Back to Top Skip to main content Skip to sub-navigation

Brief Report: Refractive Surgery Trends at Tri-Service Refractive Surgery Centers and the Impact of the COVID-19 Pandemic, Fiscal Years 2000–2020

Image of Cadet Saverio Macrina, U.S. Military Academy West Point, receives corneal cross-linking procedure at Fort Belvoir Community Hospital, Va., Nov. 21, 2016. (DoD photo by Reese Brown). Cadet Saverio Macrina, U.S. Military Academy West Point, receives corneal cross-linking procedure at Fort Belvoir Community Hospital, Va., Nov. 21, 2016. (DOD photo by Reese Brown)

Recommended Content:

Medical Surveillance Monthly Report

Background

Since the official introduction of laser refractive surgery into clinical practice throughout the Military Health System (MHS) in fiscal year 2000, these techniques have been heavily implemented in the tri-service community to better equip and improve the readiness of the U.S. military force. Military studies of refractive surgery date back to 1993, but prior to full military utilization of laser refractive surgery, spectacles or contact lenses were the mainstay to correct refractive error among military personnel.1,2 Studies on the prevalence of refractive error, including myopia, hyperopia, and astigmatism, have shown that these conditions are quite common among active component service members.3,4 Reversing such error through refractive surgery has been documented to improve military readiness, operational capability, and the quality of life of U.S. service members.5

There are 26 Department of Defense (DOD) Warfighter Refractive Surgery Centers that offer a combination of vision-correcting procedures such as photorefractive keratectomy (PRK), laser assisted in situ keratomileusis (LASIK), laser epithelial keratomileusis (LASEK), small incision lenticule extraction (SMILE), implantable collamer lens (ICL), and refractive lens exchange (RLE).6–8 The capability to readily perform surgery with laser technology using the latest refractive surgery platforms highlights the importance of optimized vision to the DOD.

The COVID-19 pandemic introduced numerous obstacles which contributed to the reduction in the number of procedures performed. These obstacles included the closure of surgical centers and lack of temporary duty travel (TDY) patients. The pandemic also resulted in a shift to pre-operative testing for COVID-19 and virtual pre-operative briefings which could potentially result in delayed or cancelled refractive surgeries.

The objective of this report was to describe trends in total numbers of refractive surgeries over the last 21 fiscal years and to demonstrate how the early COVID-19 pandemic affected military refractive surgery trends.

Methods

Data on all refractive surgery cases performed at 26 DOD Warfighter Refractive Surgery Centers were compiled by the U.S. Navy refractive surgery program manager and presented at the 2021 virtual Military Refractive Surgery Safety and Standards Symposium annual meeting.6–8 These data are summarized in this report.

The surveillance period was from 1 October 1999 through 30 September 2020 (fiscal years 2000–2020). The surveillance population included active duty service members (active component and activated Reserve/Guard members) who met eligibility criteria for refractive eye surgery. Criteria for qualifying for refractive surgery may have differed among the services, but in general, service members had to have had at least 18 months left in their service commitments, a commander's authorization letter, and no adverse personnel actions. In addition, 3 Air Force locations performed refractive surgery on a small number of non-service member beneficiaries of the Military Health System as part of a research protocol (accounting for <0.03% of Air Force refractive surgical cases for fiscal year 2020).

Results

For fiscal years 2000–2020, a total of 746,950 refractive surgeries were reported from the 26 Warfighter Tri-Service Refractive Surgery Centers. The number of surgeries performed each fiscal year ranged from a low of 4,381 refractive surgeries in 2000 to a peak of 50,690 surgeries in 2005 (Figure 1) with an average of 35,569 surgeries per year. In fiscal year 2020, 20,270 refractive surgeries were performed which represents a 38.6% decrease from the number of cases performed in 2019 (n=33,039).

During the surveillance period, there were 363,058 surgeries performed at Army refractive centers, 216,568 at Navy refractive centers, and 167,324 at Air Force refractive centers. The number of surgeries for all services declined from fiscal year 2019 to fiscal year 2020 (Army, 39.8% decrease; Navy, 34.6% decrease; Air Force, 41.0% decrease) (Figure 1).

