Citation

Colyer MH. Mil. Med. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Association of Military Surgeons of the United States)

DOI

10.1093/milmed/usaa156

PMID

32886126

Abstract

This month's issue of Military Medicine presents the results of the first peer-reviewed manuscript composed of outcomes data from the Defense and Veterans Eye Injury and Vision Registry (DVEIVR), a congressionally directed registry to track diagnoses, interventions, and follow-up each significant eye injury of active-duty personnel and managed by the Department of Defense and Veterans Administration's Vision Center of Excellence (VCOE).1 The VCOE established the DVEIVR 10 years ago as one of its primary efforts and is now realizing the results of the effort. Currently, DVEIVR is used to revise clinical practice guidelines that are data- and experience-driven, inform clinical leaders of emerging threats and opportunities, and support the Vision Research Program's $20 million annual research portfolio. The fact that DVEIVR was finally queried and published useful outcomes data is an important milestone in understanding the all-case visual outcomes in this cohort and highlights critical gaps in provider documentation to ensure valid information in clinical records.

DVEIVR was conceptualized in the years 2009 and 2010 as a response to the National Defense Authorization Act of 2008. As a part of the act, the Department of Defense and VCOE was tasked to create a "registry of information for the tracking of the diagnosis, surgical intervention or other operative procedure, other treatment, and follow-up for each case of significant eye injury incurred by a member of the Armed Forces while serving on active duty."2 Data entry commenced in January 2012. DVEIVR abstractors have analyzed over 32,000 service members' significant eye injuries, with over 178,000 unique encounters abstracted to date. The untapped potential that exists is significant, and could have major benefits to understanding patterns associated with traumatic vision loss. The manuscript describes the methods to categorize over 25,000 unique patients abstracted within the DVEIVR according to visual outcome and presence/severity of traumatic brain injury (TBI). The total analysis included 3,573 subjects, or 14% of all subjects registered within DVEIVR. The study concluded that TBI status does not correlate with severe vision loss, while eye injury severity does. The more valuable output, considering that this is the first query of DVEIVR, is that 86% of subjects identified as having eye injuries and registered in DVEIVR are still missing the most critical primary clinical outcome measure--visual acuity. This absence of data may be the result of several gaps...

Language: en