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Book and Software Review
November 2004

Textbooks of Military Medicine: Ophthalmic Care of the Combat Casualty

Author Affiliations



edited by Allen B. Thach, MD, 518 pp, with illus, $68, ISBN 0-16-051364-2,Washington DC, Office of the Surgeon General, 2003.


Copyright 2004 American Medical Association. All Rights Reserved.Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Ophthalmol. 2004;122(11):1736. doi:10.1001/archopht.122.11.1736-a

Ophthalmic Care of the Combat Casualty is notjust a text for the military ophthalmologist. Written primarily by past andpresent military ophthalmologists and directed toward a combat-injured patient,chapters on eye injuries associated with terrorist bombings and complete careof trauma injuries make this a comprehensive and versatile text for the comprehensiveand subspecialist civilian ophthalmologist.

The 495-page text with 35 contributors is well edited into 6 main sectionscovering history, basic techniques, anterior and posterior segment, oculoplastics,and miscellaneous information. The basic technique section introduces theMadigan Eye Trauma scale that would be of benefit to emergency departmentand triage personnel. The meticulous yet clear sketches by Gary Wind, MD,are excellent throughout the book, but are particularly helpful in the chapteron anesthetic care and enucleation and evisceration. The initial chapterson the history of wartime ocular injuries demonstrate that ocular trauma asa percentage of total injuries have steadily increased over the past centuryfrom 2% to 4% during WWI, to 13% in the first Persian Gulf War. The increaseduse of fragmentation munitions, the protective effect of body armor, and thereluctance of troops to wear, or be provided with, eye protection has madethe eye more exposed as a percentage of body area. Eye injuries are also muchmore common in highly mobile armored combat. The wealth of information inthe chapter on lessons learned, primarily from Vietnam and the first PersianGulf War are invaluable for military ophthalmologists. LaPiana and Mader notonly offer a rich history of eye injuries in these conflicts, but also didacticson initial and higher-level eye trauma care. The extensive injuries sustainedby both soldiers and noncombatants make a coordinated approach with a headand neck team essential.

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