Ophthalmic Injuries in the Port Explosion in Beirut, Lebanon: Lessons for Provision of Ophthalmic Trauma Care and Major Incident Management

In this month’s issue of JAMA Ophthalmology, Kheir et al¹ report ophthalmic injuries after the port explosion in Beirut, Lebanon, the largest explosion in a population center in recent history, and their institutional response to the resulting major incident, including by staff who attended on foot after destruction of both home and car. They also report the wider context of the explosion (which rendered 300 000 people newly homeless), including 400 ophthalmic injuries occurring across the city associated with the explosion. Beirut is a city of 2.2 million people, similar in population to the metropolitan area of Kansas City, Missouri, and one-third the population of the Washington, DC, metropolitan area. The scale of the major incident in proportion to the available health care facilities, many of which were also badly damaged by the explosion, is therefore difficult to imagine. The report brings into sharp focus the calamity that results when medical infrastructure is at ground zero, and the innovations and adaptations—including reliance on ocular triage, damage control ophthalmology principles, and regression to past practices—necessary to navigate the ensuing chaos.