In 2020, the types of refractive surgery approximately consisted of 65.1% PRK (n=13,201), 27.6% LASIK/LASEK (n=5,585), 4.5% SMILE (n=920), 2.7% ICL (n=540), and 0.1% RLE (n=24) (Figure 2). The percentage distributions of type of refractive surgery were similar among all the services in 2020.

Editorial Comment

This report describes trends in the numbers of refractive surgeries performed during the 21 year surveillance period, including the COVID-19 pandemic. Since fiscal year 2000, the tri-service ophthalmology community conducted 746,950 vision corrective surgeries at 26 DOD Warfighter Refractive Surgery Centers. The large number of refractive cases reported and the amount of refractive surgery centers present in the DOD speaks to the valued importance of optimal vision in U.S. military members. In addition to the warfighter's improvement in quality of life, vision corrective surgeries are used frequently in the U.S. military due to the need and for improved preparedness and performance in operational tasks.3–5 An Air Force study from 2020 reported the prevalence of myopia in 767 Air Force Basic Military Trainees. Among the trainees, 45% were found to have myopia classified as greater than -0.5 D, and 2% of trainees were found to have high myopia classified as greater than -6.0 D.In 2019, Reynolds et al. reported that 51.1% of ocular care for service members during fiscal year 2018 was dedicated to refractive error-related disorders.9 A study published in 2017 demonstrated the excellent and comparable vision outcomes of Wave-Front Guided and Wave-Front Optimized PRK on military members in regard to marksmanship, visual performance, threshold target identification, and contrast sensitivity.10 These studies shed light on the importance of refractive surgery offered by the DOD.

When analyzing the effect of the COVID-19 pandemic, a decrease in the number of refractive surgery cases performed in the tri-service community was reported. Specifically, the total number of surgeries during fiscal year 2020 was comparable to the number of surgeries in fiscal year 2002, shortly after the procedures were first introduced. The pronounced decrease in the number of surgeries performed was undoubtedly due to factors related to the SARS-CoV-2 pandemic: shutdown of DOD Warfighter Refractive Surgery Centers, unavailability of TDY patients, pre-operative SARS-CoV-2 testing, difficulty with pre-operative virtual briefings, availability of N-95 masks, properly scheduling post-operative follow-up, and limitations on family members helping with patients after surgery. The reduced number of procedures observed in fiscal year 2020 is consistent with many published reports of reduced health care utilization during the COVID-19 pandemic.11 One such report demonstrated initial reduced demand for refractive surgery which subsequently rebounded in 2021.12

In fiscal year 2020, the majority of cases were PRK followed by LASIK/LASEK and SMILE, respectively. A trend toward PRK surgery in the military has been prevalent for years; however, there has been a shift towards LASIK especially among Navy surgery centers.13,14 Various reasons exist for the preference of PRK, which include surgeon's comfort with performing PRK over LASIK, previous military policies that prohibited LASIK for special forces, and the risk of traumatic corneal flap lifting following LASIK that cannot be attended to in an environment that is not readily equipped with an ophthalmologist (e.g., deployment, training, austere environments).15 With the introduction of SMILE in 2016 after the U.S. Food and Drug Administration approval, it has been increasingly implemented in the DOD.16 SMILE has shown promise with comparable, if not better, visual outcomes than PRK and more predictable outcomes and similar corneal biomechanical stability when compared to LASIK.17,18 The emergence of new refractive surgery techniques will continue to provide opportunity for advancement in military refractive surgery.

Limitations of this study include potential bias in data retrieval and documentation. Data were individually reported from each center and were not verified with medical coding. Additionally, refractive surgeries performed outside of Warfighter Refractive Surgery Centers were not captured in this analysis.

In summary, this report demonstrates the trend in refractive surgeries at the DOD Refractive Surgery Centers and reveals the decrease in refractive surgeries during the COVID-19 pandemic. Because of the instrumental role refractive surgery plays in gaining a strategic advantage for the U.S. military warfighter, surgical procedures still continued during this period and will most likely increase to pre-pandemic numbers as the COVID-related restrictions are lifted or conditions to handle COVID-related spread are improved. Future implications from the lessons learned during the COVID-19 pandemic will provide a framework on how to troubleshoot barriers to performing refractive surgery in the future.

