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While Marine Corporal Jason Poole was spared some of the memories of the explosion that injured him, he was spared none of the force. He was on foot patrol near the Syrian border in Iraq when a roadside bomb blew up.
"And we got hit with a massive bomb. The two Iraqi guards and an interpreter were killed and I was in a coma for two months. Yeah, it was pretty bad," he said.
Eight surgeries later, Jason is deaf in his left ear and blind in his left eye. But on this trip to the VA Hospital in Palo Alto, it's the right eye doctors are concerned about.
Doctor Glenn Cockerham helped lead a study of bomb blast survivors like Jason. It is a group who, unlike in other wars, now helps make up the largest percentage of vision loss patients.
"You can imagine the blow that the face takes, particularly if they're facing the direction of the blast," said Dr. Cockerham. "It's just like a big train hitting them if they're that close."
But these traumatic eye injuries aren't always visible at first glance, like the more common gunshot wounds of previous wars. Doctors are now discovering detached retinas, ruptured corneas, even tears in the iris. And some damage is hidden well below the surface.
"The optic nerve can be damaged anywhere from brain to the eyeball," said Dr. Cockerham.
Doctor Greg Goodrich co-authored the study, which has led to stepped up diagnostic care for the most seriously injured vets.
"There is a directive from central office, based on our research, that mandates that all of them have comprehensive eye and vision examinations," said Dr. Goodrich. "This includes ocular injury, as well as brain injury that affects the visual system."
The focus on brain injury targets cases like Jason, who says he has trouble reading and focusing since his recovery.
While nobody knows how many vets may have suffered hidden vision problems, one private estimate put the number of at-risk soldiers in the hundreds of thousands.
"We do know that in the trauma center half the patients we are seeing are due to blast events," said Dr. Goodrich.
In the meantime, Poole is undergoing regular monitoring for the damage to his right eye, and setting his sights on the future.
"Angela is my fiancée and hopefully next year we'll get married," he said.
Dr. Goodrich and Dr. Cockerham have been nominated for an Olin Teague Award for their research into eye injuries. It's given for work that most improves the lives of injured veterans.
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