Comparison of domestic and war ocular injuries during the Lebanese Civil War

Abstract

Objective: To examine the differences between war and domestic ocular injuries during the Lebanese Civil War in terms of baseline characteristics, treatment provided and prognosis.

Methods: We retrospectively reviewed the charts of subjects with traumatic ocular injuries referred to a major medical center from 1980 to 1996. The variables were tabulated according to the international classification of ocular trauma.

Results: Compared to domestic ocular injuries, war injuries were significantly more likely to include males (84.7 vs. 75.1%) and adults (72.7 vs. 39.1%), concomitant systemic injury (43.7 vs. 10.1%), and bilateral ocular affection (19.3 vs. 4.4%). Also, patients with war injuries had significantly worse initial and final visual acuities, less visual improvement (28.6 vs. 44.8%), and more intraocular foreign bodies (42.9 vs. 11%), the majority being metallic removed via an electric magnet. Moreover, war injuries had significantly more posterior scleral involvement 5 mm behind the limbus (25.2 vs. 11.6%) with more secondary retinal detachment (10.3 vs. 4.8%) and vitreous hemorrhage (36.6 vs. 17.1%). Primary evisceration was performed significantly more frequently in war injuries (24.0%) than in domestic injuries (7.7%).

Conclusions: During the Lebanese Civil War, war injuries compared to domestic ones were severer resulting in more enucleation/evisceration and more retinal detachment, tended to be bilateral, and were accompanied by concurrent systemic injuries and less visual recovery. Wearing special glasses and imposing an international arms embargo are recommended to decrease ocular injuries and blinding consequences in potential future wars.