Author affiliations: United States Air Force, Medical College of Georgia at Augusta University (2d Lt Brandon Sellers, BS); United States Air Force, Air Force Refractive Surgery Consultant, Joint Base Elmendorf-Richardson, Anchorage, AK (Lt Col J. Richard Townley, MD); United States Navy, Prior Navy Refractive Surgery Program Manager, Camp Lejeune, Jacksonville, NC (CAPT Corby Ropp, DO); United States Army, Army Refractive Surgery Program Manager, Defense Health Agency Refractive Surgery Board Chair, Brooke Army Medical Center, Ft. Sam Houston, TX (LTC Gary Legault, MD). Dr. Corby Ropp died during the creation of this manuscript but was instrumental in compiling the data.

Disclaimer: The contents, views, or opin­ions expressed in this publication are those of the author(s) and do not necessarily reflect the official policy or position of the Defense Health Agency, Department of Defense, or the U.S. Government.

References

1. Lattimore MR, Jr., Schrimsher RH. Refractive error distribution and incidence among U.S. Army aviators. Mil Med. 1993;158(8):553–556.

2. Hammond MD, Madigan WP, Jr., Bower KS. Refractive surgery in the United States Army, 2000-2003. Ophthalmology. 2005;112(2):184–190.

3. Reynolds ME, Taubman SB, Stahlman S. Incidence and prevalence of selected refractive errors, active component, U.S. Armed Forces, 2001-2018. MSMR. 2019;26(9):26–30.

4. Reed DS, Ferris LM, Santamaria J, et al. Prevalence of myopia in newly enlisted airmen at Joint Base San Antonio. Clin Ophthalmol. 2020;14:133–137.

5. Sia RK, Ryan DS, Rivers BA, et al. Vision-related quality of life and perception of military readiness and capabilities following refractive surgery among active duty U.S. Military service members. J Refract Surg. 2018;34(9):597–603.

6. Legault, GL. Army refractive surgery update. Military Refractive Surgery Safety and Standards Symposium, virtual. 1 January 2021.

7. Townley, JR. Air Force refractive surgery update. Military Refractive Surgery Safety and Standards Symposium, virtual. 1 January 2021.

8. Ropp, C. Navy refractive surgery update. Military Refractive Surgery Safety and Standards Symposium, virtual. 1 January 2021.

9. Reynolds ME, Williams VF, Taubman SB, Stahlman S. Absolute and relative morbidity burdens attributable to ocular and vision-related conditions, active component, U.S. Armed Forces, 2018. MSMR. 2019;26(9):4–11.

10. Ryan DS, Sia RK, Stutzman RD, et al. Wavefront-guided versus wavefront-optimized photorefractive keratectomy: Visual and military task performance. Mil Med. 2017;182(1):e1636–e1644.

11. Moynihan R, Sanders S, Michaleff ZA, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review. BMJ Open. 2021;11(3):e045343. 

12. Bickford M, Rocha K. Impact of the COVID-19 pandemic on refractive surgery. Curr Ophthalmol Rep. 2021:1–6.

13. Stanley PF, Tanzer DJ, Schallhorn SC. Laser refractive surgery in the United States Navy. Curr Opin Ophthalmol. 2008 Jul;19(4)321–324.

14. Gao H, Miles TP, Troche R, et al. Quality of vision following LASIK and PRK-MMC for treatment of myopia. Mil Med. 2021;usab071. 

15. Shih LY, Peng KL, Chen JL. Traumatic displacement of laser in situ keratomileusis flaps: an integrated clinical case presentation. BMC Ophthalmol. 2021;21(1):177.

16. Dishler JG, Slade S, Seifert S, Schallhorn SC. Small-incision lenticule extraction (SMILE) for the correction of myopia with astigmatism: Outcomes of the United States Food and Drug Administration Premarket Approval Clinical Trial. Ophthalmology. 2020;127(8):1020–1034.

17. Sia RK, Ryan DS, Beydoun H, et al. Visual outcomes after SMILE from the first-year experience at a U.S. military refractive surgery center and comparison with PRK and LASIK outcomes. J Cataract Refract Surg. 2020;46(7):995–1002.

