Spc. Joshua Pederson was manning his armored vehicle's revolving gun turret when insurgents peppered the hulking truck with rocket propelled grenades and small arms fire.
When a round penetrated the vehicle, Pederson said he ducked inside and was hit with fragments and debris that sprayed his face and torso.
Lying in a hospital bed, a Purple Heart freshly pinned to his gown, the 24-year-old Phoenix native bore numerous scabs and sutures along his jaw line and on his eyelids. Small particles of debris had entered his eyes, though they were largely protected thanks to the ballistic-proof glasses he was wearing.
"My eyesight was blurry, but I was able to keep fighting," Pederson recalled with pupils dilated from the drops given to him by eye doctors at Kandahar Regional Military Hospital.
"I got really lucky," he said about his vision, which doctors said would be fine in a few days. He will be ready to return to duty in a couple of weeks.
With so much debris flung by gunfire, improvised explosive devices and other hazards of war, protective eyewear is mandatory for every U.S. servicemember in Afghanistan.
And because of it, the U.S. military's two in-country ophthalmologists said they are treating few U.S. forces for battled-related eye injuries that result in extensive permanent damage.
"Most are pretty good about wearing their eye protection," said Navy Lt. Cmdr. Bryan Propes, a retina surgeon trained at Johns Hopkins University who has been operating on NATO and Afghan forces, as well as Afghan civilians, since December.
Since that time Propes said he has conducted some 300 eye-related operations on more than 100 patients, most of whom also have other injuries. "It's extremely rare for someone to come in here with an isolated eye injury," he said.
Because of the widespread use of eye protection among U.S. and NATO servicemembers, Propes said that only about 10% of the eyes he treats are "non-salvageable."
Once undergoing surgery, follow-up care comes from Capt. Warren Gross, a 56-year-old Army reservist and optometrist with a practice in Miami Beach.
"It's even better here (than at home) because I have an ophthalmologist two doors down and don't have to wait for referrals," Gross said.
Not all cases are near-misses thwarted by proper eye protection. The vast majority of the worst eye-damage cases are among Afghan soldiers, police and civilians, he said. Few Afghan soldiers and police wear eye protection.
Of those injured, about one-third must undergo what is known as Open Globe Repair, when the eyeball itself is ruptured and must be sewn closed as soon as possible to avoid infection and loss of vision. Others suffer partial damages that can be treated with less invasive surgeries and techniques for flushing the eyes of debris.
Often the repair process includes stitching torn eyelids and repairing broken sockets. When patients are particularly close to a blast they can suffer "de-gloving," when portions of flesh are partially torn from the face and must be surgically reattached.
One Afghan man Propes recently treated suffered severe facial lacerations from a bomb blast that resulted in him losing both eyes, a particularly damaging outcome in Afghanistan where health care for the permanently disabled is rare.
Even Afghans suspected of participating in insurgent attacks are treated at the Kandahar facility. "It can even be a bad guy," said Navy Lt. Cmdr. Ron Schoonover, the hospital's operation center director. "We may or may not know he is one, but we treat them just the same."
Challenges for treating Afghans abound, Propes said. Often locals who are brought to the hospital for surgery or treatment never return for follow-up. "Why they don't come back one can only imagine," he said.
At the hospital at Bagram Airfield, the other large U.S. military base here, Air Force Maj. Lisa Mihora, doesn't have that problem with the Afghan nationals she treats.
"They (Afghans) come back and they say they want everything done," said Mihora, an ophthalmologist who studied at the University of Tennessee. She said that some Afghans also ask her to fix facial scars, such as acne, when treating an eye injury.
Mihora recalled one little girl who lost her eye. She was presented with a box of prosthetics from which to choose a replacement. She started to cry, thinking the eyes came from a person, Mihora said.
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