The Study Of Military Eye Injury's Characters And Epidemiology Of Various Troops

PurposeTo investigate the characters of military eye injury including demography, cause of injury, traumatic condition, treatment and prognosis, especially comparing the difference among various troops. Then provide effective methods to prevent ocular injury in the troops which have high possibility to be hurt.Methods1. The retrospective study of inpatients:Collected inpatients'record of military personnel with ocular injury in 21 regimental hospitals from 2002-01-01 to 2008-12-31, and filled in the "registered table of inpatient's military ocular injury".2. Cross-sectional investigation in out-patient clinic:Distributed "registered table of military ocular injury" to 21 regimental hospitals before 2009-01-01. When the military personnel visited the doctor because of ocular injury, simultaneously, the doctor filled in the table. The time was from 2009-01-01 to 2009-12-31.3. The pooling datas were statistically analyzed by SPSS13.0.Results1. General information:There were 953 patients with 1012 injured eyes in retrospective study. The ratio of male to female is 104.9:1 and the mean age is 23.57 years. As for cross-sectional investigation, there were 502 patients with 526 injured eyes. The ratio of male to female is 54.8:1 and the mean age is 24.28 years. 2. Causes of injury2.1 The retrospective study of inpatients:①work-related injury(29.2%):The constituent ratios of the army(34.7%) and navy(30.6%) were much higher than air force(20.1%) and armed police(20.5%).It could be often seen in surface warship force (42.5%)of navy and in armored forces (53.1%),communications corps (46.15%),engineering corps (43.9%) of the army.②sports-related injury (27.9%):The highest service is navy(40.41%).③everyday life-related injury (15.3%):Most of the injury occurred in home or habitation and on holiday.④military training-related injury(14.1%):The constituent ratio of navy is only 3.3%, but 30.8% in armed police. It was most often occurred in solder's counter-acting exercises and physical training(45.8%). In armed police, about 66.7% were occurred by exploring training methods of catching and grappling, fall training and cudgel play.2.2 Cross-sectional investigation in out-patient clinic:Work-related injury was often occurred in surface warship force (46.3%). The ratio of sports-related injury(36.1%) was higher than inpatient (27.9%); the ratio was more than 40% in trainee and administrative echelon of navy and air force, airborne troops and naval coast defense arm; the highest ratio was in cadre(50%). As for military training-related injury, the ratios of the army and armed police were 21.4% and 21.3% respectively; like retrospective study, the ratio of navy was the lowest (4.4%); and it was more often happened in skill-training (49.2%) rather than counter-acting exercises (29.5%).3. Traumatic conditionThe retrospective study of inpatients:the ratios of closed injury and opened injury were 65.5% and 10.8% respectively. Open injury was more often in the army (16.2%),especially in armored forces (21.6%).The ratio of intraocular foreign body occurred in the army was 6.2%, while navy, air force and armed police were 0.4%,3.0%,2.4% respectively.Cross-sectional investigation in out-patient clinic:the ratio of closed injury was 61.2%. There were only 8 cases of open injury. Foreign body was often involved on ocular surface and often happened in navy (12.9%)4. Analysis of the time seeing the doctorThe mean interval time of first seeing the doctor was 32.56 hours (standard deviation 285.4),with opened injury 5.683 hours (standard deviation 22.5) and closed injury 45.39 hours (standard deviation 350.4).We found that location of closed injury, involving of vitreous body and retinal detachment were close related to the interval time through analysis of gradual multivariate regression, and involving of vitreous body was negative relation.The mean interval time of seeing ophthalmologist was 50.32 hours (standard deviation 324.7),with opened injury 9.39 hours (standard deviation 24.4) and closed injury 71.77 hours (standard deviation 398.7).We found that interval time of first seeing the doctor, location of closed injury, involving of anterior chamber and retinal detachment were close related to the interval time of seeing ophthalmologist, and involving of anterior chamber was negative relation.5. The treatment of ocular injurySanitary corps or health center:the treatment rate of chemical burn was30.6% and the rate of sutured laceration in eyelid was10.2%.Regimental hospital:In the retrospective study of inpatients, there were 109 eyes with opened injury, and the rate of operation was 89.9%. Analysis of operative time showed that 62.4% operated less than 24 hours,27.5% more than 24 hours, furthermore,10.1% patients without operation. The reasons for delayed operation:①transfer treatment(46.7%);②heavy condition, need more time to prepare (16.7%);③permission of the injury, treating the complication lately(13.3%);④misdiagnosis(13.3%);⑤ignored by the patient (10%)There were 663 eyes with closed injury, and the rate of operation was 24.3%, and there were 74 eyes in regionⅠ,65 eyes in region II and 22 eyes in region III.The mean interval times of operation were 2.55 days in region I,29.45 days in region II and 87.98 days in region III. 6. The factors affecting the vision prognosis and transfer treatment:the factors strongly affected vision prognosis were open ocular injury, optic nerve's trauma, retinal detachment and involving of vitreous body. One-Way ANOVA of different services showed the vision prognosis of navy and air force was much better than that of the army and armed police.The time of transfer treatment was higher in the army and armed police than in navy and air force. The effective factors were retinal detachment, the type of open ocular injury, explosion injury and involving of vitreous body.Conclusion1. Military training-related injury is less often in navy, but more often in armed police. It is most often occurred in solder's counter-acting exercises and physical training. In armed police, exploring training methods of catching and grappling, fall training and cudgel play were the main subjects.2. Work-related injury is less often in air force and armed police, but more often in the army and navy. It is often seen in surface warship force of navy and in armored forces, communications corps, engineering corps of the army.3. In Cross-sectional investigation, military training-related injury is more often happened in skill-training, but in study of inpatients, the main causes are counter-acting exercises and physical training.4. In study of inpatients, open injury is more often in the army, especially in armored forces. Intraocular foreign body is also often seen in the army.5. The treatment of sanitary corps or health center need to enhance.6. The main reasons for delayed operation of opened ocular injury are transfer treatment, heavy condition needing more time to prepare, misdiagnosis. The delayed time is longest in closed injury of region III.7. The factors strongly affected vision prognosis are open ocular injury, optic nerve's trauma, retinal detachment, involving of vitreous body. The factors impact the times of transfer treatment are retinal detachment, the type of open ocular injury, explosion injury and vious services.