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Review Article

Blast Eye Injuries: A Review for First Responders

Michael G. Morley, MD, Jackie K. Nguyen, MD, Jeffrey S. Heier, MD, Bradford J. Shingleton, MD, Joseph F. Pasternak, MD and Kraig S. Bower, MD

Author Affiliations: Drs Morley, Nguyen, Heier, and Shingleton are with the Department of Ophthalmology, Tufts University School of Medicine; Dr Pasternak is with the Ophthalmology Service, National Naval Medical Center; and Dr Bower is with the Ophthalmology Service, Walter Reed Army Medical Center.

As the rate of terrorism increases, it is important for health care providers to become familiar with the management of injuries inflicted by blasts and explosions. This article reviews the ocular injuries associated with explosive blasts, providing basic concepts with which to approach the blast-injured patient with eye trauma. We conducted a literature review of relevant articles indexed in PubMed between 1948 and 2007. Two hundred forty-four articles were reviewed. We concluded that ocular injury is a frequent cause of morbidity in blast victims, occurring in up to 28% of blast survivors. Secondary blast injuries, resulting from flying fragments and debris, cause the majority of eye injuries among blast victims. The most common blast eye injuries include corneal abrasions and foreign bodies, eyelid lacerations, open globe injuries, and intraocular foreign bodies. Injuries to the periorbital area can be a source of significant morbidity, and ocular blast injuries have the potential to result in severe vision loss.

Key Words: eye injuries • warfare • blast injuries • terrorism • trauma • wounds and injuries • foreign bodies • review articles