18. Cao K, Liu L, Yu T, Chen F, Bai J, Liu T. Changes in corneal biomechanics during small-incision lenticule extraction (SMILE) and femtosecond-assisted laser in situ keratomileusis (FS-LASIK). Lasers Med Sci. 2020;35(3):599–609.

FIGURE 1. Number of refractive surgery cases, by service from a Tri-Service Refractive Surgery Center, fiscal years 2000–2020

FIGURE 2. Refractive surgery cases, by service and type of procedure performed at a Tri- Service Refraction Surgery Center, fiscal year 2020

You also may be interested in...

Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2006–2021

Article
4/1/2022
Marine Corps Cpl. Luis Alicea drinks water after a combat conditioning exercise at Naval Air Station Joint Reserve Base New Orleans, May 20, 2019. Photo By: Marine Corps Lance Cpl. Jose Gonzalez.

Exertional (or exercise-associated) hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 mEq/L) that develops during or up to 24 hours following prolonged physical activity. Acute hyponatremia creates an osmotic imbalance between fluids outside and inside of cells.

Recommended Content:

Medical Surveillance Monthly Report

Exertional Heat Illness at Fort Benning, GA: Unique Insights from the Army Heat Center

Article
4/1/2022
Navy Petty Officer 3rd Class Ryan Adams is being used as an example victim for cooling a heat casualty at the bi-annual hot weather standard operating procedure training aboard Marine Corps Base Camp Lejeune, N.C., Aug. 24. Adams is demonstrating the "burrito" method used to cool a heat related injury victim. Photo by Pfc. Joshua Grant.

Exertional heat illness (hereafter referred to as heat illness) spans a spectrum from relatively mild conditions such as heat cramps and heat exhaustion, to more serious and potentially life-threatening conditions such as heat injury and exertional heat stroke (hereafter heat stroke).

Recommended Content:

Medical Surveillance Monthly Report

Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2017–2021

Article
4/1/2022
The Embry-Riddle Army ROTC Ranger Challenge team heads out on the 12-mile road march after completing the timed obstacle course event of the 6th Brigade Army ROTC Ranger Challenge January 14, 2022 at Fort Benning, Ga. The Titan Brigade’s Ranger Challenge took place at Fort Benning, Ga. January 13-15, 2022. Photo by Capt. Stephanie Snyder

Exertional rhabdomyolysis is a potentially serious condition that requires a vigilant and aggressive approach. Some service members who experience exertional rhabdomyolysis may be at risk for recurrences, which may limit their military effectiveness and potentially predispose them to serious injury.

Recommended Content:

Medical Surveillance Monthly Report

Heat Illness, Active Component, U.S. Armed Forces, 2021

Article
4/1/2022
Airmen participate in the 13th Annual Fallen Defender Ruck March at Joint Base San Antonio, Nov. 6, 2020. The event honors 186 fallen security forces, security police and air police members who have made the ultimate sacrifice. Photo By: Sarayuth Pinthong, Air Force.

From 2020 to 2021, the rate of incident heat stroke was relatively stable while the rate of heat exhaustion increased slightly

Recommended Content:

Medical Surveillance Monthly Report

Obesity prevalence among active component service members prior to and during the COVID-19 pandemic, January 2018–July 2021

Article
3/1/2022
Maintaining a healthy weight is important for military members to stay fit to fight. The body mass index is a tool that can be used to determine if an individual is at an appropriate weight for their height. A person’s index is determined by their weight in kilograms divided by the square of height in meters. (U.S. Air Force photo illustration by Airman 1st Class Destinee Sweeney)

This study examined monthly prevalence of obesity and exercise in active component U.S. military members prior to and during the COVID-19 pandemic. These results suggest that the COVID-19 pandemic had a small effect on the trend of obesity in the active component U.S. military and that obesity prevalence continues to increase.

Recommended Content:

Medical Surveillance Monthly Report

Brief report: Using syndromic surveillance to monitor MIS-C associated with COVID-19 in Military Health System beneficiaries

Article
3/1/2022
Air Force 1st Lt. Anthony Albina, a critical care nurse assigned to Joint Base Andrews, Md., checks a patient’s breathing and heart rate during an intubation procedure while supporting COVID-19 response operations in Cleveland, Jan. 20, 2022.

