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Amin SV, Otti VE, Farooq AV, Shah HA. Ocular injuries from drive-by paintball shootings. Am J Ophthalmol 2022; 242:139-143. [PMID: 35594916 DOI: 10.1016/j.ajo.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/14/2022] [Accepted: 05/12/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To characterize ocular injuries from drive-by paintball shootings with a focus on the severity of injuries sustained, clinical management, and visual outcomes. DESIGN Retrospective, interventional case series. METHODS Setting: University practice and emergency department. PATIENT POPULATION Patients evaluated by the ophthalmology service for paintball injuries. OBSERVATION PROCEDURE Age, gender, eye laterality, mechanism of injury, initial best-corrected visual acuity (BCVA), and initial diagnosis. MAIN OUTCOME MEASURES Clinical intervention(s), BCVA at last follow-up visit, and severity of injuries with a focus on ruptured globes. RESULTS Twenty patients suffered unilateral ocular injuries from drive-by paintball shootings between January 2020 and December 2021. Median follow-up interval was 7.1 weeks (range: 3 days - 11.4 months). Average patient age at presentation was 36.6 years (range: 13 - 64 years-old). Fourteen patients (70%) had an initial BCVA of counting fingers (CF) or worse. Six patients (30%) suffered ruptured globe injury requiring surgical repair, of whom three (15%) underwent subsequent evisceration. Twelve patients (60%) suffered ocular injuries requiring surgical intervention. Fifteen ocular surgeries were performed on 9 patients (45%) at our institution with 3 patients referred to outside providers for definitive surgical management due to insurance. BCVA at last-follow up visit was no light perception (NLP) in five patients. CONCLUSIONS The severity of injury following paintball-induced ocular trauma is higher in this case series than what has previously been reported in the literature. Paintball guns can cause devastating ocular injury when used as an assault weapon and their use in unregulated settings bears further scrutiny.
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Weiss R, He C, Gise R, Parsikia A, Mbekeani JN. Patterns of Pediatric Firearm-Related Ocular Trauma in the United States. JAMA Ophthalmol 2021; 137:1363-1370. [PMID: 31600369 DOI: 10.1001/jamaophthalmol.2019.3562] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Gun violence represents a substantial public health issue, and firearm-related injuries rank second among the causes of injury-related deaths in children aged 0 to 17 years in the United States. Ocular trauma from firearm-related injuries can lead to devastating vision loss, but little is known to date about the specific demographics and characteristics of such injuries in children. Objective To evaluate the epidemiologic pattern of pediatric firearm-related ocular injuries. Design, Setting, and Participants This retrospective analysis used deidentified data from the National Trauma Data Bank, the largest national registry of hospitalized trauma cases in the United States. The firearm-related ocular injuries (n = 1972) of pediatric patients (defined as those younger than 21 years) hospitalized between January 1, 2008, and December 31, 2014, were analyzed. Statistical analyses were conducted from July 15, 2017, to June 15, 2019. Exposure Firearm-related ocular trauma. Main Outcomes and Measures Pediatric patients with firearm-related ocular injuries were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes and external causes of injury codes. Patient demographics (age, sex, and race/ethnicity), type of ocular injury, injury intent, geographic location, length of hospital admission, health insurance status, disposition at discharge, Injury Severity Score (ISS), and Glasgow Coma Scale (GCS) score were collected. Results A total of 8715 firearm-related ocular injuries were identified. Of these injuries, 1972 (22.6%) occurred in pediatric patients, most of whom were male (1678 [85.1%]) and adolescents (1037 [52.6%]), with a mean (SD) age of 15.2 (5) years. Common locations of injury were home (761 [38.6%]) and street (490 [24.8%]). Mean (SD) hospital length of stay was 7.6 (12) days, ISS was 16 (13.1), and GCS score was 11 (5.1). The most common types of firearm-related ocular injuries were open wound of the eyeball (820 [41.6%]) and ocular adnexa (502 [25.5%]), orbital injuries or fractures (591 [30.0%]), and contusion of the eye or adnexa (417 [21.1%]). Patients aged 0 to 3 years