Eye Problems in Mountain and Remote Areas: Prevention and Onsite Treatment—Official Recommendations of the International Commission for Mountain Emergency Medicine ICAR MEDCOM

Abstract

Although eyes are not frequently injured in the mountains, they are exposed to many adverse factors from the environment. This article, intended for first responders, paramedics, physicians, and mountaineers, is the consensus opinion of the International Commission for Mountain Emergency Medicine (ICAR-MEDCOM). Its aim is to give practical advice on the management of eye problems in mountainous and remote areas. Snow blindness and minor injuries, such as conjunctival and corneal foreign bodies, could immobilize a person and put him or her at risk of other injuries. Blunt or penetrating trauma can result in the loss of sight in the eye; this may be preventable if the injury is managed properly. In almost all cases of severe eye trauma, protecting the eye and arranging an immediate evacuation are necessary. The most common eye problems, however, are due to ultraviolet light and high altitude. People wearing contact lenses and with previous history of eye diseases are more vulnerable. Any sight-threatening eye problem or unexplained visual loss at high altitude necessitates descent. Wearing appropriate eye protection, such as sunglasses with sidepieces and goggles with polarized or photochromic lenses, could prevent most of the common eye problems in mountaineering.

Eye injuries in the extreme environment ultra-marathon runner

“…These injuries have been seen in mountaineers and parachutists 3. The presentation is often a painful eye, light sensitivity and eyelid spasm,4 as seen in our case. Corneal injury should be considered in people complaining of these symptoms following exposure to high wind speeds and cold temperatures.…”

Is the development of infectious keratoconjunctivitis in Alpine ibex and Alpine chamois influenced by topographic features?

“…However, it is probably rather the associated environmental conditions that influence the course of the disease, than elevation itself: UV light is a direct cause of damage to all eye tissues and is considered a predisposing factor of infectious keratitis in humans (Ellerton et al 2009). UV exposure is known to increase with altitude (10 % per 1,000 m, Marín et al 2005) and is expected to be particularly high in winter due to snow cover (Dolin and Johnson 1994).…”

High-energy visible light transparency and ultraviolet ray transmission of metallized rescue sheets

“…Acute eye effects include snow blindness and retinal burn. Painful injuries of cornea and conjunctiva from intense solar radiation reflected by snow or glaciers are well known medical emergencies 4,8,11,12 . Acute photokeratitis from short-term exposure to high doses of UVB rays was reported in up to 3% of high-altitude mountaineers 8,11 .…”