{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:09:57Z","timestamp":1792188597205,"version":"4.4.0"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the rates and types of open\u2010globe wounds in soldiers admitted to Walter Reed Army Medical Center from 2001 to 2011 after sustaining combat injuries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected in the Walter Reed Ocular Trauma Database. Inclusion criteria were patients who suffered open\u2010globe injuries. Open\u2010globe injuries were classified by type of wound: corneal, corneo\u2010scleral or scleral, or type of open\u2010globe injury: perforating, rupture, penetrating or intraocular foreign body. The primary analysis assessed the effect on final visual acuity (VA) and the risk of enucleation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this study, 285 (32.02%) open\u2010globe injuries were recorded in 890 eyes in the data set. Corneal wounds were noted in 127 (44.56%) eyes, corneo\u2010scleral wounds in 78 (27.37%) and scleral wounds in 129 (45.26%) eyes. The involvement of both the corneal and sclera was associated with poorer visual outcome (BCVA\u2009&lt;\u200920\/200) compared to injuries with an injury confined to either the cornea or scleral alone (p\u2009=\u20090.038). At a wound length of greater than approximately 14\u2009mm, patients had 75% chance of having a poor final VA. Enucleation was performed in 64 (22.46%) eyes of patients with wounds. The type of wound was not found to be predictive of enucleation in multivariate analysis, but rather the type of open\u2010globe injury was predictive. Perforating (OR: 1.58, 95% CI: 1.43\u20131.72) and globe rupture injuries (OR: 1.49, 95% CI: 1.33\u20131.66) were more likely to undergo enucleation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Open\u2010globe injuries occur frequently in combat ocular trauma. Poor final VA was noted most with corneo\u2010scleral wounds with approximately 50% of patients having a final VA less than 20\/200.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.14790","type":"journal-article","created":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T02:42:13Z","timestamp":1613011333000},"page":"904-908","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Open\u2010globe wounds in operation Iraqi Freedom and Operation Enduring Freedom: risk factors for poor visual outcomes and enucleation"],"prefix":"10.1111","volume":"99","author":[{"given":"Justin P.","family":"Harris","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Brooke Army Medical Center San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6084-6399","authenticated-orcid":false,"given":"Grant A.","family":"Justin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Brooke Army Medical Center San Antonio TX USA"},{"name":"Department of Surgery Uniformed Services University of the Health Science Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel I.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Research Programs Walter Reed National Military Medical Center Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fasika A.","family":"Woreta","sequence":"additional","affiliation":[{"name":"Wilmer Eye Institute Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6662-5850","authenticated-orcid":false,"given":"Rupesh V.","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Tan Tock Seng Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise S.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Warfighter Refractive Eye Surgery Program and Research Center Fort Belvoir VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Weichel","sequence":"additional","affiliation":[{"name":"Retina Group of Washington D.C. 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