had greater odds of unintentional injuries (odds ratio [OR], 4.41; 95% CI, 2.51-7.75; P < .001) and injuries occurring at home (OR, 5.39; 95% CI, 2.81-10.38; P < .001), and those aged 19 to 21 years had greater odds of assault injuries (OR, 2.17; 95% CI, 1.77-2.66; P < .001) and injuries occurring on the street (OR, 1.61; 95% CI, 1.3-1.98; P < .001). Black patients had the greatest odds of having injuries with assault intention (OR, 4.53; 95% CI, 3.68-5.59; P < .001), and white patients had the greatest likelihood for self-inflicted injury (OR, 7.1; 95% CI, 5.92-9.51; P < .001). Traumatic brain injury resulted mostly from self-inflicted trauma (OR, 5.99; 95% CI, 4.16-8.63; P < .001), as did visual pathway injuries (OR, 2.86; 95% CI, 1.95-4.20; P < .001). The inpatient mortality rate was 12.2%. Conclusions and Relevance This study found that pediatric firearm-related ocular injuries from 2008 through 2014 were predominantly sight-threatening and associated with traumatic brain injury. If the possible risk factors, including sex, age, race/ethnicity, and injury intention, can be confirmed for 2015 through 2019, these findings may be useful in developing strategies to prevent pediatric firearm-related ocular injuries.
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Affiliation(s)
- Rebecca Weiss
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York.,Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York
| | - Catherine He
- Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York
| | - Ryan Gise
- Neuro-Ophthalmology Service, Massachusetts Eye and Ear Infirmary, Boston
| | - Afshin Parsikia
- Department of Surgery (Trauma), Jacobi Medical Center, Bronx, New York
| | - Joyce N Mbekeani
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, New York.,Department of Ophthalmology and Visual Sciences, Albert Einstein College of Medicine, Bronx, New York.,Department of Surgery (Ophthalmology), Jacobi Medical Center, Bronx, New York
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3
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Affiliation(s)
- Stephen J Dain
- Optics & Radiometry Laboratory, School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia, E‐mail:
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Boret C, Brehin C, Cortey C, Chanut M, Houzé-Cerfon CH, Soler V, Claudet I. Pediatric ocular trauma: Characteristics and outcomes among a French cohort (2007–2016). Arch Pediatr 2020; 27:128-134. [DOI: 10.1016/j.arcped.2020.01.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 11/07/2019] [Accepted: 01/25/2020] [Indexed: 12/09/2022]
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Wallace DK, Repka MX, Lee KA, Melia M, Christiansen SP, Morse CL, Sprunger DT. Amblyopia Preferred Practice Pattern®. Ophthalmology 2018; 125:P105-P142. [DOI: 10.1016/j.ophtha.2017.10.008] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022] Open
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Lee KM, Seery C, Khouri AS. Traumatic glaucoma due to paintball injuries: A case series. J Curr Ophthalmol 2017; 29:318-320. [PMID: 29270481 PMCID: PMC5735233 DOI: 10.1016/j.joco.2017.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose To study the management and outcomes of patients with paintball injuries resulting in traumatic glaucoma. Methods A retrospective review was performed, identifying four patients with a confirmed diagnosis of traumatic glaucoma secondary to paintball sports. Results Four male patients with paintball gun injuries presented with a mean follow-up time of 51 months after the date of injury. The mean age was 23.5 ± 18.6 years. Three patients presented with blunt trauma, while one patient had a ruptured globe. Presenting visual acuity (VA) was hand motions in three of the patients and no light perception in the fourth patient. All patients were diagnosed with traumatic glaucoma and treated with glaucoma medications during their follow-up. Two patients received tube shunts to control intraocular pressures (IOPs). At the time of most recent follow-up, three patients had elevated IOPs and were not on any medications. VA at the last follow-up was 20/400 or worse. Conclusions Traumatic glaucoma can be managed with surgical and medical interventions, while VA usually does not return to baseline levels prior to the injury. Prognostic predictors can be used to guide treatment and identify patients who should be closely followed. Because the presentation and onset is widely variable, follow-up and screening is crucial even years after the injury.
