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Shield to Save

Serious eye injuries can occur at home, at work and on the battlefield. Since 2000, preventing and tracking of military-related eye injuries has become an area of increased focus. This focus has brought a great deal of insight into eye injury causes and treatment. The Tri-Service Vision Conservation and Readiness Program has been collaborating with multiple entities in the development of programs and processes to address these complex issues.

There are two significant priorities in being ‘Vision Ready’. The first priority is to have proper eyewear, such as a Military Combat Eye Protection (MCEP) device from the Army’s Authorized Protective Eyewear List (APEL) or a device from the Air Force’s Flight Protective Eyewear List (FPEL) and, if required, two pair of prescription spectacles and gas mask inserts. According to http://www.preventblindness.org/, “Thousands of eye accidents happen each day; 90 percent of these are preventable with the use of appropriate safety eyewear.” However, significant eye injuries can still occur even if protective measures are taken. Based on the previously mentioned quote, significant eye injuries occur about 10 percent of the time. So, what happens if you or your battle buddy sustains a significant eye injury or polytrauma injury of the face while at home, at work or on the battlefield? This article provides information on the second priority; managing significant eye injuries with a Rigid Eye Shield (RES). Properly using a RES may make the difference between saving one’s sight or irreversible blindness.Recently, the Vision Center of Excellence (VCE) provided updated information on the appropriate use of these RESs – emphasizing the importance of use at the Point of Injury (POI). Currently, efforts are in-place to train personnel on the use of these devices and allow them to be readily available. Rigid eye shields are available now in bags carried by medics and corpsmen and have been added to the Army’s new Individual First Aid Kit 2 (IFAK2). The following article highlights the importance of having rigid eye shields accessible; http://www.military.com/daily-news/2013/10/28/missing-eye-shields-put-deployed-troops-at-risk.html. However, more needs to be done to inform personnel of this critical sight-saving device. The VCE website, http://vce.health.mil/, provides guidance on how rigid eye shields can help protect injured eyes from irreversible blindness, such as:

  1. Never patch or apply a pressure dressing to an unshielded eye.
  2. Be aware that "head" dressings and "face" dressings will often cover the eye – don’t let it unless you've shielded the eye first.
  3. Don’t put anything between the shield and the eye.

The VCE has provided an Eye Injury Response Tips sheet at the following link: https://vce.health.mil/Resources/Products/Facts-Sheets/Eye-Injury-Response-Tips. This tips sheet highlights three steps and four reminders that play a positive role in saving someone's sight.

In emergency situations, the triad of ‘life, limb and eyesight’ is of highest importance. The Army’s IFAK2 now includes a rigid eye shield to better address the eyesight component of the emergency triad over the previous IFAK versions. According to the article at http://www.army.mil/article/116565, the IFAK2 has been issued to deploying Soldiers since Nov 2013. The IFAK2 is more compact (can be worn in the small of the back instead of on the hip), but still has all the equipment of the old kit and adds a second tourniquet, a second chest seal, a strap cutter and a rigid eye shield.

Additionally, significant efforts have gone towards issuing a DoD-wide Joint-Service First Aid Kit (JFAK). Standardizing medical supplies carried by each Soldier, Sailor, Airman or Marine is a significant measure to optimize POI treatment. It is anticipated that the JFAK will carry one or two eye shields, have similar contents as the IFAK2 and could be available toward the last few months of 2014. The eye shields have an NSN of 6515-01-598-1877, or 6515-01-253-8165 as an alternative option.

In conclusion, polytrauma injuries involving the eyes and face can be difficult to manage, especially when trying to determine the extent of the injury to the eye(s). However, it is better to be ‘safe than sorry’ with significant eye injuries. Therefore, when significant eye injuries are suspected, NO PRESSURE should be applied to the eyes. The rigid eye shield is designed to curve away from the eye so no contact or pressure can be applied. Although pressure may be required to stop profuse bleeding, pressure on a ruptured or perforated eye may cause the internal contents of eye to be expelled, resulting in instantaneous irreversible blindness.

Knowing these tips, whether at home, at work or on the battlefield, will help you and your battle buddy be truly, "Vision Ready"!