Strategic thinking in eye trauma management.

Treating patients with serious eye injuries is not only a difficult, but also occasionally frustrating process. Mastering the details of the management of individual tissue lesions allows one to "see the tree" but does not provide vision of the entire forest. To develop a comprehensive understanding that leads to strategic thinking before making actual reconstruction efforts, the surgeon should follow a fairly rigorous thought process to find the best possible management option for the particular injury (Fig. 1). His or her suggestion, as well as detailed information on other options, should be discussed with the patient, and the decision regarding how to proceed is best if it meets the approval of, and is supported by, the patient. Such an approach has the highest chance of rewarding the patient and the treating physician.