Vision and Return to Duty

The Vital Role of Optometry Detachments

By Maj. Jason Christman and Col. Kenney Wells

Article published on: August 14th, 2025, in the August 2025 Issue of The Pulse of Army Medicine

Read Time: < 6 mins

In military operations, the maxim “life, limb, or eyesight” has guided decisions about which injuries merit priority for rapid evacuation and subsequent medical intervention. However, as global military engagements evolve, the constraints of evacuation, combined with the delay in transporting potential replacements, place an urgency on the need to return warfighters to duty as quickly as possible. Therefore, the optometry detachments’ capability of maintaining vision readiness and increasing return-to-duty rates is vital.

All soldiers should enter the theater of war visually ready, with two pairs of glasses (one for backup), inserts for eye protection (e.g., EyePro), and a gas mask. If a soldier loses or damages their eyeglasses, it may result in a total loss of their combat capability; this event is as significant as if they had sustained a critical eye injury. Optometry detachments provide acute eye care and have glasses fabrication capabilities. The detachment can quickly fabricate glasses on-site and effectively triage and treat ocular trauma, injuries, or diseases to preserve fighting strength and unit integrity. In conflict, the ability to rapidly address eye injuries and provide vision solutions within the operational theater can significantly reduce the logistical burden and expedite the recovery process, allowing service members to remain with their units and continue their mission.

This article reviews the critical role of optometry detachments in enhancing warfighter readiness, ensuring timely triage, reducing unnecessary evacuations, and supporting the combat effectiveness of military personnel. It highlights the unique capabilities of the 215th Medical Detachment, a fully mobile optometry and glasses fabrication unit deployed in Korea, that serves as a prime example of modern field optometry operations.

Evolution of Optometry in the Military

Since World War I, military optometrists have played a crucial role in providing vision care to combatants and noncombatants. During World War II, the Korean War, and the Vietnam War, the deployment of optometrists marked a significant advancement by ensuring that military personnel could maintain optimal visual performance in the most demanding combat environments. During the Vietnam War, the deployment of field optometry teams at the division level marked a significant advancement. These specialized teams were able to deploy far forward in the theater along with the troops, and their capability to fabricate and rapidly distribute eyeglasses maintained operational readiness (McAlister et al., 2021). This legacy of service and dedication continues, with optometrists and their support teams deploying in every conflict zone.

Staff Sgt. Zaneisha Hein, a drill sergeant with the 14th Military Police Brigade, sights in her monocular night vision device July 21, during the Red Phase Task Module for the 2025 Maneuver Support Center of Excellence Drill Sergeant of the Year Competition at Fort Leonard Wood’s Training Area 247M.

During operations in Afghanistan and Iraq, forward- deployed optometrists played a crucial role in maintaining the vision and health of soldiers in the field. They provided not only corrective eyewear but also treated eye injuries and trauma caused by dust, debris, and combat-related incidents. In these dusty and harsh environments, soldiers frequently suffered from ocular injuries related to helicopter rotor wash, explosives, and sandstorms. Forward-deployed optometrists enabled immediate treatment, preventing more serious complications, and ensuring that soldiers remained combat-ready.

The Role of Optometry Detachments in Peacetime and Conflict

In peacetime, garrison-based optometrists at military treatment facilities (MTFs) play a crucial role in maintaining the overall vision and optical readiness of military personnel. They perform routine eye exams, update corrective glasses, screen for eye diseases, and manage various ocular conditions. Optometrists in MTFs and in optical fabrication laboratories, such as those in San Antonio, TX, and like the Naval Ophthalmic Readiness Activity (NORA), produce the optical devices that soldiers require for deployment. Optometry teams also support vision conservation initiatives by ensuring soldiers are fit for service, meeting the visual requirements for military training, and facilitating occupational changes based on vision needs. During peacetime, optometry detachments also support vision care at the MTFs for soldiers and their dependents. They are prepared to support humanitarian missions and provide individual readiness training worldwide.