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7
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Miller KE. Pediatric Ocular Trauma: an Update. CURRENT OPHTHALMOLOGY REPORTS 2017. [DOI: 10.1007/s40135-017-0130-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ghazanfari-Nasrabad M, Amrollahi-Sharifabadi M, Kargar-Bideh O, Azizi-Sharifabad S. Permanent Ocular Injury Following Paintball Pellet Hit: A Medicolegal Case. J Forensic Sci 2015. [DOI: 10.1111/1556-4029.12917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Mahdi Ghazanfari-Nasrabad
- Legal Medicine Research Center; Legal Medicine Organization; Bahar Cross Taleghani Avenue Tehran 1114795113 Iran
- Legal Medicine Center of Yazd; Legal Medicine Organization; Dadgostari Aly Farokhi Street Yazd City 8913813419 Yazd Province Iran
| | - Mohammad Amrollahi-Sharifabadi
- Legal Medicine Research Center; Legal Medicine Organization; Bahar Cross Taleghani Avenue Tehran 1114795113 Iran
- Legal Medicine Center of Yazd; Legal Medicine Organization; Dadgostari Aly Farokhi Street Yazd City 8913813419 Yazd Province Iran
| | - Omidreza Kargar-Bideh
- Legal Medicine Research Center; Legal Medicine Organization; Bahar Cross Taleghani Avenue Tehran 1114795113 Iran
- Legal Medicine Center of Yazd; Legal Medicine Organization; Dadgostari Aly Farokhi Street Yazd City 8913813419 Yazd Province Iran
| | - Saeed Azizi-Sharifabad
- Legal Medicine Research Center; Legal Medicine Organization; Bahar Cross Taleghani Avenue Tehran 1114795113 Iran
- Legal Medicine Center of Yazd; Legal Medicine Organization; Dadgostari Aly Farokhi Street Yazd City 8913813419 Yazd Province Iran
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Lee R, Fredrick D. Pediatric eye injuries due to nonpowder guns in the United States, 2002-2012. J AAPOS 2015; 19:163-8.e1. [PMID: 25818283 DOI: 10.1016/j.jaapos.2015.01.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 12/31/2014] [Accepted: 01/26/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To identify epidemiologic trends in nonpowder gun-related pediatric eye injuries and to determine factors associated with severe injury requiring hospital admission. METHODS US emergency department data on pediatric eye injuries between 2002 and 2012 were reviewed using the National Electronic Injury Surveillance System. Literature review was conducted to determine trends in visual outcomes after treatment and use of eye protection. RESULTS In 2012 roughly 3,161 children were treated in US emergency departments for nonpowder gun-related eye injuries. Since 2010 rates of severe nonpowder gun pediatric eye injury have increased by over 500% (P = 0.039). Specifically, while rates of hospital admission due to paintball gun eye injury have dropped precipitously (P = 0.0077), rates of admissions for air gun eye injuries have increased by over 600% since 2010 (P = 0.033). Children sustaining eye injury due to air guns are more likely to be diagnosed and admitted with foreign body or ocular puncture injury. Roughly 28% of documented cases of airsoft or BB gun-related injury had visual acuity worse than 20/50 after initial treatment. Over 98% of injuries occurred without eye protection. CONCLUSIONS Air guns are rising in popularity and now account for the majority of pediatric eye injuries requiring hospital admissions. These eye injuries occur without ocular protection and may lead to permanent eye injury. Increasing regulations for eye protection, sales, and usage of air guns are needed to prevent serious pediatric eye injuries.
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Affiliation(s)
- Rachel Lee
- Stanford University School of Medicine, Palo Alto, California.
