Battlefield vision: eyeglasses for the soldier.

Have you ever wondered how a Soldier gets a new pair of eyeglasses if his become scratched, broken, or lost during a deployment? Well, wonder no more! Soldiers can order glasses in theater and, on some occasions, have them fabricated within 24 hours.

In Iraq, the optical fabrication mission is to maintain the optical readiness of all supported units by providing efficient and timely optical fabrication services, assisting commanders in ordering and procuring all required spectacle devices (including ballistic eyewear), and sustaining vision readiness and unit mission capability.

The optical fabrication mission started in Operation Iraqi Freedom (OIF) 1 with the deployment of the 172d Medical Logistics Battalion, an Army Reserve unit from Ogden, Utah, that filled roughly 1,700 orders. During OIF 2, the 226th Medical Logistics Battalion from Miseau, Germany, picked up the mission and produced nearly 5,000 orders in theater.

The 32d Medical Logistics Battalion, an Active Army unit under the 44th Medical Command at Fort Bragg, North Carolina, deployed in support of OIF 04-06 and filled a record 22,337 orders. The 226th Medical Logistics Battalion returned for OIF 05-07 as the 226th Multifunctional Medical Battalion (MMB) and continued the mission by producing 14,693 pairs of spectacles. The 32d Medical Logistics Battalion is now an MMB and is back for OIF 06-08 as part of Task Force 3 Medical Command, which provides the full spectrum of healthcare services to military personnel in Iraq.

Lens Prescriptions and Frames

To have a pair of glasses fabricated, a Soldier needs a copy of his spectacle prescription. A spectacle prescription that is dated within the past year is best, but, if a Soldier is in theater and he needs glasses critically, any personal prescription will suffice. The prescription should include the pupillary distance, which is the distance between the centers of the pupils of each eye. Having the correct pupillary distance ensures that the optical centers of the lenses will line up properly over the Soldier's pupils. Glasses made without the individual's correct pupillary distance may be less comfortable. When the spectacle prescription is small, Soldiers who wear a pair of glasses fabricated with an incorrect pupillary distance may or may not notice a difference; with larger prescriptions, glasses without the correct pupillary distance may cause eye strain. If glasses are very poorly aligned, they may induce discomfort, distortion, or headaches.

If a Soldier does not have an actual prescription handy, he has several options. He can go to 1 of the 12 optometrists who currently are deployed in theater to have a refraction done to determine his prescription. Or he may bring an old pair of spectacles to an optometry clinic or the fabrication lab to have the prescription read by a special optical device, the lensometer. If he has already ordered glasses while deployed, he may go back to that clinic and have that prescription looked up in the Spectacle Request Transmittal System. A fourth option is on its way: the Army is currently working on a system that will allow Soldiers to request their past military prescriptions on a website and order the needed eyewear with the click of a mouse. This initiative will eliminate the need for lengthy and time-consuming round-trip visits to the nearest optometry asset in theater just to obtain a spectacle prescription.

Once the Soldier has determined his prescription, he needs to select a frame. Within theater, the optical laboratories are limited to the following frames: the frame of choice (FOC) model number 350 LO (Land Operations) in black or silver, 801 LO in silver and copper, and flight goggle LO in black and silver. [The Army FOC program allows Soldiers to select a civilian-style frame for one of their two pairs of military-issue glasses.] These frames were selected specifically because they fit underneath the land operations goggles, thus allowing Soldiers with eyeglass prescriptions to wear combat eye protection (CEP). Also available are the standard MS9 and FS9 military and flight spectacles (otherwise known as birth control glasses, or BCGs, because of their high durability but nonexistent aesthetic value), the MCU2 or MAGI (Ranger) glasses, the BLPS (ballistic/laser protective spectacles) M40 pro-mask insert, and a prescription lens carrier for the Uvex XC, ESS [Eye Safety Systems, Inc.] ICE [interchangeable component eyeshield] II, Revision Sawfly, or Body Specs pistol combat eye protection.

Combat Eye Protection

Lessons learned from recent conflicts have demonstrated that 10 percent of casualties can be expected to incur eye injuries and that 90 percent of eye injuries are preventable. In a war in which improvised explosive devices, mortars, sand, wind, and dust are encountered on a daily basis, it is imperative that a Soldier be outfitted with individual ballistic and ultraviolet A and B radiation eye protection.

Several protective eyewear systems are currently approved for Army use. Some of these systems can be worn only by individuals who do not require prescription lenses, while others can be worn by both prescription and non-prescription eyewear users.

For Soldiers who require a prescription, the Uvex XC, ESS ICE II, Revision Sawfly, and Body Specs Pistol eyewear are authorized options. For non-prescription wearers, the Wiley X SG-1 and PT-1 and the Oakley SI Military M frame are additional options. All Soldiers also are authorized to wear the ESS LO goggle, the ESS vehicle operations goggle, and the ESS low profile NVG goggle. The arena flakjak goggle is only for Soldiers who do not require optical correction.

