The Role of Angiogenesis Factors in the Formation of Vascular Changes in Scleroderma by Assessment of the Concentrations of VEGF and sVEGFR2 in Blood Serum and Tear Fluid.

Systemic sclerosis (SSc) is a connective tissue disorder characterized by tissue hypoxia, excessive fibrosis of skin and internal organs, and angiogenesis imbalance. The aim of the study was to evaluate in SSc patients the association between the retinal microcirculation disturbances and the presence of peripheral trophic changes and to determine the role of angiogenesis factors in the formation of vascular changes in scleroderma. Twenty-five SSc patients and 25 age- and sex-matched healthy controls were included to the study. Assay of vascular endothelial growth factor (VEGF) and soluble VEGF receptor-2 (sVEGFR-2) in blood serum and tears was done for all patients and controls using enzyme-linked immunosorbent assay. Retinal blood circulation was investigated with fluorescein angiography (FA) in the SSc patients only. In our research, proportion of mainly hypertensive patients presenting with a large spectrum of retinal microvascular lesions was 72%, while proportion of patients with skin microvascular lesions within distal phalanxes of fingers and toes was 76%. We noticed that patients with pathological changes in the FA examination had finger ulcerations significantly more often than patients without changes in the eye fundus. There were no statistically significant differences in the serum concentration of VEGF and sVEGFR2 between subjects in both analyzed groups. Analysis of lower levels of VEGF (p = <0.001) and sVEGFR-2 (p = <0.001) in blood serum accompanied by simultaneous higher levels of VEGF/sVEGFR-2 ratio in tears of SSc patients, as compared with the control group, indicates the superiority of proangiogenic factors in patients' tears.

Matrix Metalloproteinases MMP-2 and MMP-9, Their Inhibitors TIMP-1 and TIMP-2, Vascular Endothelial Growth Factor and sVEGFR-2 as Predictive Markers of Ischemic Retinopathy in Patients with Systemic Sclerosis-Case Series Report.

Systemic sclerosis (SSc) is an autoimmune connective tissue disorder associated with multiple organ involvement. The aim of the study was to present two SSc patients who were diagnosed with ischemic retinopathy in both eyes. As a background to our case study, we decided to investigate the imbalance of angiogenesis factors in 25 SSc patients in relation to 25 healthy controls. Assays of matrix metalloproteinases-2 and -9 (MMP-2, MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1) and -2 (TIMP-2), vascular endothelial growth factor (VEGF), and soluble VEGF receptor-2 (sVEGFR-2) in blood serum and tears were performed. A significantly increased levels of MMP-9 in serum and tears, (p = 0.0375 and p < 0.001, respectively) as well as VEGF/sVEGFR-2 ratio in tears (p < 0.001) were found in the whole SSc patients group compared with controls, while reduced levels of these parameters in patients with ischemic sclerodermic retinopathy were noted. We also observed decreased level MMP-2 in tears and increased levels of TIMP-2 in blood serum and tears of SSc patients with retinal ischemic changes. MMP-9, MMP-2, TIMP-2, and VEGF/sVEGFR-2 may play a crucial role in ischemic retinal degeneration or retinal reorganization in SSc.

Optical coherence tomography and magnetic resonance imaging visual pathway evaluation in Wolfram syndrome.

AIM: The aim of this study was to assess parameters of retinal morphology by using high-definition optical coherence tomography (OCT) in patients with Wolfram syndrome (WFS) and their relation to optic tract atrophy in magnetic resonance imaging (MRI). METHOD: High-definition OCT and MRI parameters were evaluated in 12 patients with WFS (three males, nine females; median age at examination 12y 8mo, range 10y 2mo-15y 11mo) and referred to 30 individuals with type 1 diabetes (T1D) (12 males, 18 females; median age at examination 20y 5mo, range 16y 8mo-21y 4mo) and 33 typically developing comparison participants (10 males, 23 females; median age at examination 20y 7mo, range 13y-22y 4mo). RESULTS: Total thickness and quadrant thickness of the retinal nerve fibre layer (RNFL), macular full-thickness parameters and macular ganglion cell layer/inner plexiform layer, intraorbital and intracranial thickness of the optical nerve, as well as the optic chiasm and visual tracts were significantly reduced in patients with WFS compared with those having T1D and the typically developing comparison participants. Optic chiasm thickness correlated negatively in patients with WFS with both age (r=-0.79; p=0.002) and duration of diabetes (r=-0.62; p=0.032). Thickness of the intraorbital parts of the optic nerves in patients with WFS correlated positively with thickness of the superior RNFL (r=0.73; p=0.006). INTERPRETATION: High-definition OCT in combination with MRI could become an important tool for evaluating the effectiveness of therapeutic trials in patients with WFS. WHAT THIS PAPER ADDS: Provides evidence of significant reduction of retinal parameters and optic nerves in patients with Wolfram syndrome (WFS). Shows correlations between magnetic resonance imaging parameters and retinal morphology parameters in patients with WFS.