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Abbott J, Shah P. The epidemiology and etiology of pediatric ocular trauma. Surv Ophthalmol 2014; 58:476-85. [PMID: 23969021 DOI: 10.1016/j.survophthal.2012.10.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 10/11/2012] [Accepted: 10/16/2012] [Indexed: 11/25/2022]
Abstract
Eighteen million people worldwide have uniocular blindness from traumatic injury. Injuries occur disproportionally commonly in childhood. Every year a quarter of a million children present with serious ocular trauma. For the vast majority the injury is preventable. We review the international literature that identifies high-risk circumstances.
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Affiliation(s)
- Joseph Abbott
- Moorfields Eye Hospital, University College London Partners, London, UK.
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Pollard KA, Xiang H, Smith GA. Pediatric eye injuries treated in US emergency departments, 1990-2009. Clin Pediatr (Phila) 2012; 51:374-81. [PMID: 22199176 DOI: 10.1177/0009922811427583] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study investigates activity- and consumer product-related eye injuries treated in US hospital emergency departments among children <18 years old using National Electronic Injury Surveillance System data from 1990 through 2009. An estimated 1,406,200 (95% confidence interval = 1,223,409-1,588,992) activity- and consumer product-related pediatric eye injuries occurred during the study period, averaging 70,310 annually. The annual number of injuries declined significantly by 17%. Patients ≤ 4 years of age accounted for 32% of all injuries and had the highest mean annual eye injury rate (11.31 per 10,000 population). Eye injuries associated with sports and recreation (24%) and chemicals (17%) occurred most frequently. The majority (69%) of eye injuries occurred at home. Opportunities exist to further decrease these injuries. Pediatricians should educate child caregivers and children about risks for eye injuries in the home and about use of appropriate protective eyewear during sports.
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Affiliation(s)
- Katherine A Pollard
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA
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12
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Abstract
Pediatric anesthesiologists care for children with penetrating trauma from nonpowder (BB and pellet) guns. We present the case of a 9-year-old boy who required urgent median sternotomy for cardiac tamponade after sustaining a close-range BB gun injury to the chest. After summarizing the epidemiology of nonpowder gun injuries in children, we clarify the nomenclature, ballistics, and mechanisms of these guns, discuss the tendency to minimize these kinds of injuries, explain bullet embolization, and review (by body area) current clinical management issues.
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Affiliation(s)
- Shad Misseldine
- Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA, USA
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13
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Feier CC, Mallon W. Injury pattern of the stingball. J Emerg Med 2010; 38:444-448. [PMID: 18687559 DOI: 10.1016/j.jemermed.2007.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2007] [Revised: 09/04/2007] [Accepted: 09/04/2007] [Indexed: 05/26/2023]
Abstract
The stingball is a "maximum effect device" delivering up to four stimuli for psychological and physiological effect, including rubber pellets, light, sound, and an optional chemical agent. The purpose of this case report is to describe the injury patterns of a less-lethal weapon that has been in use for over 20 years. Although the stingball has been available for many years, there is very little experience with it in the medical community. We describe the case of an inmate at Los Angeles county jail brought to LAC+USC Emergency Department after sustaining injuries from the deployment of a stingball to break up a jail riot.
