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Michael E. DeBakey VA Medical Center - Houston, Texas

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Houston VA Cares for U.S. Marine Injured in Iraq

July 14, 2005

Houston VA Cares for U.S. Marine Injured in Iraq

Blinded by rocket-propelled grenade, soldier has recovered vision far beyond his doctor's expectations.

July 14, 2005

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U.S. Marine 1st Lt. David Lewis was a special guest speaker at the 2004 City of Houston Veterans' Day Parade, just a few months after shrapnel from a rocket-propelled grenade in Iraq left him blind. Because of the expert medical care Lewis received at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, the soldier's vision has recovered far beyond his doctor's expectations.
photo by Agenda Burnett, MEDVAMC Media Section

by Mathew Benz, M.D., MEDVAMC Surgical Retina Specialist

HOUSTON - In August 2004, fighting broke out in Najaf, Iraq between the U.S. Marines and a militant group of Iraqi insurgents known as the al-Mahdi Army. The majority of the military conflict was located around the Imam Ali shrine and the Wadi al-Salam cemetery. It was during this conflict on August 5, 2004, that a local Houstonian, U.S. Marine 1st Lt. David Lewis was blinded in battle.

The 27-year-old platoon commander and his team of approximately 35 Marines had entered the cemetery to clear out insurgent fighters. It was around 8 p.m. and the sun was starting to set, so Lewis and his platoon fell back to prepare for the evening.

"I'd taken a knee and was putting Marines in place," said Lewis. In order to wipe the sweat away from his eyes, he lifted up the ballistic goggles that he wore for eye protection. "I hadn't had those things off for maybe more than two minutes, I mean I wore them religiously."

Just at that moment, something to the left caught his eye and he saw a flash of light. "I turned over just in time to see that a RPG [rocket-propelled grenade] had been fired from about 30 meters away."

Unable to escape from the RPG that he saw heading straight towards him, Lewis had only enough time to turn his head down away from the oncoming missile. Grazing off his helmet, the RPG exploded nearby and spun Lewis around.

Metallic pieces of shrapnel flew into Lewis' eyes, face, and body, causing him broken bones, blindness, and other serious injuries.

"It blew out my ear drum in my right ear, it cracked facial bones on the right side of my face around my eye, [and] I had a puncture wound in my right cheekbone," said Lewis.

A small piece of shrapnel even lodged in Lewis' brain, where it still remains today. He also sustained shrapnel damage to the entire left side of his body. His eye injuries, however, were the most severe.

Immediately following the explosion, Lewis quickly assessed the extent of his damages and was relieved that he could still move his fingers and toes. But then he realized that there was something seriously wrong.

"I was sitting there blinking and I was trying to open my eyes and I couldn't see anything," said Lewis. "I didn't want to touch my face in case I didn't have a face and I wanted to remain calm for my platoon."

Lewis was helpless in the midst of the fighting until he was found by his platoon sergeant and eventually taken to safety.

After being seen by military doctors in Baghdad, in Germany, and then in Bethesda, Maryland, Lewis chose to go to the Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC) in Houston, Texas for specialized care.

Examined by Mathew Benz, M.D., MEDVAMC surgical retina specialist, Mitchell Weikert, M.D., MEDVAMC anterior segment specialist, and Silvia Orengo, M.D., MEDVAMC Eye Care Line executive, Lewis was found to have multiple pieces of shrapnel in his eyes, some of which were embedded in the retina and in the macula of both eyes. The particles of shrapnel were tiny little pieces, probably the size of a grain of salt and yet they caused significant damage to his eyes. In addition to perforations, a retinal tear, and a traumatic cataract that was brought on by the concussion from the blast, Lewis had vitreous hemorrhage as well as early signs of retinal detachment.

"He was just able to see shadows, hand motions. It was very bad," said Benz.

Benz, Weikert, and their colleagues performed multiple surgical procedures on Lewis' eyes in order to remove the foreign bodies and to repair the substantial damage they caused. In addition to removing the foreign bodies from the eyes, the team performed a cataract removal and implanted a new lens in the left eye. They also performed a pars plana vitrectomy and scleral buckle in both eyes. Silicone oil, which acts like a cast and keeps the retina in place, was also placed in the left eye.

"I just had confidence that the doctors were going to be able to fix my eyes," said Lewis.

Five months after Lewis' injuries occurred, Benz removed the oil as well as some scar tissue that had built up around Lewis' new lens. He hopes that this will be Lewis' final surgery.

Because of the expert medical care Lewis received at the MEDVAMC, the soldier's vision has recovered far beyond his doctor's expectations. In his right eye, Lewis' corrected visual acuity is 20/20, and he can now see well enough to recognize faces and even read. Although Lewis is near-sighted, with corrective eyewear, he will be able to live a normal life, have a normal job, and even drive.

In spite of the frustrations that result from having impaired vision, Lewis does not spend his time worrying or being angry about what his injured eyes prevent him from doing. He is grateful and thankful for the progress he has made. In the past few months, Lewis has shared his experiences and his positive attitude with many community groups and organizations, including the Houston Military Affairs Association, the West Point Society of Greater Houston, and the Paralyzed Veterans of American. He has also given motivational speeches to young adults at Reagan High School.

Stationed at Camp Pendleton near San Diego, Lewis is currently awaiting a medical discharge from the U.S. Marines, but would like to return to Iraq as a civilian contractor.

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