The widespread use of explosive devices during recent armed conflicts has led to an increase in both the frequency and severity of ocular injuries among military personnel and civilians. This article presents the results of ophthalmological care provided at the municipal enterprise “Dnipropetrovsk Regional Clinical Ophthalmological Hospital” for more than 1000 victims during the Anti-Terrorist Operation (2014–2021) and 8300 during the full-scale war in Ukraine (2022–2025). A comparative retrospective analysis revealed an increase in trauma severity since 2022, with a high rate (83.4%) of combined injuries involving eyes and other organs and systems, necessitating a multidisciplinary approach. The incidence of binocular injuries increased from 34% in 2014–2021 to 64% in 2022–2025. Severe and extremely severe injuries increased from 55% before 2022 to 67% thereafter. In 13% of cases, injuries resulted in complete eye destruction. In the structure of combat eye injuries from 2014 to 2021, penetrating eye wounds prevailed (43%), contusions constituted 27% and burns 11%. However, in 2022–2025, the frequency of second- and third-degree contusions increased to 36%, and combined injuries rose to 14%. The polymorphism of mine-explosive eye injuries during the full-scale war resulted in changes in surgical care volume, including a 1.7-fold increased need for combined specialized interventions (vitreoretinal surgery, traumatic cataract extraction with IOL implantation, eyelid plastic surgery), from 35% (2014–2021) to 58% (2022–2025). Military injuries are notably more severe compared to domestic trauma. While mild injuries (57%) dominated in domestic trauma, with visual acuity (VA) of 0.1–0.5 at admission and 0.6–1.0 at discharge, combat injuries were predominantly severe (67%), moderate in 33%, with VA typically less than 0.1 at admission and 0.1–0.5 at discharge. Severe mine-explosive injuries accounted for 94% of cases. Delayed hospitalization (2–13 days post-injury) was common due to evacuation difficulties and severe concomitant pathology requiring prioritized care in multidisciplinary hospitals. Frequent associated injuries included facial bone fractures (11%), limb injuries (19%), inflamed soft-tissue facial wounds (31%), and traumatic brain injury (28%). However, the use of modern surgical techniques and equipment in a highly specialized clinic enabled good postoperative functional outcomes even in severe and extremely severe cases. Optimal functional results were achieved when patients were admitted to a specialized ophthalmological clinic within 12 h post-injury, with up to 80% achieving VA 0.6–1.0 upon discharge, whereas delayed admission reduced this figure to 23%.

Features of Eye Trauma Management in Modern War Conditions

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发表日期：

2026年

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Valerii Serdiuk,
Natalia Klopotskaya

摘要

The widespread use of explosive devices during recent armed conflicts has led to an increase in both the frequency and severity of ocular injuries among military personnel and civilians. This article presents the results of ophthalmological care provided at the municipal enterprise “Dnipropetrovsk Regional Clinical Ophthalmological Hospital” for more than 1000 victims during the Anti-Terrorist Operation (2014–2021) and 8300 during the full-scale war in Ukraine (2022–2025). A comparative retrospective analysis revealed an increase in trauma severity since 2022, with a high rate (83.4%) of combined injuries involving eyes and other organs and systems, necessitating a multidisciplinary approach. The incidence of binocular injuries increased from 34% in 2014–2021 to 64% in 2022–2025. Severe and extremely severe injuries increased from 55% before 2022 to 67% thereafter. In 13% of cases, injuries resulted in complete eye destruction. In the structure of combat eye injuries from 2014 to 2021, penetrating eye wounds prevailed (43%), contusions constituted 27% and burns 11%. However, in 2022–2025, the frequency of second- and third-degree contusions increased to 36%, and combined injuries rose to 14%. The polymorphism of mine-explosive eye injuries during the full-scale war resulted in changes in surgical care volume, including a 1.7-fold increased need for combined specialized interventions (vitreoretinal surgery, traumatic cataract extraction with IOL implantation, eyelid plastic surgery), from 35% (2014–2021) to 58% (2022–2025). Military injuries are notably more severe compared to domestic trauma. While mild injuries (57%) dominated in domestic trauma, with visual acuity (VA) of 0.1–0.5 at admission and 0.6–1.0 at discharge, combat injuries were predominantly severe (67%), moderate in 33%, with VA typically less than 0.1 at admission and 0.1–0.5 at discharge. Severe mine-explosive injuries accounted for 94% of cases. Delayed hospitalization (2–13 days post-injury) was common due to evacuation difficulties and severe concomitant pathology requiring prioritized care in multidisciplinary hospitals. Frequent associated injuries included facial bone fractures (11%), limb injuries (19%), inflamed soft-tissue facial wounds (31%), and traumatic brain injury (28%). However, the use of modern surgical techniques and equipment in a highly specialized clinic enabled good postoperative functional outcomes even in severe and extremely severe cases. Optimal functional results were achieved when patients were admitted to a specialized ophthalmological clinic within 12 h post-injury, with up to 80% achieving VA 0.6–1.0 upon discharge, whereas delayed admission reduced this figure to 23%.