During conflict, the logistics of shipping and distributing replacement optical devices to the theater of war are complex and may increase delivery times. Similarly, evacuations for minor ocular injuries or diseases will be costly or unfeasible. Optometry detachments will take vision care and the fabrication of optical devices forward into the theater of war, returning ocular and optical casualties to duty as quickly as possible, and reducing the burden on the logistical system. Keeping warfighters with their units and close to their fighting positions during recovery is critical in reducing rates of post-traumatic stress disorder (Reger, 2016).

Optometry detachments provide fully mobile eyecare and optical fabrication services by operating independently or split into two semi-independent teams. The detachment is equipped with tents, portable generators, and transportation capability to support rapid and flexible operations. It can move far forward to Role 2 locations, providing acute and routine eye care, triage, refraction, and fabrication of glasses.

In-theater eye care ensures that personnel who experience eye injuries or vision-related conditions are treated quickly and effectively, often without requiring evacuation from the combat zone. For example, common eye conditions such as bacterial conjunctivitis or corneal abrasions can be treated rapidly. Lost or broken eyeglasses can also be fabricated on-site, allowing soldiers to return to their units with minimal disruption to their operational readiness.

The Mobile Capabilities of Optometry Detachments: A Case Study

The 215th Medical Detachment (MD), stationed in Daegu, South Korea, is a fully mobile optometry and eyeglass fabrication unit that operates independently or as two semi-independent teams to extend its capabilities across the battlefield. Subordinate to the 168th Multifunctional Medical Battalion, the 215th MD is responsible for providing vision care to remote locations across the Korean Peninsula, particularly to small joint bases that lack standalone optometry clinics.

The 215th MD conducts battle drills involving rapid setup, tear-down, patient examinations, and lens fabrication to demonstrate their quick response capabilities in the field. The ability to quickly set up and tear down medical facilities, including specialized ophthalmic equipment, has proven essential when responding to emergencies or supporting military operations. With its mobile capability and swift response, the 215th MD has been successful in ensuring that service members have rapid access to eye examinations, prescription updates, and on-the-spot eyeglass fabrication—safeguarding that personnel remain capable of fulfilling their duties.

Soon, optometry detachments will benefit from lighter and more portable edgers—machines used to shape and finish materials. This advancement will shorten setup time and reduce the footprint of these detachments, making them even more versatile and responsive in the theater.

The Strategic Advantage of Mobile Optometry in Conflict

In modern warfare, the ability to maintain operational capability despite injury is a decisive factor. Optometry detachments ensure that service members with vision-related injuries or who rely on eyeglasses for operational effectiveness can remain with their units by providing in-theater eye care and fabricating lenses in the field. These capabilities conserve fighting strength by enabling service members to return to duty without the need for evacuation.

Optometry detachments play a critical role in minimizing DNBI and traumatic evacuations related to vision. There are numerous clinical accounts of mobile optometry detachments in conflict areas that help sustain military readiness. For example, a soldier in Iraq had a non-resolving red eye condition and was set to be evacuated from the theater. A field optometrist treated the casualty for acute uveitis, and the soldier was able to return to duty. Another case was that of a sergeant with a nonhealing and recurrent corneal abrasion, who required special treatment by an eyecare provider. However, an Army optometrist treated and managed the eye injury, allowing the sergeant to remain with the unit and continue training, maintaining the unit’s integrity and the success of the mission. Soldiers who are misdiagnosed or whose eye injuries are overestimated in severity may be effectively treated by an optometrist in the theater, thereby reducing ocular morbidity and increasing the availability of limited evacuation assets for higher-priority injuries.

Conclusion

As military conflicts become increasingly complex and prolonged, the need for in-theater medical capabilities that can rapidly return troops to operational status is critical. Optometry detachments, exemplified by the 215th Medical Detachment, are a vital component of this capability. By providing eye care and glasses fabrication within the theater, optometry detachments minimize evacuation requirements, reduce logistics burdens, and enhance the overall combat readiness of military personnel. The integration of mobile optometry into field operations is essential for treating eye injuries and ensuring the sustained effectiveness of warfighters in combat.

In future conflicts, the nation that can return its wounded to the battlefield most efficiently will have a distinct advantage. Therefore, the role of optometry detachments in tactical operations must be recognized, prioritized, and continually developed to ensure that military forces maintain peak performance throughout all phases of conflict.

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