MicroRNA Expression Analysis in Serum of Patients with Congenital Hemochromatosis and Age-Related Macular Degeneration (AMD).

BACKGROUND Congenital hemochromatosis is a disorder caused by mutations of genes involved in iron metabolism, leading to increased levels of iron concentration in tissues and serum. High concentrations of iron can lead to the development of AMD. The aim of this study was to analyze circulating miRNAs in the serum of congenital hemochromatosis patients with AMD and their correlation with the expression of genes involved in iron metabolism. MATERIAL AND METHODS Peripheral blood monolayer cells and serum were obtained from patients with congenital hemochromatosis, congenital hemochromatosis and AMD, AMD patients without congenital hemochromatosis, and healthy controls. Serum miRNAs expressions were analyzed by RT-PCR (qRT-PCR) using TaqMan MicroRNA probes, and proteins levels were measured by ELSA kits. Gene polymorphisms in TF and TFRC genes were determined using the TaqMan discrimination assay. RESULTS Statistical analysis of the miRNAs expressions selected for further study the miR-31, miR-133a, miR-141, miR-145, miR-149, and miR-182, which are involved in the posttranscriptional expression of iron-related genes: TF, TFRI, DMT1, FTL, and FPN1. It was discovered that the observed changes in the expressions of the miRNAs was correlated with the level of protein in the serum of the analyzed genes. There were no statistically significant differences in the distribution of genotype and allele frequencies in TF and TFRC genes between analyzed groups of patients. CONCLUSIONS The differences studied in the miRNA serum profile, in conjunction with the changes in the analyzed protein levels, may be useful in the early detection of congenital hemochromatosis in patients who may develop AMD disease.

[Potential impact of colors of filters used in sunglasses on the melatonin suppression process]. / Potencjalny wplyw barwy filtrów w okularach chroniacych przed olsnieniem slonecznym na wydzielanie melatoniny.

BACKGROUND: In this article the methods for determining spectral transmittance of optical radiation in the visible waveband range through selected materials used as optical filters against solar glare were described. MATERIAL AND METHODS: Transmittance coefficients specified for the fraction of light passing through tested filters, taking into account the mechanism of eye adaptation to daylight and night vision and the melatonin suppression process were compared for 4 dyed sunglass filters. RESULTS: The values of transmittance coefficients specified for wavelength bands, 380-780 nm (for visible range) and 425-560 nm (for blue light range affecting the melatonin suppression process) were determined. CONCLUSIONS: The use of sunglasses with different color filters modifies the spectral characteristics of transmittance (spectrum) of visible light reaching the eye (including blue radiation) in such a way that it may have a potential impact on the melatonin suppression process. Med Pr 2017;68(5):629-637.

Light transmission through intraocular lenses with or without yellow chromophore (blue light filter) and its potential influence on functional vision in everyday environmental conditions.

In this research the factors used to evaluate the light transmission through two types of acrylic hydrophobic intraocular lenses, one that contained yellow chromophore that blocks blue light transmission and the other which did not contain that filter, were defined according to various light condition, e.g., daylight and at night. The potential influence of light transmission trough intraocular lenses with or without yellow chromophore on functional vision in everyday environmental conditions was analysed.

Glistening phenomenon in acrylic hydrophobic intraocular lenses ­ how do perioperative factors and concomitant diseases effect it's incidence and severity.