SARS CoV-2 and the illness it causes, COVID-19, have exacted a heavy toll on the global community. Most of the identified disease has been in the elderly and adults. The goal of this analysis was to ascertain if user-built ESSENCE queries applied to records of outpatient MHS health care encounters are capable of detecting MIS-C cases that have not been identified or reported by local public health departments.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Medical Separation from Service Among Incident Cases of Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
3/1/2022
Marines hike to the next training location during Exercise Baccarat in Aveyron, Occitanie, France, Oct.16, 2021. Exercise Baccarat is a three-week joint exercise with Marines and the French Foreign Legion that challenges forces with physical and tactical training. Photo By: Marine Corps Lance Cpl. Jennifer Reyes

Osteoarthritis (OA) is the most common adult joint disease and predominantly involves the weight-bearing joints. This condition, including spondylosis (OA of the spine), results in significant disability and resource utilization and is a leading cause of medical separation from military service.

Recommended Content:

Medical Surveillance Monthly Report

Update: Malaria, U.S. Armed Forces, 2021

Article
3/1/2022
Mosquitos – like this one, collected as part of a military study in North Carolina – were used during USAMRDC’s initial RTS,S vaccine studies nearly 40 years ago. (Photo courtesy: AFC Kimberly Barrera)

Malaria infection remains an important health threat to U.S. service members who are located in endemic areas because of long-term duty assignments, participation in shorter-term contingency operations, or personal travel. In 2021, a total of 20 service members were diagnosed with or reported to have malaria.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance snapshot: Health care burden attributable to osteoarthritis and spondylosis, active component, U.S. Armed Forces, 2016–2020

Article
2/1/2022
Air Force security forces trainees climb a hill during a 3-mile ruck march to commemorate National Police Week at Joint Base San Antonio, May 13, 2019. Photo By: Sarayuth Pinthong, Air Force

This snapshot summarizes the total numbers of inpatient and outpatient encounters with an OA or spondylosis diagnosis in the first diagnostic position and the total numbers of unique individuals affected by these conditions during the same 5-year surveillance period.

Recommended Content:

Medical Surveillance Monthly Report

A new approach to categorization of ocular injury among U.S. Armed Forces

Article
2/1/2022
Air Force and Space Force Surgeon General Lt. Gen. Dorothy Hogg receives an eye exam from Air Force Reserve Maj. Leslie Wilderson at Joint Base Anacostia-Bolling, Washington, D.C., March 26, 2021. Photo By: Air Force Staff Sgt. Kayla White

Ocular injuries present an ongoing threat to readiness and retention of service members. This report describes a new approach to categorizing ocular injury using Military Health System data, the application of an algorithm to a dataset, and the verification of the results using an audit of clinical data.

Recommended Content:

Medical Surveillance Monthly Report

Diagnosis of hepatitis C infection and cascade of care in the active component, U.S. Armed Forces, 2020

Article
2/1/2022
Navy Petty Officer 2nd Class Cecil Dorse, left, and Navy Petty Officer 3rd Class Janet Rosas test blood samples aboard the Military Sealift Command hospital ship USNS Comfort while the ship is in New York City in support of the nation’s COVID-19 response, April 6, 2020. Photo By: Navy Petty Officer 2nd Class Sara Eshleman

Hepatitis C virus (HCV) infection rates are rising in the U.S. despite widely available tools to identify and effectively treat nearly all of these cases. This cross-sectional study aimed to use laboratory data to evaluate the prevalence of HCV diagnoses among active component U.S. military service members.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Lengths of Hospital Stays for Service Members Diagnosed with Sepsis, Active Component, U.S. Armed Forces, 2011–2020

Article
1/1/2022
The (left to right) Senior Airman Austin Shrewsbury, 88th Diagnostics and Therapeutic Squadron medical laboratory technician, works with student, Airman 1st Class Taylor Altman, 88th Diagnostics and Therapeutic Squadron medical laboratory technician, to identify bacteria of patient’s cultures inside the microbiology laboratory at Wright-Patterson Air Force Base medical center June 30, 2017.

Sepsis is a serious and life-threatening organ dysfunction caused by a dysregulated host response to infection. In the U.S., sepsis is a leading cause of in-hospital mortality and 1 of the most expensive conditions treated in U.S. hospitals.

