Explosive Weapons Trauma Care Collective (EXTRACCT) Blast Injury Clinical Practice Guideline: Ocular Trauma

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Butterfield E.
Bolt A.
Clare G.
Mattia J.
TinU A.M.
Ndyabawe I.
Schwab L.
Wagner,S. K.

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2025

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INTRODUCTION: This clinical practice guideline from the Explosive Weapons Trauma Care Collective (EXTRACCT) group reviews current best practice for the management of ocular trauma in conflict-affected regions, where explosive weapons are used and healthcare infrastructure is limited. METHOD(S): An expert literature review of current practice is presented with practical resource-adapted guidelines constructed through expert consensus from ophthalmologists, emergency care providers and allied health professionals with field experience. RESULT(S): The guideline provides recommendations for the assessment, classification and management of major and minor ocular injuries encountered in low-resource settings, particularly during conflict. Guidance is written for frontline healthcare workers who may be addressing such injuries in the absence of specialist ophthalmology expertise and equipment. Dosing of ophthalmic therapeutics is provided. CONCLUSION(S): Actionable context-appropriate strategies to manage ocular trauma caused by explosive weapons can reduce vision loss and improve patient outcomes where specialized ophthalmic care is scarce. Copyright © 2025 The Author(s). World Journal of Surgery published by John Wiley & Sons Ltd on behalf of International Society of Surgery/Societe Internationale de Chirurgie (ISS/SIC).

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World journal of surgery

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