuries in Suicide Bomber Terrorist Attacks “ The Tel Aviv Medical Center Experience"

Meeting Abstract

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  • Adiel Barak - Tel Aviv/Israel

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V049

The electronic version of this article is the complete one and can be found online at:

Published: June 18, 2008

© 2008 Barak.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: The number and extent of worldwide suicide attacks has risen sharply in recent years. The objectives of this retrospective study are: to determine the prevalence and outcome of the victims who sustained ocular injury, to describe the activities of ophthalmologists in the setting of an emergency department (ED) receiving mass casualties of a suicide bombing attack and to illustrate some of the treatment obstacles that they encountered and the protocol.

Methods: Design: Retrospective, interventional case series. Participants: Victims of 13 suicide bombing attacks (2000‑2004), treated at level I trauma center of an Israeli tertiary care, municipal medical center.

Main Outcome Measures: Description of the ophthalmologist’s role in the setting of mass evacuation to emergency facilities; prevalence and outcome of patients managed according to the recommended guidelines. Reemphasis of logistic and therapeutic guidelines for management of ocular injuries.

Results: The trauma center database yielded information on a total of 352 casualties from 13 suicide bombing attacks, including 17 surviving patients with any ocular/periocular trauma resulting from suicide bombing attacks. Six eyes required and underwent urgent primary closure of laceration for primary repair of open globe, one unsalvageable eye underwent primary enucleation, and two eyes underwent exploration of subconjunctival hemorrhage. Four eyes required additional surgical intervention which was performed within 7 days (large intravitreal foreign bodies were extracted from 3 eyes whose final visual acuity was poor, and an intra‑lenticular foreign body was extracted from the fourth eye whose final visual acuity was 6/12). The remaining 8 patients received medical treatment as indicated and were continued to be followed-up.

Discussion: Ocular trauma management under conditions of mass injuries requires special utilization of manpower and resources. Guidelines for efficacious patient management, description of the ophthalmologist’s role, and the experience of one emergency facility are presented.