Recommended Content:

Medical Surveillance Monthly Report

Description of a COVID-19 Beta Variant Outbreak, Joint Base Lewis-McChord, WA, February–March 2021

Article
1/1/2022
U.S. Army Soldiers from 1-17th Infantry Battalion, 2nd Stryker Brigade, 2nd Infantry Division, clear an objective during the training exercise Bayonet Focus 19-02 at Yakima Training Center, Wash., May 6, 2019. Bayonet Focus is a training exercise designed to assess Soldiers’ ability to preform tasks and complete objectives under conditions experienced during combat situations. (U.S. Army photo by Spc. Angel Ruszkiewicz)

This report describes an outbreak of SARS-CoV-2, the causative agent of COVID-19, that peaked during 21–26 February 2021 and was tied to a single military training event. A total of 143 laboratory-confirmed cases were identified.

Recommended Content:

Medical Surveillance Monthly Report

COVID-19 and Depressive Symptoms Among Active Component U.S. Service Members, January 2019–July 2021

Article
1/1/2022
With the holiday season upon us, the cold, dark days that winter brings, and the social distancing and movement restrictions brought about by COVID-19, it’s not uncommon for people to feel depressed. (Photo by Erin Bolling)

This study examined the rates of depressive symptoms in active component U.S. service members prior to and during the COVID-19 pandemic and evaluated whether SARS-CoV-2 test results (positive or negative) were associated with self-reported depressive symptoms.

Recommended Content:

Medical Surveillance Monthly Report

Update: Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
12/1/2021
Osteoarthritis (OA) knee . film x-ray AP ( anterior - posterior ) and lateral view of knee show narrow joint space, osteophyte ( spur ), subchondral sclerosis, knee joint inflammation. Photo by: iStockPhoto

Osteoarthritis (OA), the most com­mon adult joint disease, is primarily a degenerative disorder of the entire joint organ, including the subchondral bone, synovium, and periarticular structures (e.g., tendons, ligaments, bursae). Spondylosis, often referred to as OA of the spine, is characterized by degenerative changes in the vertebral discs, joints, and vertebral bodies.

Recommended Content:

Medical Surveillance Monthly Report

Exertional Hyponatremia, Active Component, U.S. Armed Forces, 2006–2021

Article
4/1/2022
Marine Corps Cpl. Luis Alicea drinks water after a combat conditioning exercise at Naval Air Station Joint Reserve Base New Orleans, May 20, 2019. Photo By: Marine Corps Lance Cpl. Jose Gonzalez.

Exertional (or exercise-associated) hyponatremia refers to a low serum, plasma, or blood sodium concentration (below 135 mEq/L) that develops during or up to 24 hours following prolonged physical activity. Acute hyponatremia creates an osmotic imbalance between fluids outside and inside of cells.

Recommended Content:

Medical Surveillance Monthly Report

Exertional Heat Illness at Fort Benning, GA: Unique Insights from the Army Heat Center

Article
4/1/2022
Navy Petty Officer 3rd Class Ryan Adams is being used as an example victim for cooling a heat casualty at the bi-annual hot weather standard operating procedure training aboard Marine Corps Base Camp Lejeune, N.C., Aug. 24. Adams is demonstrating the "burrito" method used to cool a heat related injury victim. Photo by Pfc. Joshua Grant.

Exertional heat illness (hereafter referred to as heat illness) spans a spectrum from relatively mild conditions such as heat cramps and heat exhaustion, to more serious and potentially life-threatening conditions such as heat injury and exertional heat stroke (hereafter heat stroke).

Recommended Content:

Medical Surveillance Monthly Report

Exertional Rhabdomyolysis, Active Component, U.S. Armed Forces, 2017–2021

Article
4/1/2022
The Embry-Riddle Army ROTC Ranger Challenge team heads out on the 12-mile road march after completing the timed obstacle course event of the 6th Brigade Army ROTC Ranger Challenge January 14, 2022 at Fort Benning, Ga. The Titan Brigade’s Ranger Challenge took place at Fort Benning, Ga. January 13-15, 2022. Photo by Capt. Stephanie Snyder

Exertional rhabdomyolysis is a potentially serious condition that requires a vigilant and aggressive approach. Some service members who experience exertional rhabdomyolysis may be at risk for recurrences, which may limit their military effectiveness and potentially predispose them to serious injury.

