Page 20 - Journal of Special Operations Medicine - Summer 2014

Figure 2 Sub-1mm corneal FB removed from aviator at a Figure 3 Medic using the hand-help slit lamp to examine the
Role 1 flight line aid station using a hand-held portable slit anterior segment.
lamp. The FB is visible at the tip of the catheter.

would indicate an open globe.) Erythromycin ophthal-
mic ointment was placed into the eye, and the patient
was seen the following morning, when fluorescein stain- Figure 4 Close-up view of corner through the hand-held
ing did not reveal an epithelial defect. The aviator was slit lamp.
cleared for flight.

Technical Specifications
Eidolon’s Hand Held Slit Lamp Model 510LS (Loupe
System) provided an excellent view of the cornea and
anterior chamber. It is available with quick-change,
color-coded loupes (lenses) that snap in and out of a
specially designed housing. This enables increases in
magnification from ×5 to ×15. The Model 510LS comes
standard with 20D (×5) and 40D (×10) loupes. A 60D
(×15) loupe is available as an option. The device pro-
vides several hours of use with two “AA” batteries. It
weighs approximately 8oz and has a suggested retail
price of $495. This compares well with older designs in addition to their military occupational specialties.”
1
(such as the Haag-Streit BA-904 “hand-held” portable The experiences of BG Enzenauer as a Special Forces
slit lamp) that, although portable, are too large and battalion flight surgeon deployed to Afghanistan proved
heavy for use in austere settings. For example, the SL-15 that emergency eye care and surgery as provided for Al-
Kowa portable device has an advantage over traditional lied, Coalition, and host nationals built significant rap-
table-mounted systems, but at 28oz with an additional port and trust. This is in keeping with the Special Forces
44oz charging stand, the net 4.5 lb device is again not “winning the hearts and minds” philosophy, and this
practical for SOFMED applications. Figures 3 and 4 quote is also fitting for combat aviation (the 1-135th
demonstrate the ease of use by our medic for anterior ARB is a Missouri Army National Guard AH-64 unit).
segment evaluation. Figure 4 clearly shows the slit lamp It is our opinion that pushing the highest skill level
illumination of the cornea. forward by both “man and machine” is just as critical
for combat aviation mission success. Given the extent,
Our experience as eye surgeons (R.W.E. and C.J.C.) in nature, and incidence of ocular trauma in recent con-
austere deployed environments demonstrates the util- flicts, it is that apparent that military medical provid-
ity of these devices. We encourage the availability of a ers must continue to transition from the boundaries of
hand-held portable slit lamp for SOFMED teams. The what is possible to better mirror the standard of civil-
rationale for this recommendation follows. ian care. We (R.W.E. and C.J.C.) are willing to teach
2,3
any SOFMED and aviation providers who are willing
to learn and demonstrate proficiency. We are develop-
Implications for Aviation Medicine ing advanced nonlive tissue derived skills simulators for
and SOFMED
corneal injury, open globe, and orbital compartment
“The National Guard has extensive capabilities that syndrome and expect to have prototypes available at the
are impossible to attain in active duty units, largely be- 2014 Special Operations Medical Association Scientific
cause its citizen Soldiers bring their civilian expertise Assembly and Exhibition (SOMSA).

10 Journal of Special Operations Medicine Volume 14, Edition 2/Summer 2014