BB Gun-Related Open Globe Injuries.

PURPOSE: To describe the characteristics and outcomes of patients treated for BB and pellet gun-related open globe injuries.

DESIGN

Retrospective case series.

PARTICIPANTS

Patients presenting to a tertiary care trauma center with open globes secondary to BB or pellet gun injury from January 2002 to November 2017.

METHODS

A retrospective chart review was conducted of all patients presenting with open globe injuries from January 2002 to November 2017. Charts were reviewed to isolate the mechanism of injury related to BB or pellet guns. Demographic data, injury type, presenting clinical examination findings, visual acuity (VA), secondary ocular complications, necessary surgical procedures and long-term outcome data were recorded. Additionally, the ocular trauma score (OTS) was calculated for all patients who had documented VA on presentation.

MAIN OUTCOME MEASURE: Final VA.

RESULTS

During the study period, 681 open globe injuries were identified, 16 of which met inclusion criteria. Fourteen cases were due to injury from a BB gun and 2 were due to a pellet gun. Fourteen of the 16 patients (88%) were males. The average age of patients at time of presentation was 14±6.4 years (range, 4-28 years). Common presenting complications included hyphema, traumatic cataract, and retinal detachment. Twelve of the 16 patients required at least one additional surgery after open globe repair. Fifteen (94%) patients had hand motion-only or worse vision at time of final presentation. Eight patients had no light perception vision in the injured eye at final follow-up.

CONCLUSIONS

Open globe injuries related to BB or pellet guns result in devastating visual outcomes. They are often associated with multiple complications and the need for additional surgeries. Modern surgical techniques can increase the rate of globe salvage although final vision remains poor. The study findings highlight the risks associated with widely available BB and pellet guns and underscore the importance of eye protection in this setting.