Features of the clinical picture and treatment of primary and secondary glaucoma in military personnel — participants in a modern military conflict

Purpose of the study was to investigate the etiopathogenesis and clinical course of primary and secondary glaucoma in military personnel participating in a modern military conflict (MMC).

Material and methods. We analyzed the medical records of 18 patients — military personnel who participated in MMCs and underwent examination and treatment at the department of ophthalmology of the Military Medical Academy from 2022 to 2024 with suspected glaucoma or with glaucoma diagnosed before the onset of MMC. In all cases, the diagnosis of glaucoma was confirmed or established for the first time based on international standards — according to the methods of structural and functional assessment of the optic nerve head.

Results. Of the 18 patients, 4 servicemen (5 eyes) aged 48 ± 6 years had primary open-angle glaucoma diagnosed long before arrival at the theater of military operations. However, due to violation of the local hypotensive therapy regimen, three of them experienced disease progression. Thirteen patients (13 eyes) aged 27 ± 4 years were diagnosed with secondary post-traumatic glaucoma, which developed because of combined damage to the organ of vision due to mine-blast trauma within a period of 5 to 15 months. Secondary post-traumatic ocular hypertension was diagnosed in only one patient. In most cases (61 %), it was not possible to achieve compensation of ophthalmotonus, despite the maximum regimen of local hypotensive therapy, therefore, various surgical interventions were performed with a positive effect. In the remaining cases (39 %), compensation of intraocular pressure and stabilization of the glaucoma process were achieved through the selection of an individual regimen of local hypotensive therapy.

Conclusion. Modern military operations undoubtedly contribute to the increase in the proportion of post-traumatic glaucoma. To prevent injury to the organ of vision and, accordingly, secondary post-traumatic glaucoma, it is necessary to use anti-fragmentation or tactical glasses during active combat operations.

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