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ANZAC Day - the work of a consultant ophthalmologist in the Australian Army

To mark ANZAC Day this year, we interviewed Dr William Glasson on what it’s like working as a consultant ophthalmologist in the Australian Army.

Bill Glasson photo

1. Can you tell us a bit about your role as a consultant ophthalmologist to the Australian Army?
I’ve been part of the medical side of the Australian military for approximately 35 years. I was a 5th-year medical student when I first joined. During school, I was a cadet so having experience in the military, I saw it as a great opportunity to work as a doctor in the military force. I’m still an active Reservist. I’m a Lieutenant Colonel in the army and I was a medical officer for an artillery unit based in Southeast Queensland for 10-15 years. Now I work at a consultant level at the military base where I provide eye services and advice to the Department of Defence around the list of medical conditions people can/can’t have in the army and what we’ve agreed to accept in terms of visual limits, visual acuity, colour vision, etc. My role involves a lot of advice around policy to the Australian Defence Force for both soldiers working on the frontline as well as those working in the rear aspects of the military force.

2. What are the most common eye injuries you see working on the frontline?
I like to think of eye injuries in terms of military or non-military related. Obviously, non-military related eye problems are similar to those of the general community such as conjunctivitis, vision problems, etc. For the most part, we’re dealing with a group of young and healthy individuals needing glasses or contact lenses. They usually present with general complaints or refractive errors but there are some cases where there is trauma to the eye - blunt injuries to the eye, some even penetrating the eye, although we do make sure there are preventative measures in place such as wearing protective glasses where it’s needed.
In terms of the back of the eye, we don’t see too many problems because they are a younger generation. We do get some who have diabetes so we need to keep a check on them and follow up on any treatment plans.
In terms of those that are on the frontline or those injuries that occur during military operations, the big one would be explosive injuries and IEDs that send pieces of sharp shrapnel through the air which can penetrate one or both eyes. In the worst-case scenario, this can lead to blindness or losing your eyes. Injuries from IEDs was one of the major issues during operations in Afghanistan and the Middle East particularly.
Also, laser is used a lot these days in terms of military equipment so people that are exposed to laser beam injuries need to be assessed and treated according to whether the damage is to the front or the back of the eye.
Troops on the ground are exposed to extremely harsh conditions - dust is a major issue and they get dust and dirt in their eyes. They’re exposed to extreme heat, high wind and high UV conditions which put the eyes at risk. There’s also the potential to be exposed to chemical injuries so it’s very important to ensure that the eyes are adequately protected in these tough conditions.

3. What would a typical day look like for medical corps? What’s involved?
A typical day in the medical corp can be quite similar to running a general clinic. You’re dealing with the typical things that the younger generation would present with such as conjunctivitis, pterygium, sore eyes, red eyes - those common conditions that we see in the mainstream community and those you would see in a typical eye clinic. You’ll also see people who wear glasses that will come in because their glasses are broken or their scripts are wrong or they wear contact lenses and they’ve developed an infection. So, contact lens related injuries and issues are not uncommon.
Not that we want contact lenses worn frontline. In fact, only those in non-frontline positions can wear contact lenses so we have a range of issues related to that.  

3. How is working as a military ophthalmologist different to working in a clinical setting?
The pathology you see is very similar. But, generally, you are working with young, healthy people and what they present with is usually very different to what you’d see in your day-to-day ophthalmology clinics where you’re mainly dealing with older patients who have cataracts, macular degeneration, etc. This would take up 90% of your time in general ophthalmology.
Whereas, in the military, you’re working with young people and you’d mostly be dealing with refractive errors. Occasionally, you’ll come across those with a family history of glaucoma or another condition which you might treat.
Given the extreme conditions troops are exposed to, you also need to educate them on maintaining their eye health - wearing sunglasses, how to treat blepharitis and keeping dust out of their eyes.

4. How did you spend ANZAC Day this year?

One of my family members was an ex-prisoner of war. He was taken in Singapore and fought in the Borneo campaign. When he was captured, he was taken to Sandakan, which is in Borneo, and he was brutalised for five years while he was imprisoned. He eventually came back to Australia, went on to study medicine and became a very successful doctor. So in honour of him and to commemorate fallen ANZACs, my wife and I help to organise a formal service at the Sandakan memorial in New Farm, Queensland.


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