No longer will a farmer be jabbed in the eye by a pitchfork in Garrett County or a youngster shot in the eye with a BB gun in St. Mary's County have to be transported clear across Maryland to Baltimore for specialized emergency medical care.
Instead, those emergencies, as well as similar emergencies in Washington, Allegany, Frederick, Montgomery, Prince George's Calvert and Charles counties, will now be handled by an eye trauma service established at Georgetwon University Medical Center in Washington as an offical part of the Maryland state emergency medical services system.
The new eye service has been developed as a cooperative venture involving Georgetown on the Washington end and Johns Hopkins Hospital in Baltimore on the Maryland end. Patients in those areas of Maryland not served by the Georgetown unit will be taken care of at Hopkins.
While the need for such a service may not seem great, eye trauma is indeed a major medical problem.
There are about 198,000 penetrating eye injuries every year in the U.S., said Dr. Leonard Parver, director of the new service at Georgetwon, "and such injuries are the fourth leading indication for the admission of an eye patient to a hospital."
According to Parver, "what we offer is a regional cooperative effort to deliver eye care in a hospitalized area."
The service, he said, will care fro "any severe ocular injury," including penetration of the eye by a foreign object, an accident in which an object is lodged within the eye and other problems such as detached retinas.
The service includes the establishment of a special telephone number at Georgetown - 625-EYES - by which individuals or officials in outlying jurisdictions can alert the service that an emergency is coming in.
Parver said there will always be two or three ophthalmologic surgeons on call 24 hours a day, one of whom is a specialist in injuries to the front of the eye, another of whom specializes in the back area of the eye and one who a specialist in occular plastic surgery, the repair of the eye lids and the tissue around the eye.
The announcement of the service's establishment - and the willingness of Maryland authorities to have Maryland residents taken to Georgetown by Maryland State Police medivac helpicopter - comes at a time when officials in Maryland and the District are apparantly at loggerheads over how to deal with other types of trauma victims.
Maryland authorities have insisted, for example, that their helicopters bypass the trauma center at the Washington Hospital Center to take accident victims in Montgomery and Prince George's counties to the Shock-Trauma Unit at University Hospital in Baltimore.
Sources have said that the reason Parver and his Johns Hopkins collaborators had no trouble selling the idea of their service to the leaders of Maryland's state system is that is is noncompetitive - it does not threaten to empty beds in the Shock-Trauma Unit - just as a hand trauma service at Baltimore's Union Memorial Hospital, a burn unit at the Washington Hospital Center and several other specialty units are noncompetitive.
A spokeswoman for the Maryland system said the eye trauma service was included in the state program because it was needed. She said competition has nothing to do with the criteria by which services are judged.
Although the helicopter service will be available for the service - Georgetown is one of two hospitals in Washington with a helicopter pad; the Washington Hospital Center is the other - Parver said most patients will probably be brought to Georgetown and Hopkins by ambulance or private automobile.
Only if the injury is one that threatens permanent loss of vision if not attended to within minutes, will the helicopters be used, he said.
The concept of creating such a service "started out as an academic interest," said Parver. "We saw the need and we're trying to fill it." He said he hopes the service will be a "prototype for a national eye trauma service."
Parver said the services at Hopkins and Georgetown will, for the first time, allow for the uniform gathering of data about types and treatments of serious eye injuries.
Because of the cooperation between the two services, he said, physicians will be able to study about 300 trauma cases a year, all of which will be documented and filed in a like manner, allowing an accurate comparison of different treatment methods for similar injuries.