Blinded by war: Injuries send troops into darkness -
Blinded by war: Injuries send troops into
darkness - USATODAY.com By Gregg Zoroya, USA TODAY
ARLINGTON, Va. - Two days before a 10-mile race
here, Army 1st Lt. Ivan Castro is explaining how he will run tethered to another
soldier - one who can see.
As he speaks, his wife lovingly extends her right hand to Castro's face, fingers
outstretched. But Evelyn Galvis pauses inches away.
"I used to be able to reach out and touch him, caress him, without telling him
first, 'I'm going to touch your face,' " she says. Now, "if I just reach out and
touch him, he'll startle."
Castro, 40, a paratrooper with the 82nd Airborne Division, is one of more than
1,100 veterans of Iraq and Afghanistan - 13% of all seriously wounded casualties
- to undergo surgery for damaged eyes. That is the highest percentage for eye
wounds in any major conflict dating to World War I, according to research
published in the Survey of Ophthalmology.
It's a reflection of how eye injuries have become one of the most devastating
consequences of a war in which roadside bombs, mortars and grenades are the most
commonly used weapons against U.S. troops. Brain injuries and amputations have
long been the focus of the damage such weapons are inflicting, but the Army has
acknowledged in recent weeks that serious eye wounds have accumulated at almost
twice the rate as wounds requiring amputations.
Body armor that protects vital organs and the skull is saving lives. But troops'
eyes and limbs remain particularly vulnerable to the blizzard of shrapnel from
such explosions.
Each explosion unleashes large metal shards and thousands of fragments, says
Army Col. Robert Mazzoli, an ophthalmological consultant to the Army surgeon
general. "Those small missiles are generally innocuous if they hit
the(protected) forehead, face (or) chest but are devastating when they hit the
eye," he says.
Surgical facilities are kept close to the fighting, so troops can be treated in
minutes. Partial or total vision has been restored in most cases involving eye
injuries, military statistics show. But hundreds of troops have been left with
impaired vision, and dozens have been blinded.
Troops in Iraq routinely wear protective eyewear, but it doesn't always work.
When a roadside bomb in Baghdad blew a hole through the heavily armored vehicle
carrying Army Sgt. Luis Martinez last April, the force from the blast stripped
off his helmet, headset and goggles. After the dust settled, Martinez, 38, could
see nothing out of his left eye and only streaks of blood in his right. He
waited for help, terrified about the damage to his eyes.
"That was the first thing I asked" hospital personnel, the National Guard
soldier recalls. " 'Am I going to be blind?' "
Surgeons later restored vision to his right eye, although bits of glass are
embedded there. He remains blind in his left.
"At least God was kind enough to protect me, to keep my right eye and see my
family," says Martinez, of Vega Alta, Puerto Rico, who is married and the father
of three.
Formidable challenges await troops who return home blind or with serious eye
injuries. In the most severe cases, they will struggle to cope emotionally and
financially.
About 70% of all sensory perception is through vision, says R. Cameron VanRoekel,
an Army major and staff optometrist at Walter Reed Army Medical Center in
Washington. As a result, the families of visually impaired soldiers wrestle with
a contradiction: The wounded often have hard-driving personalities that have
helped them succeed in the military. Now dependent on others, they find it
difficult to accept help.
Because the Pentagon has no rehabilitation services for the blind, the path to
recovery often leads directly to the Department of Veterans Affairs. The VA
operates 10 centers across the country for blind rehabilitation that teach
visually impaired veterans how to function in society. The centers have 241beds,
and it takes an average of nearly three months to get in. Iraq and Afghanistan
casualties go to the front of the line, says Stan Poel, VA director of
rehabilitation services for the blind. So far, 53 have enrolled in the blind
rehabilitation programs, the VA says.
The department plans to open three more centers beginning in 2010, Poel says.
'He has no light in his life'
Even now, more than a year after her husband's return from Iraq, Connie Acosta
is taken aback to find her home dark after sunset, the lights off as if no one
is there.