The aim: To evaluate the effect of selected perioperative factors and concomitant diseases on glistening of acrylic hydrophobic intraocular lens after phacoemulsification in a prospective study. Material and methods: 252 consecutive patients undergoing phacoemulsification with IOLs AcrySof IQ implantation were enrolled. The relationship between glistening and such factors as time of the surgery, the mean power and time of ultrasound energy, temperature of infusion fluids, type of cartridge, mean power of intraocular lens, trypan blue staining as well as some concomitant systemic and local diseases were analysed. The aforementioned factors were assessed a month 1. and 6. as well as after 1 and 2 years postoperatively. Results: Glistening incidence and severity increased significantly at each follow up. The use of cartridge D during intraocular lens implantation was related with significantly higher incidence of glistening as compared to using cartridge C. Higher refractive power of intraocular lens was related with increased incidence of glistening. Significantly higher intensity of the glistening was assessed in patients who suffered from diabetes. In turn, patients with uveitis presented with statistically lower severity of glistening. There was no association between other analysed factors and glistening. Conclusion: Glistening commonly occurs in patients after phacoemulsification and acrylic hydrophobic intraocular lenses (AcrySof Alcon Labs) implantation. Some intraoperative factors such as refractive power of the lens and smaller diameter of the cartridge were assessed to be significantly correlated. It might indicate that potential damage to the intraocular lens may play a role in development of glistening. Significantly higher severity of glistening was shown in patients with diabetes, which may imply the role of breakdown of physiological intraocular barriers. It is further supported by the demonstrated lower intensity of glistening in patients uveitis receiving high intensity steroid therapy.

The opinion of the Expert Group of the Polish Society of Ophthalmology on using nepafenac in the prevention of postoperative macular edema after cataract surgery in diabetic patients.

Nepafenac is an innovative non-steroidal anti-inflammatory drug used in ophthalmology for the prevention of macular edema after cataract surgery. Along with its anti-inflammatory effect, nepafenac has some unique properties which distinguish it from other non-steroidal anti-inflammatory drugs. It is a prodrug activated to amfenac after it penetrates through the corneal layers to the aqueous humour and the ciliary body. Having electrically neutral molecules of lipophilic properties, nepafenac does not accumulate in the cornea and does not cause its degeneration. Additionally, it quickly achieves higher concentrations in the aqueous humour as compared to other non-steroidal anti-inflammatory drugs. Nepafenac shows high selectivity and activity against COX-2 isoform, the key enzyme implicated in inducing inflammation, which is the main cause of macular edema. Furthermore, nepafenac has the unique scleral and suprachoroidal distribution pathways. Finally, its effect on the intraocular pressure is none to negligible. Nepafenac treatment should be initiated prior to cataract surgery and continued long enough to reduce the risk of late-onset macular edema. The Expert Group of the Polish Society of Ophthalmology consider using nepafenac in the prevention of post­operative macular edema in diabetic patients undergoing cataract surgery as expedient and reasonable. The proposed optimum pre- and postoperative treatment regimen can be modified for individualised therapy.

Serum MicroRNAs as Potential Biomarkers of AMD.

BACKGROUND: Age-related macular degeneration (AMD) is a major cause of blindness worldwide. Circulating microRNAs (miRNAs) in serum have emerged as novel candidate biomarkers for many diseases. The aim of the present study was to identify a serum microRNA (miRNA) expression profile specific for dry and wet forms of AMD. MATERIAL AND METHODS: Serum miRNA expression was first screened using TaqMan® Human MicroRNA Array A (Applied Biosystems). An extensive, self-validated, individual, quantitative RT-PCR (qRT-PCR) study was then performed on a cohort of 300 AMD patients (150 wet form and 150 dry form) and 200 controls. The Mann-Whitney U test and nonparametric Spearman's rank correlation coefficient were used for statistical analysis. RESULTS: miRNA expression analysis revealed increased expression of miR661 and miR3121 in serum of patients with dry AMD and miR4258, miR889, and Let7 in patients with wet form. Expression of analyzed miRNA was not observed or remained at low level in controls. CONCLUSIONS: Differences in miRNA serum profile exist between patients with wet and dry form of AMD, which indicates miRNAs as potential biomarkers of AMD. Further studies should be performed to confirm its significance in clinical practice.

Sturge-Weber syndrome type II treated with PDL 595 nm laser.

Sturge-Weber syndrome (SWS) is rare congenital disorder presenting facial port-wine stains (PWS) eye abnormalities and cerebrovascular malformations. The frequency of SWS is estimated at 1 in 50 000. Cerebrovascular abnormalities can be responsible for seizures, hemiparesis, mental retardation and ophthalmologic abnormalities cause intraocular pressure, glaucoma. Etiopathogenesis of SWS remains elusive. We present a case of a 7-year-old girl with SWS type II. A port-wine stain involves the upper right part of half face and has been associated with glaucoma of both eyes. In the Department of Dermatology in 2009-2012 we performed 23 procedures within 2 months. We have been using PDL laser at wavelength 595 nm and very good cosmetic results were achieved. Given positive treatment effects, the laser therapy of port-wine stains is a method of selection. Port-wine stains in the course of SWS requires a large number of laser treatment.

