Page 140 - Journal of Special Operations Medicine - Fall 2014

THE ASSISTANT SECRETARY OF DEFENSE

1200 DEFENSE PENTAGON
WASHINGTON, DC 20301-1200

HEALTH AFFAIRS JUL-7-2014

MEMORANDUM FOR THE ASSISTANT SECRETARY OF THE ARMY (MANPOWER AND RESERVE AFFAIRS)
ASSISTANT SECRETARY OF THE NAVY (MANPOWER AND RESERVE AFFAIRS)
ASSISTANT SECRETARY OF THE AIR FORCE (MANPOWER AND RESERVE AFFAIRS)
DIRECTOR, JOINT STAFF

SUBJECT: Treatment of Traumatic Eye Injuries

The Joint Trauma System (JTS) provides the Department of Defense (DoD) with performance data on battlefield
treatment. JTS data from 2012 to 2013 demonstrated a 40 percent compliance rate in treating traumatic eye injuries
in accordance with DoD ocular trauma treatment guidelines. The JTS Clinical Practice Guidelines, Tactical Combat
Casualty Care Guidelines, and the Vision Center of Excellence’s recommendations (enclosed) advocate for the use of
a rigid eye shield and rapid evacuation to an ophthalmologist when treating traumatic eye injuries. This is the only
authorized clinical practice guideline for treating traumatic eye injuries.

There are two major factors contributing to the low compliance rate. First, Service medical doctrine and train-
ing are outdated and they instruct the provider to place an eye patch and pressure dressing over the injured eye, in
contrast to the current recommendations. Second, Service medical equipment sets and vehicle first aid kits contain
eye patches and pressure dressings instead of rigid eye shields for use in the event of a traumatic eye injury.

To prevent additional damage to injured eyes, the Military Services and the Joint Staff should take actions to
review and update their doctrine and training to reflect the most current DoD ocular trauma treatment guidelines.
The Services should replace the eye patch kit, NSN 6545-00-853-6309 ($35.00 each), with the rigid eye shield with
garter kit, NSN 6515-01-598-1877 ($2.00 each). Implementation, education, and training costs would be the re-
sponsibility of the Military Services. Ms. Elizabeth Fudge is my point of contact for receiving information on plans
to implement the current treatment guidelines. She will update me in 60 days from the date of this memorandum.
Ms. Fudge may be reached at (703) 681-8295 or at Elizabeth.Fudge@dha.mil.

132 Journal of Special Operations Medicine Volume 14, Edition 3/Fall 2014