Then she finds him - sitting in a recliner in their Santa Fe Springs, Calif.,
house, listening to classic rock. Sgt. Maj. Jesse Acosta was blinded in a mortar
attack 22 months ago. He doesn't need the lights.
That realization often makes Connie cry. "You kind of never get used to the fact
that he really can't see," she says. "He has no light in his life at all."
The tiny piece of shrapnel that blinded Acosta, 50, an Army reservist, father of
four and grandfather of three, was precise in its destruction.
On the morning of Jan. 16 last year, Acosta led soldiers on a 3-mile fitness run
across Camp Anaconda in Balad, Iraq. Suddenly, insurgents attacked the camp with
mortars.
Acosta remembers that he stopped, turned to yell at his soldiers and then dived
for cover.
"Bam! That was it," he recalls. "Lights out."
An explosion about 60 feet away sent a piece of shrapnel - perhaps
three-quarters of an inch long - through his left eye. It struck his brain and
came out his right eye.
"It was a perfect hit," Acosta says.
Rushed to the Air Force Hospital at Anaconda, he spent seven hours in surgery.
Army Maj. Raymond Cho, an ophthalmologist, removed Acosta's right eye and
carefully reassembled his left one.
"I didn't want him waking up missing both eyes and wondering for the rest of his
life, 'Gosh, could they have saved at least one?' " Cho says. "So he knows that
we did everything we could."
Acosta regained consciousness as he was being returned to the USA. In Germany, a
doctor told him that his right eye was gone and his left eye, although stitched
together, likely would never see light.
"He said, 'You're going to have to start a whole new life from here on,' "
Acosta recalls.
"I go, 'So I won't be able to see my kids? My grandkids? Nobody? I won't be able
to see blue skies?'
"He said, 'Nope.'
"I just sat there. What could I do?
"A lot of things went through my mind," Acosta says. "Am I going to be accepted
this way? Am I going to be rejected? I was pretty independent all my life, and I
did everything. So it was pretty tough."
VA plans more clinics
Pentagon doctors can rebuild eyes, reconstruct eye sockets and nurse casualties
back to health, but soldiers with serious vision problems who want to learn how
to adapt into civilian life must rely on VA centers that also serve the elderly
and other veterans.
The VA plans to invest $40 million this fiscal year to create 55 outpatient
clinics across the nation, providing rehabilitation for veterans learning to
cope with partial vision, says James Orcutt, the VA's director for
ophthalmology.
The department also is taking part in two clinical trials focusing on artificial
vision, says Ronald Schuchard, director of the Atlanta VA rehabilitation
research and development center. The trials involve implanting silicon chips in
eyes. The chips act as receptors that can transform light into electrical
signals that can be transmitted to the brain. It is cutting-edge research,
Schuchard says.
However, Orcutt says, "I think we're a long way from a practical use of some of
these."
At the VA's rehab centers for the blind, specialists teach orientation and
mobility skills. Visually impaired veterans learn to use a white cane, public
transportation and perform daily routines. They also are offered computer
instruction and the use of special scanners for reading text. They are assessed
and treated, if necessary, for psychological readjustment to their sight loss.
The VA does not provide guide dogs, but it helps link veterans with guide-dog
schools that commonly provide a dog and training virtually free to veterans,
Poel says.
Iraq veterans sometimes find the VA blind rehab programs, which cater largely to
elderly veterans, to be a poor fit for a younger generation. Army 1st Lt. Castro
says he felt somewhat out of place during rehab at a VA facility in Augusta, Ga.
After the Army sent Jesse Acosta to a VA center for the blind in Palo Alto,
Calif., for rehabilitation in January 2006, he and his wife became unhappy with
the facility, describing it as having a "nursing home" atmosphere. It isa
five-hour drive from his home.
"It did not fit my needs," Acosta says.
He left the VA after a few months and was accepted, free of charge, into the
Junior Blind of America rehab program near his home in Santa Fe Springs. Last
month, he completed training with his new guide dog at The Seeing Eye school in
Morristown, N.J., and now has Charlie, a German shepherd.
