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

Ocular Blast Injuries in Terrorism

Meeting Abstract

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  • Deepak Kalra - Chandimandir/India

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. DocISOTRG2008V050

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

Published: June 18, 2008

© 2008 Kalra.
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.



Purpose: The incidence of ocular trauma has risen tremendously as warfare has progressed from the use of conventional guns and bayonets to more powerful and sophisticated explosives used by terrorists: from 2% in the World Wars to over 12% in a proxy war fought recently. The author was involved in treating massive numbers of ocular casualties in one such hostile Operation. This study reveals the front line profile and management of such casualties.

Methods: Over 250 ocular casualties were studied over a period of 10 years. Their evacuation and management was constrained by enemy action, inclement weather and difficulties of casualty evacuation. Thus, the treatment was perforce in stages:

  • Initial Management: in War Zone was purely of life saving nature.
  • Secondary Management: was rendered in Forward Hospitals.
  • Tertiary management: was left to the Eye Centres, where the patients reached either directly or through the previous stages.

All these casualties were put through routine eye examination to extent possible, including radiological, USG and CT Scan, if patient's general condition permitted.

Results: The incidence of adnexal injuries because of shrapnel was very high, ie 50%. Conjunctival and corneal FBs were almost ubiquitous in their presence from IED Blasts, producing a typical peppering of the cornea and the surrounding tissues. Lens injuries were common, about 40% . FBs consisted of stone chips, metal fragments and explosive dust. Endophthalmitis was rare.

In all, 32.5% casualties had perforating eye injuries, an incidence never seen in civilian trauma.

13.33% lost sight.

Cconclusion: This is one of the largest prospective studies of ocular trauma in a proxy war, which has revealed a disproportionately high incidence of eye injuries in such ops because of the use of IEDs and bombs. The authors have suggested numerous management doctrines to bring down the morbidity in such casualties.