Recommended Content:

Medical Surveillance Monthly Report

Heat Illness, Active Component, U.S. Armed Forces, 2021

Article
4/1/2022
Airmen participate in the 13th Annual Fallen Defender Ruck March at Joint Base San Antonio, Nov. 6, 2020. The event honors 186 fallen security forces, security police and air police members who have made the ultimate sacrifice. Photo By: Sarayuth Pinthong, Air Force.

From 2020 to 2021, the rate of incident heat stroke was relatively stable while the rate of heat exhaustion increased slightly

Recommended Content:

Medical Surveillance Monthly Report

Obesity prevalence among active component service members prior to and during the COVID-19 pandemic, January 2018–July 2021

Article
3/1/2022
Maintaining a healthy weight is important for military members to stay fit to fight. The body mass index is a tool that can be used to determine if an individual is at an appropriate weight for their height. A person’s index is determined by their weight in kilograms divided by the square of height in meters. (U.S. Air Force photo illustration by Airman 1st Class Destinee Sweeney)

This study examined monthly prevalence of obesity and exercise in active component U.S. military members prior to and during the COVID-19 pandemic. These results suggest that the COVID-19 pandemic had a small effect on the trend of obesity in the active component U.S. military and that obesity prevalence continues to increase.

Recommended Content:

Medical Surveillance Monthly Report

Brief report: Using syndromic surveillance to monitor MIS-C associated with COVID-19 in Military Health System beneficiaries

Article
3/1/2022
Air Force 1st Lt. Anthony Albina, a critical care nurse assigned to Joint Base Andrews, Md., checks a patient’s breathing and heart rate during an intubation procedure while supporting COVID-19 response operations in Cleveland, Jan. 20, 2022.

SARS CoV-2 and the illness it causes, COVID-19, have exacted a heavy toll on the global community. Most of the identified disease has been in the elderly and adults. The goal of this analysis was to ascertain if user-built ESSENCE queries applied to records of outpatient MHS health care encounters are capable of detecting MIS-C cases that have not been identified or reported by local public health departments.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Medical Separation from Service Among Incident Cases of Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
3/1/2022
Marines hike to the next training location during Exercise Baccarat in Aveyron, Occitanie, France, Oct.16, 2021. Exercise Baccarat is a three-week joint exercise with Marines and the French Foreign Legion that challenges forces with physical and tactical training. Photo By: Marine Corps Lance Cpl. Jennifer Reyes

Osteoarthritis (OA) is the most common adult joint disease and predominantly involves the weight-bearing joints. This condition, including spondylosis (OA of the spine), results in significant disability and resource utilization and is a leading cause of medical separation from military service.

Recommended Content:

Medical Surveillance Monthly Report

Update: Malaria, U.S. Armed Forces, 2021

Article
3/1/2022
Mosquitos – like this one, collected as part of a military study in North Carolina – were used during USAMRDC’s initial RTS,S vaccine studies nearly 40 years ago. (Photo courtesy: AFC Kimberly Barrera)

Malaria infection remains an important health threat to U.S. service members who are located in endemic areas because of long-term duty assignments, participation in shorter-term contingency operations, or personal travel. In 2021, a total of 20 service members were diagnosed with or reported to have malaria.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance snapshot: Health care burden attributable to osteoarthritis and spondylosis, active component, U.S. Armed Forces, 2016–2020

Article
2/1/2022
Air Force security forces trainees climb a hill during a 3-mile ruck march to commemorate National Police Week at Joint Base San Antonio, May 13, 2019. Photo By: Sarayuth Pinthong, Air Force

This snapshot summarizes the total numbers of inpatient and outpatient encounters with an OA or spondylosis diagnosis in the first diagnostic position and the total numbers of unique individuals affected by these conditions during the same 5-year surveillance period.

Recommended Content:

Medical Surveillance Monthly Report

A new approach to categorization of ocular injury among U.S. Armed Forces

Article
2/1/2022
Air Force and Space Force Surgeon General Lt. Gen. Dorothy Hogg receives an eye exam from Air Force Reserve Maj. Leslie Wilderson at Joint Base Anacostia-Bolling, Washington, D.C., March 26, 2021. Photo By: Air Force Staff Sgt. Kayla White

Ocular injuries present an ongoing threat to readiness and retention of service members. This report describes a new approach to categorizing ocular injury using Military Health System data, the application of an algorithm to a dataset, and the verification of the results using an audit of clinical data.

