Preventing Red Eye Syndrome in Military Personnel Through a Multimodal Eye Hygiene Intervention: A Controlled Before-and-After Study

Abstract

Background. Red eye syndrome is an occupational health concern in military populations, where environmental exposures, communal living, and intensive training may contribute to ocular surface disorders and infectious conjunctivitis. This study evaluated the association between a multimodal eye hygiene intervention and the incidence and clinical burden of red eye syndrome among military personnel.
Materials and Methods. A controlled before-and-after study included 2,914 personnel from two military units: Unit A (n=1,438; intervention) and Unit B (n=1,476; control). Following a retrospective baseline assessment in 2024, a multimodal intervention combining isotonic saline cleansing, hyaluronic acid-containing eye drops, eyelid hygiene, and health education was implemented in Unit A during 2025, while Unit B continued routine practice. Outcomes included red eye syndrome incidence, clinical diagnosis distribution, and temporary work incapacity.
Results. Baseline incidence was comparable between Unit A and Unit B (199.5 vs. 196.5 cases per 1,000 personnel), with no significant difference in diagnostic distribution (P=0.954). During the intervention period, incidence decreased to 105.7 per 1,000 in Unit A, representing a 47.0% relative reduction, while remaining largely unchanged in Unit B (192.4 per 1,000). The proportion of bacterial conjunctivitis decreased in Unit A, and mean temporary work incapacity decreased descriptively for most diagnoses.
Conclusions. The multimodal eye hygiene intervention was associated with reduced red eye syndrome incidence and temporary work incapacity among military personnel. Larger multicenter and cluster-controlled studies are needed to confirm these findings.