All that is left, Acosta says, is figuring out the rest of his life.
He has fought a medical discharge from the Army until his medical care is
complete. Ultimately, he will earn disability income for his wounds. Acosta was
an energy technician with Southern California Gas before he was called to active
duty.
He is still with the company, though unpaid, and a different job awaitshim - one
tailored to his disability, Connie Acosta says. It's unclear whether Jesse will
want it, she says.
"We're hoping for the best," she says. "He's the type that constantly has to be
kept busy. We always have an agenda. I have a calendar going constantly with
things happening."
It begins when they wake, and he wants to know the weather and the color of the
sky, she says. Nothing in the house can be moved; he's memorized the location of
every chair and table.
He has his routines and chores, including weightlifting in the backyard or
fiddling with the fuel pump on the 1969 Dodge Dart. (He fixed it.) Daughter
Brittany, 14, is mustered into duty to operate the computer for her father until
she pleads for a break.
"Taking care of Jesse has been an experience," Connie Acosta says. "He's a
sergeant major in the Army, and they're tough people. He's a tough person to
live with and then, worse, being blind.
"Sometimes, he can be demanding. And I deal with it. I'm used to making sure
that everything's in line. That he's got everything. And that's basically all
I've got to do."
'I want to feel productive'
Castro thought he knew how his life would play out.
A former Army Ranger who had worked his way out of the enlisted ranks to earn an
officer's commission, Castro commanded a scout reconnaissance platoon and
dreamed of becoming a Special Forces team leader.
Instead, the last thing he would ever see was the colorless expanse of an Iraqi
roof in Youssifiyah, Iraq.
A mortar round landed a few feet away from him there on Sept. 2, 2006. The blast
killed two other soldiers from the 82nd Airborne Division and sent shrapnel
tearing into Castro's left side. The explosion damaged a shoulder, broke an arm,
fractured facial bones and collapsed his lungs. Doctors amputated part of a
finger.
The blast also drove the frame of his protective eyewear into his face. When
Castro regained consciousness days later at the National Naval Medical Center in
Bethesda, Md., his wife, Evelyn, sat at his bedside. She told him his right eye
was gone, but doctors hoped to salvage vision in his left.
The surgeons later removed one last piece of shrapnel from that eye. When they
took off his bandages and flashed a light for Castro to see, he thought the eye
was still covered. "That's when he told me, 'Ivan, you're not going to be able
to see again,' " Castro recalls. "I swore (it was like) I was standing between
the World Trade Center and the two towers had just come down on my shoulders."
From that moment on, through convalescence and rehabilitation, Castro would
struggle to regain a measure of independence.
Castro has become an advocate of rehabilitation funding for the blind, visiting
members of Congress. After the 10-mile race in October, he ran the Marine Corps
Marathon three weeks later, finishing in 4 hours and 14 minutes.
He concedes that he needs his wife's help. Evelyn Galvis gave up her career as a
bilingual speech pathologist in Fayetteville, N.C., to help her husband. She
supervises his medical care and drives him around.
She guides him through crowds, keeping him aware of raised edges in the walkway
and steps. She reads his menu in restaurants and tells him where the food sits
on the table. She watches him memorize his hotel room, starting from the doorway
and circling within the four walls to keep account of beds, the tables, the
wastebasket, the bathroom.
"My husband used to be a very independent individual," she says.
Castro hopes to stay in the military.
The Army has let several amputees stay in the ranks as well as one blind
captain, who will be an instructor at West Point Military Academy after
completing post-graduate education. Castro awaits word on his future; the
Pentagon won't comment on his situation.
"There's a world in front of me I can't predict or envision because I haven't
been there yet. I haven't lived this yet. I haven't lived blind," he says. "All
I ask is to stay in the Army and finish out my years ... I want to feel
productive."
The only good news for now is when he sleeps, Castro says.
"I've had dreams where I know I'm blind and, guess what? I've regained my
vision," he says. Reality floods back each morning.
"There's not a night that I don't pray and ask God, when I wake up, that I wake
up seeing."