Recommended Content:

Medical Surveillance Monthly Report

Diagnosis of hepatitis C infection and cascade of care in the active component, U.S. Armed Forces, 2020

Article
2/1/2022
Navy Petty Officer 2nd Class Cecil Dorse, left, and Navy Petty Officer 3rd Class Janet Rosas test blood samples aboard the Military Sealift Command hospital ship USNS Comfort while the ship is in New York City in support of the nation’s COVID-19 response, April 6, 2020. Photo By: Navy Petty Officer 2nd Class Sara Eshleman

Hepatitis C virus (HCV) infection rates are rising in the U.S. despite widely available tools to identify and effectively treat nearly all of these cases. This cross-sectional study aimed to use laboratory data to evaluate the prevalence of HCV diagnoses among active component U.S. military service members.

Recommended Content:

Medical Surveillance Monthly Report

Surveillance Snapshot: Lengths of Hospital Stays for Service Members Diagnosed with Sepsis, Active Component, U.S. Armed Forces, 2011–2020

Article
1/1/2022
The (left to right) Senior Airman Austin Shrewsbury, 88th Diagnostics and Therapeutic Squadron medical laboratory technician, works with student, Airman 1st Class Taylor Altman, 88th Diagnostics and Therapeutic Squadron medical laboratory technician, to identify bacteria of patient’s cultures inside the microbiology laboratory at Wright-Patterson Air Force Base medical center June 30, 2017.

Sepsis is a serious and life-threatening organ dysfunction caused by a dysregulated host response to infection. In the U.S., sepsis is a leading cause of in-hospital mortality and 1 of the most expensive conditions treated in U.S. hospitals.

Recommended Content:

Medical Surveillance Monthly Report

Description of a COVID-19 Beta Variant Outbreak, Joint Base Lewis-McChord, WA, February–March 2021

Article
1/1/2022
U.S. Army Soldiers from 1-17th Infantry Battalion, 2nd Stryker Brigade, 2nd Infantry Division, clear an objective during the training exercise Bayonet Focus 19-02 at Yakima Training Center, Wash., May 6, 2019. Bayonet Focus is a training exercise designed to assess Soldiers’ ability to preform tasks and complete objectives under conditions experienced during combat situations. (U.S. Army photo by Spc. Angel Ruszkiewicz)

This report describes an outbreak of SARS-CoV-2, the causative agent of COVID-19, that peaked during 21–26 February 2021 and was tied to a single military training event. A total of 143 laboratory-confirmed cases were identified.

Recommended Content:

Medical Surveillance Monthly Report

COVID-19 and Depressive Symptoms Among Active Component U.S. Service Members, January 2019–July 2021

Article
1/1/2022
With the holiday season upon us, the cold, dark days that winter brings, and the social distancing and movement restrictions brought about by COVID-19, it’s not uncommon for people to feel depressed. (Photo by Erin Bolling)

This study examined the rates of depressive symptoms in active component U.S. service members prior to and during the COVID-19 pandemic and evaluated whether SARS-CoV-2 test results (positive or negative) were associated with self-reported depressive symptoms.

Recommended Content:

Medical Surveillance Monthly Report

Update: Osteoarthritis and Spondylosis, Active Component, U.S. Armed Forces, 2016–2020

Article
12/1/2021
Osteoarthritis (OA) knee . film x-ray AP ( anterior - posterior ) and lateral view of knee show narrow joint space, osteophyte ( spur ), subchondral sclerosis, knee joint inflammation. Photo by: iStockPhoto

Osteoarthritis (OA), the most com­mon adult joint disease, is primarily a degenerative disorder of the entire joint organ, including the subchondral bone, synovium, and periarticular structures (e.g., tendons, ligaments, bursae). Spondylosis, often referred to as OA of the spine, is characterized by degenerative changes in the vertebral discs, joints, and vertebral bodies.

Recommended Content:

Medical Surveillance Monthly Report
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 12
Refine your search
Last Updated: May 23, 2022

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.