Aeromedical evacuation (AE) is often performed in order to preserve “Life, Limb, or Eyesight.” Of these, often sight is most highly valued by patients. During AE, appropriate medical care of ocular casualties is essential. The goal is to prevent future eye injury while providing rapid and efficient transportation to a facility capable of providing ophthalmologic care. AE patients with serious ocular injuries are commonly transported as litter patients. Those who are ambulatory will require additional assistance, orientation, and guidance while entering or exiting the aircraft. Altitude-related decreases in pressure are typically not issues for most ocular injuries. Important exceptions are patients recently treated with intraocular gas or the rare occurrence of intraorbital or intraocular air after open orbit injury or ocular surgery: Decreased pressure at cruise altitude will increase gas volume and thus intraocular pressure. A sudden increase in eye pain in patients with serious ocular injuries can indicate an ophthalmologic emergency such as orbital compartment syndrome or acute glaucoma. In-flight recognition and timely response to increased symptoms in these patients is necessary to preserve sight.
