Ophthalmic trauma and disease encountered at Walter Reed National Military Medical Center during Operation Allies Refuge and Operation Allies Welcome

Abstract

Introduction
Operation Allies Refuge (OAR) and Operation Allies Welcome (OAW) were a combined United States Military Operation to airlift at-risk Afghan civilians from Afghanistan during the final days of the War in Afghanistan. During these operations, the international airport in Kabul was attacked, killing and injuring over 200 people. The evacuations continued with many of the injured military members and Afghan civilians receiving treatment at Walter Reed National Military Medical Center (WRNMMC).
Methods
A retrospective review was performed on all OAR and OAW patients who received care from the Ophthalmology Service at WRNMMC during 2021-2022. Anyone who was evacuated to the United States and required hospitalization were transferred and admitted to the inpatient service. Hospital policy states that all medevac patients receive a full dilated ophthalmic exam upon admission. Hence, all OAR/OAW patients received full dilated ophthalmic exams to evaluate for any ocular trauma involvement or ophthalmic disease.
Results
Fifty-five OAR/OAW patients were evaluated by the Ophthalmology Service during their hospitalization. Twelve (22%) patients had ophthalmic involvement or disease. Of the 12 patients, 3 (25%) were active-duty service members, and the remaining 9 (75%) were Afghan travelers. Eight patients (68%) sustained ophthalmic trauma due to the blast at the Kabul Airport, one of which required surgical intervention. In addition to the above traumatic findings, we also observed the following chronic diseases: 1 patient (8%) was diagnosed with malnutrition/vitamin deficiency, and 1 (8%) was diagnosed with a lysosomal storage disorder.
Conclusions
Ophthalmic evaluation of patients evacuated from trauma zones can uncover occult traumatic and chronic conditions. This highlights the importance of timely ophthalmic examination in polytrauma patients.