[Benefits of Iris Claw lens implantation among present methods of surgical correction of aphakia with insufficient capsular support]. / Korzysci wszczepu soczewki Iris Claw w swietle wspólczesnych meted chirurgicznej korekcji bezsoczewkowosci wobec braku odpowiedniego podparcia torebkowego.

Both anatomical and functional benefits associated with the implantation of intraocular lenses are the basis for the use of multiple surgical methods in intraocular lens surgery. To achieve adequate stability of the intraocular lens in cases of insufficient capsular support one may choose angle-supported anterior chamber intraocular lenses, iris-fixated intraocular lenses, iris-sutured or transsclerally sutured posterior chamber intraocular lenses. The transscleral IOL stabilization, most commonly used in clinical practice, seems particularly valuable in eyes with decreased corneal endothelial cell density, shallow anterior chamber, anatomical abnormalities of the iris and iridocorneal angle and uncontrolled glaucoma. Angle-supported anterior chamber IOLs, although easy to implant, can result in excessive endothelial cell loss or secondary glaucoma. Fixated to the midperipherial iris the Iris Claw lens seems to be an interesting and increasingly more popular alternative to other surgical methods used for cases of insufficient capsular support. The paper discusses some aspects of clinical and technical Iris Claw lens implantation in the correction of aphakia.

Latanoprost is effective in reducing high intraocular pressure associated with Graves' ophthalmopathy.

PURPOSE: To assess the efficacy and tolerability of latanoprost in the treatment of glaucoma and ocular hypertension associated with Graves' ophthalmopathy. Prospective interventional case series. MATERIALS AND METHODS: 28 patients (19 females and 9 males) aged from 31 to 68 (mean age 45.5 +/- 5.6), presenting with diagnosis of Graves' ophthalmopathy and intraocular pressure equal to 25.0 mmHg or more. 18 Patients presented with inflammatory stage of Graves' ophthalmopathy. 22 patients were within the first two years from the onset of symptoms of Graves' ophthalmopathy. 6 patients had exophthalmos and history of active Graves' ophthalmopathy. Intraocular pressure was measured before treatment, and at two, four and six weeks of treatment with latanoprost at 9 am. Ocular symptoms and signs were noted before and after the treatment period. RESULTS: The mean baseline intraocular pressure was 26.6 +/- 2.5 mmHg, ranging from 25.0 mmHg to 42 mmHg. In two weeks of treatment, the mean intraocular pressure was 18.6 +/- 2.3 mmHg (min 12.0 mmHg, max 27.0 mmHg). At 4 weeks mean intraocular pressure was 18.4 +/- 2.2 mmHg (min 11.0 mmHg, max 28.0 mmHg). At 6 weeks mean intraocular pressure was 18.7 +/- 1.9 mmHg (ranging from 11 mmHg to 25.0 mmHg). 3 patients experienced mild side effects. CONCLUSIONS: Latanoprost is effective and well tolerated in the treatment of increased intraocular pressure associated with Graves' ophthalmopathy.

Behçet's disease leaves the silk road.

Behçet's disease is rarely recognized among Caucasians, while it is endemic in countries of the Eastern and Central Asia, especially in Turkey. The aim of the manuscript is to present the clinical picture, diagnosis criteria and therapeutic approaches of this rare disease which, because of intensive migration, can occur not only in particular regions of the world.

Assessment of skin microcirculation by laser Doppler flowmetry in systemic sclerosis patients.