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Affiliation(s)
- Chris C Feier
- Department of Emergency Medicine, Los Angeles County + University of Southern California Medical Center and the Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Kay CN, Saunders TS, Pavan PR. Ocular injuries sustained in paintball trauma. Graefes Arch Clin Exp Ophthalmol 2010; 248:331-2. [PMID: 20091178 DOI: 10.1007/s00417-009-1294-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 12/21/2009] [Accepted: 12/24/2009] [Indexed: 11/26/2022] Open
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Reddy AK, Ray R, Yen KG. Surgical intervention for traumatic cataracts in children: Epidemiology, complications, and outcomes. J AAPOS 2009; 13:170-4. [PMID: 19393516 DOI: 10.1016/j.jaapos.2008.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 10/17/2008] [Accepted: 10/18/2008] [Indexed: 10/20/2022]
Abstract
PURPOSE To describe the presentation, treatment, and outcomes of a series of patients with unilateral traumatic cataracts. METHODS Retrospective, noncomparative review of 25 consecutive children with unilateral traumatic cataracts managed at a single institution during a 5-year period with regard to demographic data, mode of injury, clinical course, and outcome. RESULTS Paintball and BB gun injuries were the most common mode of injury, accounting for 28% of all cases, followed by injury from pens and pencils (16%). Preoperative visual acuity was poor in 19 patients (76%), and final postoperative visual acuity was poor (20/200 or worse) in 4 patients (16%); this difference was statistically significant (p < 0.001). Twenty-one percent of children with poor vision on initial examination had poor vision at their final examination, and no patients with vision better than 20/200 on initial examination developed poor vision postoperatively (p = 0.29). Patients who developed poor final vision were younger on average than those who achieved satisfactory vision (5.25 years vs 7.5 years). Poor visual outcome did not appear to depend on the time from injury to presentation and time interval between injury and cataract extraction. CONCLUSIONS Children with visually significant traumatic cataracts can have good outcomes if they are managed aggressively and appropriately. In our patient population, paintballs and BB guns accounted for more than 25% of traumatic cataract injuries, and a large number of traumatic cataracts were sustained by pens and pencils.
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Affiliation(s)
- Ashvini K Reddy
- Department of Ophthalmology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas 77030-2316, USA
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Bouhaimed M, Alwohaib M, Alabdulrazzaq S, Jasem M. Toy gun ocular injuries associated with festive holidays in Kuwait. Graefes Arch Clin Exp Ophthalmol 2008; 247:463-7. [DOI: 10.1007/s00417-008-0956-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Revised: 09/12/2008] [Accepted: 09/15/2008] [Indexed: 11/30/2022] Open
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Guerrero MA, Zhou W, El Sayed HF, Kougias P, Lin PH. Subcapsular hematoma of the kidney secondary to paintball pellet injuries. J Emerg Med 2007; 36:300-1. [PMID: 17945457 DOI: 10.1016/j.jemermed.2007.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2005] [Revised: 08/09/2006] [Accepted: 11/06/2006] [Indexed: 10/21/2022]
Affiliation(s)
- Marlon A Guerrero
- Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey, Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA
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Abstract
PURPOSE OF REVIEW The aim of this article is to evaluate and review the scientific literature on pediatric ocular trauma from the past several years. Recent advancements have recognized mechanisms of injury that may be unique to children, require different treatment course than adults, and raise multiple public health concerns. RECENT FINDINGS Epidemiologic studies have shown that ocular trauma is a major cause of monocular blindness and potential disability in children worldwide. The mechanisms of injury are quite variable and often found under mundane circumstances. Orbital fractures in children are more likely to cause entrapment of orbital contents due to the structure of orbital bones at an early age and require earlier surgical repair. The management of traumatic hyphema responds well to outpatient care and topical aminocaproic acid. The management of traumatic cataracts has been enhanced with new iris-fixated lens implants. Endophthalmitis after ocular trauma carries a significantly worse prognosis, which may be reduced by early referral and intervention. SUMMARY This review broadens our understanding of the mechanisms, treatment, and prognostic indicators in pediatric ocular trauma. This will allow improved clinical care of these injuries.
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Affiliation(s)
- Jonathan H Salvin
- Division of Ophthalmology, Nemours/Alfred I. DuPont Hospital for Children, Jefferson Medical College, Wilmington, Delaware 19899, USA.
