War-Related Eye Injuries: Later Treatment and Reconstruction in Antalya

An eye injured by a blast, a fragment or a bullet rarely needs just one operation. The first surgery is usually done close to where the injury happened: it closes the wound and protects the eye from infection. After that, many people face a longer road of planned treatment, and the same question: what can still be done?

This page explains the common types of war-related eye injuries, the usual order of treatment and what you can send for a review before any trip. It is written for service members and civilians, and for the families who help them.

How common are eye injuries in war?

The eyes are a tiny part of the body, yet they are injured often in modern wars. In US forces in Iraq and Afghanistan, 10–15% of combat injuries involved the eye. At Kyiv's main military hospital, the share was similar.

Most of these injuries come from mines, blasts and flying fragments; bullets cause fewer than 1 in 10. In the same hospital in 2022, about 3 in 10 patients had both eyes injured or one eye destroyed (29.8%). About 8 in 10 also had injuries elsewhere in the body (81.4%), so eye care is often planned alongside other treatment.

What kinds of eye injuries happen?

Doctors first ask whether the wall of the eye is broken and what lies behind the wound. One eye can have several of these injuries at once.

In US troops wounded in 2001–2011, about 1 in 5 injured eyes had a foreign body inside (18.6%). Doctors estimate the chance of useful sight with the Ocular Trauma Score. It combines the vision measured soon after the injury with the type of wound and its complications.

What happens in the first hours?

The first care is given by the medical team near the place of injury. Its aim is to protect the eye and close the wound quickly. Guidelines of the US military and the 2026 Ukrainian standard for combat eye trauma agree on the main steps. The eye is covered with a rigid shield, not a bandage, and antibiotics and protection against tetanus are given. A CT of the orbits is done when a fragment is suspected. Where possible, an open eye is closed by surgery within the first 24 hours.

What treatment comes later, and when?

After the wound is closed, many eyes need further surgery. The plan depends on the injury, so the order below is common, not fixed.

Fragments inside the eye and retina surgery

A fragment inside the eye is removed during a vitrectomy, an operation inside the eye done by a retina surgeon. The timing depends on the material. Wood, soil and other organic material carry a high risk of infection and are removed urgently. Small metal fragments can sometimes wait a little under antibiotics. In US troops, they were removed after a median of 21 days, and none of 79 eyes developed an infection. Iron or copper left in the eye can slowly damage the retina, so every retained fragment needs a clear plan.

If metal may still be in the eye or the socket, an MRI must not be done until metal has been ruled out: the magnet can move the fragment. CT is the scan used to find fragments. Plastic fragments from drones can look like metal on CT, which is one more reason to send the images themselves, not only the report. In Antalya, retina surgery is planned together with retina surgeons.

Cataract after an injury

An injury can cloud the lens, tear its thin capsule or break the fibres that hold it. Doctors have not agreed on one right time for the operation. Waiting until the eye is quiet makes the choice of lens power more accurate. The artificial lens is placed in the capsule, in front of it or fixed to the wall of the eye, depending on what support is left.

Prof. Türkoğlu performs cataract surgery in complex eyes, including eyes that were injured or had retina surgery; her specialty thesis was on cataract surgery after vitrectomy. She has also published on eye injuries, including a study of 206 patients with bleeding in the front of the eye after trauma (traumatic hyphema). Details are on the page about complex cataract surgery.

Eyelids, tear ducts and a drooping lid

Cuts of the eyelids and tear canals should be repaired early. Even so, problems often remain after the first repair: a notched or scarred lid, a lid that does not close, a drooping upper lid (ptosis) or constant watering. These are treated with planned oculoplastic surgery, often months after the injury, when the swelling has settled. Prof. Türkoğlu performs this surgery herself; see eyelid surgery, ptosis and tear duct surgery.

Fractures of the eye socket

A fracture of the floor or wall of the socket can trap an eye muscle, cause double vision or let the eye sink back. For an isolated floor fracture, surgeons usually wait at least 14 days and decide by 3–4 weeks. A trapped muscle with pain or nausea is an exception and needs urgent surgery. Thin-slice CT is the key scan. Fracture repair is planned together with orbital and maxillofacial surgeons.

When an eye cannot be saved

Sometimes an injured eye stays blind and becomes painful or shrinks. The options are then a thin cosmetic shell worn over the eye, or removal of the eye (evisceration or enucleation) with an orbital implant. After removal, a custom artificial eye is usually fitted about 4–8 weeks later. Prof. Türkoğlu performs these operations; the artificial eye itself is made by an ocularist. See artificial eye.

Does removing the injured eye protect the other eye?

People with a badly injured eye often hear about sympathetic ophthalmia, an inflammation that can attack the healthy eye after an injury to the other one. It is rare: it occurs in about 1–2 of every 1,000 people after an open eye injury (0.12–0.19%). About 3 in 4 cases begin within 6 months.

Removing a severely injured eye was long advised partly to prevent it. Recent research has not shown that removing an eye soon after an injury lowers this risk. So the decision to remove an eye now rests mainly on pain, comfort, appearance and the chance of sight. If your healthy eye becomes red, painful, sensitive to light or blurred, see an eye doctor promptly.

What are the chances of keeping the eye and sight?

The outlook depends mostly on the vision soon after the injury and on the type of wound. Published results give a rough idea:

• In a Turkish military series (103 injured eyes of 74 soldiers), the eye was kept in 88% (88.3%), and 35% of eyes (34.9%) reached a vision of 20/40 or better.
• At Kyiv's main military hospital, vision improved over 6 months of follow-up in 65% of eyes that arrived seeing only light or hand movements.

These numbers describe groups of people, not your own eye. An examination and your records show what can realistically be gained.

Can a blast affect vision without injuring the eye?

Yes. A blast can injure the brain even when the eyes look normal. After blast-related mild brain injury, 40–68% of people have problems with vision. Common complaints are sensitivity to light, blurred vision, trouble reading and focusing, and eyes that do not work together. In 639 US service members, light sensitivity was still present in 20% after 1 month and in 7% after 1 year.

These problems are assessed with a full eye examination, often together with a neurologist or a neuro-ophthalmologist. Vision rehabilitation can help even when the letters on the eye chart are sharp.

How do you get a review from abroad?

You can send your records before any trip. Prof. Türkoğlu reviews them and explains what could help now, what later, and whether a visit to Antalya makes sense. Useful documents are:

• discharge summaries and operation notes;
• CT images of the orbits and head as image files, not only the written report;
• photos of the eyes and eyelids;
• recent vision measurements for each eye and the eye pressure;
• a list of medicines and allergies.

Consultations are held in English or Turkish. If needed, BergemHealth, the practice's international patient coordination partner, provides an interpreter and a personal escort who speak Ukrainian and Russian. It also helps with transfers and accommodation. See second opinion and international patients.

Care for war-related eye injuries in Antalya

Prof. Dr. Elif Betül Türkoğlu is a Professor of Ophthalmology in Antalya, Türkiye. She treats eye tumors, performs cataract surgery in complex eyes and oculoplastic surgery: eyelids, tear ducts, the eye socket and removal of an eye with an implant. For injured eyes, she offers a review of records, an examination and planned surgery in these areas. Retina surgery and fracture repair are planned together with the relevant specialists.