DoD and VA Vision Care
Increases Focus on Eye Injuries

Combat in the Middle East has dramatically increased the number of eye injuries occurring among service members. Eyes can be injured in a number of ways, all requiring different approaches to treatment and care. Those most commonly experienced by deployed military personnel today are a result of explosive devices and projectiles; traumatic brain injury (TBI) which can cause visual disorders; and injury caused by exposure to chemicals, biohazards, lasers or extreme environmental conditions. More than 1,000 combat-related eye injuries were treated between 2003 and 2007.

Understanding and treating these injuries is very challenging. Many are quite rare in the civilian community and have been uncommon in the military until OIF and OEF. Consequently, the Department of Defense (DoD) and the Veterans Administration (VA) are pooling their resources to establish the DoD/VA Vision Center of Excellence (VCE). This will allow for continuity of care as personnel transition back and forth from military to veterans status and a pooling of treatment and research expertise.

Eye injuries can be quite complicated. With blast injuries, trauma occurs to retinal, nerve, eyeball, and eye socket tissue. The overall effect on the eye and vision is not yet well-understood. In the case of TBI, damage to the ocular is often the most significant visual impact, but brain damage that affects how one sees or interprets what s/he is seeing can also occur. About 60-70 percent of severe and moderate TBI cases and 40 percent of mild TBI cases include some form of visual impairment. The VCE will help to coordinate and track successful treatment plans and outcomes.

The VCE focuses on five major areas of eye health: developing treatments for TBI-associated visual problems; treatments to slow or stop vision loss in traumatic optic nerve diseases; developing models of the mechanisms of primary blast injury to the eye and vision system; methods to test visual dysfunction in people with brain damage; and treatments for blast and burn injury to ocular structures. Since many practitioners are not familiar with traumatic eye injuries, they are also developing teaching models for training care providers in the treatment of eye injuries.

Even as the treatment of eye injuries reaches new levels of capability, improvements in combat protective eyewear are decreasing the numbers of eye injuries from ballistic (projectile) impacts. As yet, no new equipment has been developed to lessen the impact of blast injuries. The VCE plans to participate in the redesign of facial protective gear for this purpose.

Additional information:
VCE Press Release: New DoD/VA Center to Improve Eye Care
The Army Vision Readiness and Conservation Program