Ocular damage due to chlorhexidine versus eyeshield thermal injury

Thermal eye injuries from dermatologic laser treatments-an experimental study

In recent years, severe ocular complications after dermatological laser therapies have been reported. One hypothesis is thermal damage due to heating of the metal eye shields. The aim of the present study is to evaluate the safety of ocular metal eye shields during laser therapy of the periocular region. For the experimental study, porcine eyelids were exposed to continuously increasing laser energy and multiple pulses using a number of dermatologic laser systems. Temperature differences of the convex and concave surface of metal eye shields were constantly measured using a thermocouple. Maximum increase of the convex surface of shields was + 8.9 °C (± 0.1 °C) provided by the long-pulsed alexandrite laser (20-25-J/cm2 energy, 15-mm spot size, 20-ms pulse duration, 1 Hz). Present data indicate that metal eye shields provide sufficient thermal protection when clinically used laser parameters are applied. Other safety precautions continue to be essential to protect both the patient and the laser operator. These include the use of nonreflective metal eye shields, precise knowledge of laser physics, and a clear understanding of how they interact with ocular and periocular anatomy.

Traumatic Facial Tattoo Injuries From Gunpowder and Ammunition: A Case Series

Background and Overview

Gunpowder inclusion injuries are rare occurrences in the civilian sector but are more frequently encountered in the military setting. The authors report a case series of 3 active duty military service members treated by an Army hospital's Oral & Maxillofacial Surgery service for the removal of embedded gunpowder particles so as to avoid traumatic tattooing.

Case Description

Three otherwise healthy active duty military service members were treated for gunpowder inclusion injuries incurred while conducting live fire training exercises at a state-side military installation between 2018 and 2019. All 3 males presented with injuries of the same etiology: Their weapons malfunctioned, and while visually inspecting the action, a round exploded close to the face. This peppered the face with gunpowder particles that were both superficially and deeply embedded. Treatment focused on individual removal using fine forceps. The patients were followed up and healed quickly without any complications, specifically without traumatic tattooing from the gunpowder injuries.

Conclusion and Practical Implications

Gunpowder inclusion injuries should be addressed quickly to remove the particles before epidermal healing occurs, thus avoiding the complication of traumatic tattooing. This surgical team recommends meticulous fine forceps removal as the treatment of choice for larger particles.