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Kennedy EA, Ng TP, McNally C, Stitzel JD, Duma SM. Risk functions for human and porcine eye rupture based on projectile characteristics of blunt objects. STAPP CAR CRASH JOURNAL 2006; 50:651-71. [PMID: 17311182 DOI: 10.4271/2006-22-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Eye ruptures are among the most devastating eye injuries and can occur in automobile crashes, sporting impacts, and military events, where blunt projectile impacts to the eye can be encountered. The purpose of this study was to develop injury risk functions for globe rupture of both human and porcine eyes from blunt projectile impacts. This study was completed in two parts by combining published eye experiments with new test data. In the first part, data from 57 eye impact tests that were reported in the literature were analyzed. Projectile characteristics such as mass, cross-sectional area, and velocity, as well as injury outcome were noted for all tests. Data were sorted by species type and areas were identified where a paucity of data existed, based on the kinetic and normalized energy of assaulting objects. For the second part, a total of 126 projectile tests were performed on human and porcine eyes. Projectiles used for these tests included blunt aluminum projectiles, BBs, foam pellets, Airsoft pellets, and paintballs. Data for each projectile were recorded prior to testing and high-speed video was used to determine projectile velocity prior to striking the eye. In part three the data were pooled for a total of 183 eye impact tests, 83 human and 100 porcine, and were analyzed to develop the injury risk criteria. Binary logistic regression was used to develop injury risk functions based on kinetic and normalized energy. Probit analysis was used to estimate confidence intervals for the injury risk functions. Porcine eyes were found to be significantly stronger than human eyes in resisting globe rupture (p=0.01). For porcine eyes a 50% risk of globe rupture was found to be 71,145 J/m2, with a confidence interval of 63,245 J/m2 to 80,390 J/m2. Human eyes were found to have a 50% risk of globe rupture at a lower, 35,519 J/m2, with confidence intervals of 32,018 J/m2 to 40,641 J/m2. The results presented in this paper are useful in estimating the risk of globe rupture when projectile parameters are known, or can be used to validate computational eye models.
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Affiliation(s)
- Eric A Kennedy
- Virginia Tech - Wake Forest, Center for Injury Biomechanics, 100F Randolph Hall, Blacksburg, VA 24061, USA
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Abstract
OBJECTIVE To present the descriptive epidemiology of gun-related eye injury in the United States from 1993 through 2002. METHODS Data from the National Electronic Injury Surveillance System was used to estimate the number of patients treated in the United States for gun-related eye injury (GEI) (air guns and firearms), air gun-related eye injury (AEI) (BB/pellet guns and rifles) and firearm-related eye injury (FEI) (all powder discharge guns) during the time period 1993 through 2002. Rates were calculated according to age, gender, race, weapon type and circumstances surrounding the injury event (e.g., locale and intent). RESULTS The rate of gun-related eye injury in the United States declined to 7.5 per 1,000,000 in 2002 from 14.8 per 1,000,000 in 1993, representing a decline of approximately 5.4% per year (p = 0.0002), due primarily to a decline in the rate of FEI (6.7% per year, p = 0.029). The rate of AEI was relatively constant. GEI rates were highest among those aged 10-19 years, males, and Blacks. The overall rate of AEI was higher than the rate of FEI (6.0 per 1,000,000 and 5.1 per 1,000,000, respectively). According to race, the rate of FEI was higher than the rate of AEI in Blacks whereas the rate of AEI was higher than the rate of FEI in Whites and Hispanics. The majority of GEIs occurred at home and were unintentional. CONCLUSION The rate of gun-related eye injury in the United States declined from 1993 through 2002 primarily due to a reduction in firearm-related eye injury, whereas the rate of air gun-related eye injury remained constant. Persons who were young, Black, and male were at highest risk for gun-related eye injury.
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Affiliation(s)
- Gerald McGwin
- Department of Ophthalmology & Surgery, School of Medicine, University of Alabama, Birmingham, AL 35294-0009, USA.
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Misra A, Cohen VML, Burton RL. Severe ocular trauma in a young girl with a paintball pellet. J Pediatr 2005; 147:868. [PMID: 16356452 DOI: 10.1016/j.jpeds.2005.06.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2005] [Accepted: 06/16/2005] [Indexed: 11/23/2022]
Affiliation(s)
- Aseema Misra
- Ophthalmology Department, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk, NR4 7UZ, UK.
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