INTRODUCTION: First lesions to occur in the course of systemic sclerosis (SSc) involve microcirculation. AIM: The study involved assessment of the suitability of laser Doppler flowmetry (LDF) in examination of the performance of skin microcirculation in the distal portion of the upper extremity in SSc patients. MATERIAL AND METHODS: Overall the study involved 27 patients with systemic sclerosis. The control group comprised age - and gender-matched 27 healthy individuals. All the study subjects underwent microcirculation perfusion measurement at rest (rest flow - RF) as well as microcirculatory flow challenge tests - reactive hyperaemia test (RHT) and thermal stimulation test (TST). RESULTS: The study did not show any differences in the skin microcirculation perfusion at rest between the test group and the control, while reactive hyperaemia test results revealed significantly lower skin microcirculation perfusion values during the cuff inflation in SSc patients, as compared to the controls. In the test group, a lower perfusion value was observed during secondary hyperaemia following cuff release. Comparative analysis of skin microcirculation perfusion changes during the thermal stimulation test revealed a significantly lower change of the perfusion value and longer time of return to the baseline in the test group as compared to the control group. CONCLUSIONS: The study performed has shown the suitability of LDF in the assessment of the microangiopathy degree in systemic sclerosis patients. The skin perfusion value in SSc patients should be assessed on the basis of parameters obtained in microcirculation challenge tests.

Selective Bowman's layer transplantation in the treatment of neurotrophic corneal ulcers.

The aim of this paper is to present the surgical technique of selective Bowman's layer transplantation as well as the results of the surgery in patients with trophic corneal ulcers. The methodology of the study included three eyes from three patients with neurotrophic corneal ulcers grafting with corneal Bowman's layer. Pre- and postoperative analyses of the anterior segment of the eye were based on optical coherence tomography and slit-lamp assessment. Postoperatively a gradual corneal stroma restoration and fast corneal epithelialization were noticed. Based on our observations, the stiff and firm structure of Bowman's layer is supposed to strengthen the corneal surface and maintain its shape. It acts also as an antipathogen and antitoxin corneal barrier. Application of this acellular corneal layer transplantation to cover trophic corneal ulcers is an interesting, modern and crucial method of neurotrophic keratitis treatment.

[Refractive errors in patients with cerebral palsy]. / Ocena wystepowania wad wzroku u pacjentów z mózgowym porazeniem dzieciecym.

UNLABELLED: Ocular changes are common in patients with cerebral palsy (CP) and they exist in about 50% of cases. The most common are refractive errors and strabismus disease. The aim of the paper was to estimate the relativeness between refractive errors and neurological pathologies in patients with selected types of CP. MATERIAL AND METHODS. The subject of the analysis was showing refractive errors in patients within two groups of CP: diplegia spastica and tetraparesis, with nervous system pathologies taken into account. Results. This study was proven some correlations between refractive errors and type of CP and severity of the CP classified in GMFCS scale. CONCLUSIONS: Refractive errors were more common in patients with tetraparesis than with diplegia spastica. In the group with diplegia spastica more common were myopia and astigmatism, however in tetraparesis - hyperopia.

[Ocular manifestation of langerhans' cells histiocytosis - case report]. / Zmiany oczne w przebiegu histiocytozy z komórek langerhansa - opis przypadku.

PURPOSE: To present a case of a young female suffering from Langerhans' cells histiocytosis of the lungs with ocular involvement. MATERIAL/ RESULTS: Patient was primarily admitted to the ophthalmology department due to bilateral mature cataract. Phacoemulsification did not improved visual acuity. Based on ophthalmological examination, spectral coherence tomography scans and fundus angiography and previous medical history, concomitant advanced changes e.g. optic nerve atrophy and severe obliteration of retinal vessels was revealed CONCLUSIONS: Our case presents one of rare ophthalmic localization of Langerhans, cells histiocytosis within vessels wall and/ or optic nerve that can be potentially the reason of that arterial and vein obliteration and optic nerve atrophy.

[Alterations in tears aqueous layer during cytostatics treatment]. / Zmiany w warstwie wodnej lez podczas leczenia cytostatykami.

