Vastly improved personal body armor dramatically reduced penetrating wounds to the torso, but the head, arms, and legs remained subject to blast and bullet injuries. The latter led to the highest percentage of amputations among U.S. military wounded since the Civil War, but the escalating levels of care available, from the moment of injury, meant many who would have died in the field in previous wars survived, often with seriously damaged limbs saved, others eligible for technologically advanced prosthetics. In the case of lower-limb prosthetics, some claim they are better than the legs with which they were born.
“In the past, people with such horrific injuries never would have made it off the battlefield alive. Today they do, and we have to figure out how to put a private’s face back together and often restore vision. An Air Force surgeon on his third combat deployment told me the magnitude of facial injuries from this war is unbelievable. [In the first decade alone], surgeons in Afghanistan said, about 16 percent of all wounded evacuated to Landstuhl had some form of eye trauma.”
Advances in injury prevention, plus early diagnosis and treatment of those who were wounded, including “invisible” trauma to the brain, have saved the lives and quality of life of thousands of servicemen and women since 9/11. Those advances were carried over to post-service care through the Department of Veterans Affairs (VA) and into civilian medicine, as well.
But while warfighter protective gear has saved lives, the changing nature of combat and enemy tactics have also increased injuries – and resulting medical research and care. Since 9/11, the majority of DOD vision research funding has gone toward battlefield eye trauma treatment, diagnosis, surgical approaches, TBI-related vision impairment, and other combat injuries.
While the vast majority of reported eye injuries are listed as mild or superficial, the wars in Southwest Asia also saw an increase in serious retinal, optic nerve, and burn injuries to the eye, with blast-related eye injuries leaving thousands of warfighters at a high risk of eventual blindness. Those and other blast injuries require immediate action in the field if the wounded warrior is to reach advanced medical care in a condition conducive to saving a limb, hearing, sight, etc.
“It’s not unusual for doctors at Walter Reed and Landstuhl to spend hours trying to rebuild an eyeball that was severely damaged. There are no civilian injuries that come close to what we are facing on today’s battlefield from blast injuries. Ophthalmologists called to active service and deployed to Iraq or Afghanistan say they had never seen, in private practice, what they had to deal with there,” according to Tom Zampieri, a Vietnam-era Army medic and, after returning to college, an Army National Guard flight surgeon. Today, blinded in a non-military-related accident, he is director of government relations for the Blinded Veterans Association.
“In the past, people with such horrific injuries never would have made it off the battlefield alive. Today they do, and we have to figure out how to put a private’s face back together and often restore vision. An Air Force surgeon on his third combat deployment told me the magnitude of facial injuries from this war is unbelievable. [In the first decade alone], surgeons in Afghanistan said, about 16 percent of all wounded evacuated to Landstuhl had some form of eye trauma.”
Several ophthalmologists assigned to the 332nd Expeditionary Medical Operations Squadron operate on a trauma patient who sustained extensive eye injuries during combat operations in Iraq. The increased number of traumatic eye injuries sustained in Southwest Asia has resulted in the majority of the Defense Department’s vision research funding being directed toward battlefield eye trauma treatment, diagnosis, surgical approaches, TBI-related vision impairment, and other combat injuries. Photo by Staff Sgt. Julie Showalter
Zampieri said deployment-related trauma research is directed toward tissue, cornea, and retina repair, with the hope some ongoing research into neural systems will help down the road. Also some years away from possible application will be the result of current research into tissue regeneration, such as regrowing parts of the retina or growing a new cornea using stem cells.
Programs at the U.S. Army’s Telemedicine & Advanced Technology Research Center (TATRC) are focusing on a wide range of battlefield and post-evacuation solutions to meet operational gaps in theater health services regarding vision, field medical robotics, biomedical technologies, sleep deprivation, nutrition and hydration, and more.
In March 2016, TATRC’s Operational Telemedicine Lab partnered with the Marine Corps Warfighting Lab (MCWL) to conduct experiments in battlefield medical situational awareness and combat casualty care during the Rim of the Pacific (RIMPAC) 2016 exercise in Hawaii and Southern California. MCWL inserted a forward surgical unit, a maneuvering shock trauma squad, and a shock trauma squad operating within an aircraft into the Southern California urban terrain operations.