Combat ocular trauma in counterinsurgency operations.

PURPOSE: To identify the pattern, distribution, and causes of ocular injuries among the security personnel participating in counterinsurgency operations (CIOps). METHODS: This was a multicentric, retrospective review of chart records of patients reporting to three hospitals located in the geographic region affected by CIOps. The hospital registry was examined for all patients diagnosed with any type of ocular trauma between January 1, 2016, and December 31, 2019. A standardized proforma was filled out using the case records, and entries were validated. RESULTS: A total of 131 ocular injuries fulfilled the criteria of the study. The mean age of the patients was 32.46 ± 10.2 years. All the patients were males. The causes of the injuries were explosive blasts in 60 eyes (45.80%), gunshot wounds in 15 eyes (11.42%), stone pelting in 16 eyes (12.21%), training-related causes in 26 eyes (29.84%), vehicular accidents in 13 eyes (9.92%), and battery blast in one eye (0.76%). Among the type of injuries, open globe injuries included 66 eyes (50.38%), closed globe injuries included 35 eyes (26.72%), isolated lid lacerations included 14 eyes (10.68%), and isolated chemical injury was seen in two eyes (1.52%). Optic nerve head avulsion was seen in two eyes (1.52%). CONCLUSION: The study revealed a considerable number of ocular injuries related to combat, with explosive bursts being the leading cause. The incidence of ocular injuries was found to be highest in zone 1. This study emphasizes the importance of the need for soldiers deployed in active CIOps regions to wear protective eyewear, such as ballistic goggles or military combat eye protection, to reduce the risk of ocular injuries.

Hyperhomocysteinemia, High Altitude, and Varied Retinal Manifestations: Unravelling the Enigma.

Rana, Vipin, Meenu Dangi, Sandepan Bandopadhayay, Vijay K. Sharma, Satyabrat Srikumar, Jitesh Goyal, and B.V. Rao. Hyperhomocysteinemia, High Altitude, and Varied Retinal Manifestations: Unravelling the Enigma. High Alt Med Biol. 24:234-237, 2023.-We present five cases of young defense personnel, who were posted at high altitude (HA) for >6 months and presented with reduction of vision between June 2022 and February 2023. The diagnosis made were ocular ischemic syndrome, central retinal artery occlusion, central retinal vein occlusion, branch retinal vein occlusion, and branch retinal artery occlusion. There were no associated comorbidities. Hematological workup revealed increased serum homocysteine and hemoglobin in all patients. Computed tomography angiography was done in cases of ocular ischemic syndrome, and central retinal artery occlusion, which revealed occlusion of carotid artery. All patients were given tab folic acid in view of hyperhomocysteinemia (HHcy). This case series highlights that prolonged exposure to HA may lead to HHcy, which can directly or indirectly lead to various sight-threatening retinal diseases. Thus, effective preventive strategies, such as dietary or pharmacological interventions aimed at lowering serum homocysteine levels, are crucial for individuals posted at HA for longer duration.