All CEP must pass extraordinary tests that challenge the item's ballistic protection, flame retardance, and other elements of safety. At this time, five CEP items accept an optical insert. The CEP items that hold an insert must pass additional safety tests to ensure that the insert is securely fastened within the CEP and does not create a hazard of its own. Combining a CEP item with an insert can also challenge the optics of the system. In poorly designed systems, Soldiers with higher prescriptions could find the optics distorted or uncomfortable.

Ordering

The ideal way to order spectacles from the lab is through the Spectacle Request Transmittal System (SRTS). This method is possible only if units are collocated with, or have access to, optometry assets within the theater. For units without access to SRTS, the optical fabrication lab has established an online account to receive orders electronically. Orders can be submitted in the form of a scanned prescription, a DD Form 771 (Eyewear Prescription), or an email containing the pertinent information.

The following items are the minimum information required to process an order--

* The patient's name, rank, and Social Security number.

* The patient's address, to include unit and Army post office (APO).

* A current spectacle prescription.

* The patient's pupillary distance.

* The frame type and quantity.

Some information is not required, but it is helpful in ensuring that the Soldier receives properly fitted spectacles. This information can be found on a previous DD 771. If not supplied, the lab will substitute information as needed. This information includes--*

* Frame model number.

* Frame eye and bridge size. [The bridge is the piece of eyewear that connects the lenses over the nose.]

* Frame color.

* Frame temple length and type. [Temples are the arms of eyewear, running from the lenses to the ears.]

* Segment height (for multifocal prescriptions only).

Fabrication

For prescriptions that are transmitted through SRTS, the optical lab prints out a DD 771 that lists all of the information needed to fabricate the spectacles. The technician looks at the prescription, makes sure it falls within the lab's capabilities, edits the prescription, and pulls the lens blanks that will be used to fabricate the lenses and places them in a tray. The lenses then are taken to the lensometer, and the optical centers are dotted for proper placement of the "block." The lenses then are "edged" and safety-beveled to prevent flaking and sharp edges.

If the lenses will be used as sunlenses, they are placed in a tint bath until they reach the desired darkness, then cleaned, placed into the frame, and inspected. The finished eyewear then is wrapped and packaged for shipping through the Military Postal Service (MPS).

The optical fabrication lab also is outfitted with an OptiCast System, which is used to fabricate bifocal lenses. A liquid monomer is injected between two molds and a specially designed gasket. The mold assembly then is placed in a light-curing chamber and allowed to harden overnight. The next day, the lenses are ready to be edged and inserted into the frame.

Turn-Around Time

The estimated time needed to complete an order depends on the lab's workload, though most glasses are generally shipped within 48 hours of an order's receipt. Emergency orders can be processed in as little as 1 hour for single-vision glasses and 24 hours for bifocals if the lenses are in stock. If the lenses are out of stock or out of the lab's range of capability, the orders are forwarded to the labs at the U.S. Army Medical Materiel Center-Europe in Pirmasens, Germany, or the Naval Ophthalmic Support and Training Activity at Yorktown, Virginia. Turn-around time for orders sent to Germany or Virginia may vary from 2 to 6 weeks.

Once the glasses are made, they are packaged for shipment and dropped off at the post office and shipped via MPS. Orders are sent directly to the address provided by the unit, clinic, or individual Soldier. The class VIII (medical materiel) supply system is also used to deliver to locations with optical forward distribution teams.

Optical fabrication is an asset that is a force multiplier. It allows for quick, efficient delivery of eyewear that keeps our troops vision ready and, therefore, mission ready.

CAPTAIN JOY A. SCHMALZLE, O.D., F.A.A.O., IS THE CHIEF OF OPTICAL FABRICATION IN THE 32D MULTIFUNCTIONAL MEDICAL BATTALION AT FORT BRAGG, NORTH CAROLINA (CURRENTLY STATIONED AT CAMP ANACONDA IN IRAQ). SHE HAS A B.A. DEGREE IN PSYCHOLOGY FROM WEST CHESTER UNIVERSITY OF PENNSYLVANIA, A B.S. DEGREE IN BASIC SCIENCE AND A DOCTOR OF OPTOMETRY DEGREE FROM THE PENNSYLVANIA COLLEGE OF OPTOMETRY, AND WAS RESIDENCY-TRAINED AT THE STATE UNIVERSITY OF NEW YORK COLLEGE OF OPTOMETRY. SHE IS A GRADUATE OF THE MEDICAL DEPARTMENT CAPTAINS CAREER COURSE.