PURPOSE: The aim of the study was to evaluate tears secretion, pH and lysozyme activity in tears aqueous layer during chemotherapy in lung, breast and bowel cancer. MATERIAL AND METHODS: 36 patients were enrolled to the study. Depending on the type of cancer and type of chemotherapy patients were divided into three groups. Group I (12 patients) diagnosed with non-small-cell lung cancer treated with PE schema (cisplatin, etoposide), Group II (12 patients) with breast cancer treated with FAC schema (fluorouracil, doxorubicin, cyclophosphamide), Group III (12 patients) with bowel cancer treated with FU/LV schema (fluorouracil, leucovorin). In all the patients: Schirmer's I test, pH measurements and lysozyme test were performed. Patients were examined before chemotherapy, after 2nd, 4th, 6th cycle. RESULTS: In group I and II lowering of tears secretion (p < 0.001) was revealed. In group III there was higher tears secretion (p < 0.001). PH was lowered after 2nd chemotherapy course in group I and II. In further treatment pH value were in the same lower level as after the second course. In group III there was higher pH--more alkaline (p < 0.001) after 2nd cycle of treatment and it was on the same level to the end of the examination process. Lowering of lysozyme activity in the tears film in all groups (p < 0.001) was established. The higher alterations of the lysozyme activity were observed in group treated with FAC schema. CONCLUSIONS: Cytostatic treatment has major influence on tears aqueous layer causing alterations of tears secretions. PH alterations depending on type of chemotherapy was observed. Lowering of lysozyme activity in tears was observed. All the deteriorations aggravate with duration of chemotherapy. Alterations of tears film parameters during chemotherapy may influence upon eye surface homeostasis and infectious complication. tears aqueous layer, Schirmer's test, lysozyme activity, tears pH.

[Influence of cancer chemotherapy on conjunctival epithelium and goblet cells]. / Wplyw chemioterapii stosowaney w leczeniu nowotworów zlosliwych na stan nablonka i komórek kubkowych spojówki.

PURPOSE: Evaluation of different types of chemotherapy schemes administered in lung, breast and bowel cancer on conjunctival epithelium and goblet cells morphology. MATERIAL AND METHODS: 36 patients (72 eyes) were enrolled to the study. Patients were divided into three groups depending on type of cancer and chemotherapy: group I - patients diagnosed with non- small cells lung cancer treated with PE schema (cisplatin, etoposide), group II - with breast cancer treated with FAC schema (fluorouracil, doxorubicin, cyclophosphamide), group Ill - bowel cancer treated with FU/LV schema (fluorouracil, leucovorin). Examinations were performed before chemotherapy and after Il'th, IV'th, VI'th chemotherapy cycle. Conjuntival specimen were obtained with exfoliative cytology, stained with PAS and hematoxyline. RESULTS: Statistically significant deterioration of conjunctival epithelium and goblet cells in all the groups in each time of examination (p<0.001) was observed. Alterations were aggravated with duration of chemotherapy. Before chemotherapy all the patients had normal epithelium and goblet cells (grade 0 or 1 according to the Nelson's scale). Conjunctival cells status gradually deteriorated and altered from the normal glandular epithelium to the squamous cells epithelium through the process of squamous metaplasia. In further chemotherapy cycles each patient (1,0 fraction) had abnormal morphology of epithelium and goblet cells (grade 2 or 3 of Nelson's scale). CONCLUSIONS: Chemotherapy induces squamous metaplasia of epithelium and the reduction of number of conjunctival goblet cells. This abnormalities were time dependent and increased with duration of chemotherapy and were not depended on type of chemotherapy scheme.

[Ocular findings in Polish Armed Forces in Iraq and Afghanistan, a review of medical examinations by The Military Medical Commission in Lodz]. / Analiza okulistyczna stanu zdrowia zolnierzy powracajqcych z misji w iraku i w Afganistanie na podstawie badan Terenowej Wojskowej Komisji Lekarskiej (TWKL) w Lodzi.

PURPOSE: To determine the prevalence of ocular disorders among Polish soldiers returning from Iraq and Afghanistan military campaigns. MATERIAL AND METHODS: A retrospective review of medical records of the Military Medical Commission of Lodz, Poland was performed. Records of 296 randomly selected soldiers, including 98 who returned from Iraq in 2004 and in 198 who returned from Afghanistan in 2012, were assessed. All subjects underwent comprehensive ocular examinations according to the military regulations. We used statistical analysis to review the results. RESULTS: The incidence of ocular disorders in Iraq and Afghanistan groups was 17.3% and 15.1%, respectively. The study revealed that the most common disorders among soldiers were refractive errors affecting 6.8% subjects, followed by defective color vision (4.7%) and solar retinopathy (3.0%). Combat injuries were diagnosed in 3 subjects, including 2 cases of corneal injury and 1 case of retinal detachment due to blast exposure. CONCLUSIONS: Combat injuries occurred in 1% of soldiers returning from Iraq and Afghanistan military campaigns. There were no statistically significant differences between Iraq and Afghanistan groups in the incidence of ocular disorders. Solar retinopathy was the most common problem related to the long-term exposure to rough climate conditions in both groups. ocular findings, Iraq, Afghanistan.