Indian Journal of Medicine and Healthcare

Open Access Open Access  Restricted Access Subscription Access

Visual Outcome of Closed Globe Injury Due to Shotgun Pellet


Affiliations
1 Government Medical College, Srinagar, India
2 Ophthalmology, Government Medical College, Srinagar, India
 

Purpose: To characterize closed globe injuries due to pellets and determine prognosis of such injuries.

Methods: It was a prospective observational study and was carried between July 2016 and Jan 2018. About 253 eyes of 249 patients were included in the study. Injuries were classified in accordance with BETT (Birmingham Eye Trauma Terminology) terminology and Ocular Trauma Classification System as shown in and significance was determined for this classification.

Results: Majority of 163 (65.5%) patients was in the age group of 17-26 years and of246 (98.8%) patients were males. Most common presenting grade of vision was Grade A in 36.7% of eyes while most common type of injury was type A (Contusions) in 53%. Most common zone of injury was Zone I in 40.7%. Subconjunctival hemorrhage was most common ocular finding in 179 (70.7%) eyes followed by hyphema in 97 (38.3%) eyes. Visual outcome was found to be 6/36 or better in 226 (89.3%) of eyes. At the end of the study macular hole was present in 2 eyes, pseudophakia in 1, and cataract in 5, and distortion of foveal contour due to epiretinal membrane in 3, some macular scarring in 7, and RD in 2 eyes.

Conclusion: Zone III involvement need of vitrectomy, non-perception of light and relative afferent pupillary deficit at presentation is associated with poor outcome. Interventions in form of medical and surgical modalities significantly improve outcome.


Keywords

Ocular Trauma, Eye Injury, Closed Globe, Shotgun, Pellet, Visual Outcome.
User
Notifications

  • B. Tylefors. Epidemiologic patterns of ocular trauma. Australian and New Zealand Journal of Ophthalmology. 1992; 20(2), 95-8

  • What are pellet guns and why are they lethal?http://www.thehindu.com/news/national/other-states/what-are-pellet-guns-and-why-are-they-lethal/article8880015.ece. Date accessed: 21/07/2016.

  • NRA Firearms Fact Book data. https://openlibrary.org/books/OL8412575M/Nra_Firearms_Fact_Book_(Item_01560). Date accessed: 06/1993.

  • R.E. Morris, C.D. Witherspoon, R.M. Feist, J.B. Byrne, E.E. Ottemiller. Bilateral ocular shotgun injury. American Journal of Ophthalmology. 1987; 103, 695-700.

  • World Medical Association. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects". JAMA. 2013; 310(20), 2191–2194.

  • F. Kuhn, R. Morris, C.D. Witherspoon, K. Heimann, J. Jeffers, G. Treister. A standardized classification of ocular trauma terminology. Ophthalmology. 1996; 103, 240–243.

  • D.J. Pieramici, P. Sternberg, A.M. Aaberg. A system for classifying mechanical injuries of the eye (globe). American Journal of Ophthalmology. 1997; 123(6), 820–831.

  • D.I. Bowen, D.M. Magauran. Ocular injuries caused by airgun pellets: an analysis of 105 cases. British Medical Journal. 1973; 1(5849), 333-337.

  • K.W. Sharif, C.N. McGhee, R.C. Tomlinson. Ocular trauma caused by airgun pellets: a ten year survey. EyeLondon. 1990; 4(6), 855-60.

  • Z. Khoueir, G. Cherfan, A. Assi. Vitreoretinal surgery for shotgun eye in-juries: outcomes and complications. Eye London. 2015; 29(7), 881e887.

  • G.N. Shuttleworth, P. Galloway, J.M. Sparrow, C. Lane. Ocular air gun in-juries: a one-year surveillance study in the UK and Eire (BOSU). 2001-2002. Eye London. 2009; 23(6), 1370e1376.

  • A.M. Kolomeyer, A. Shah, A.M. Bauza, P.D. Langer, M.A. Zarbin, N. Bhagat. Nail gun-induced open-globe injuries: a 10-year retrospective review. Retina. 2014; 34(2), 254e261.

  • D.W. Young, J.M. Little. Pellet-gun eye injuries. Can Journal of Ophthalmology. 1985; 20(1), 9e10.

  • D. Sevel, A.D. Atkins. Pellet gun injuries of the eye. South African Medical Journal. 1978; 54(14), 566e568.

  • M. Al-Amry, H. Al-Taweel, N. Al-Enazi, M. Alrobaian, S. Al-Othaimeen. Retained periorbital and intracranial air-gun pellets causing sclopetaria and visual loss. Saudi Journal of Ophthalmology. 2014; 28(3), 228e233.

  • O.D. Schein, C. Enger, J.M. Tielsch. The context and consequences of ocular injuries from air guns. American Journal of Ophthalmology. 1994; 117(4), 501e506.

  • S.K. Arya, S. Malhotra, S.P. Dhir, S. Sood S. Ocular fireworks injuries. Clinical features and visual outcome. Indian Journal of Ophthalmology. 2001; 49(3), 189-90.

  • Review of Ophthalmology. https://www.elsevier.com/books/review-of-ophthalmology/friedman/978-0-323-39056-9. Date accessed: 02/2017.


Abstract Views: 485

PDF Views: 176




  • Visual Outcome of Closed Globe Injury Due to Shotgun Pellet

Abstract Views: 485  |  PDF Views: 176

Authors

Faisal Qayoom Shah
Government Medical College, Srinagar, India
Syed Tariq Qureshi
Ophthalmology, Government Medical College, Srinagar, India
Arshi Nazir
Government Medical College, Srinagar, India

Abstract


Purpose: To characterize closed globe injuries due to pellets and determine prognosis of such injuries.

Methods: It was a prospective observational study and was carried between July 2016 and Jan 2018. About 253 eyes of 249 patients were included in the study. Injuries were classified in accordance with BETT (Birmingham Eye Trauma Terminology) terminology and Ocular Trauma Classification System as shown in and significance was determined for this classification.

Results: Majority of 163 (65.5%) patients was in the age group of 17-26 years and of246 (98.8%) patients were males. Most common presenting grade of vision was Grade A in 36.7% of eyes while most common type of injury was type A (Contusions) in 53%. Most common zone of injury was Zone I in 40.7%. Subconjunctival hemorrhage was most common ocular finding in 179 (70.7%) eyes followed by hyphema in 97 (38.3%) eyes. Visual outcome was found to be 6/36 or better in 226 (89.3%) of eyes. At the end of the study macular hole was present in 2 eyes, pseudophakia in 1, and cataract in 5, and distortion of foveal contour due to epiretinal membrane in 3, some macular scarring in 7, and RD in 2 eyes.

Conclusion: Zone III involvement need of vitrectomy, non-perception of light and relative afferent pupillary deficit at presentation is associated with poor outcome. Interventions in form of medical and surgical modalities significantly improve outcome.


Keywords


Ocular Trauma, Eye Injury, Closed Globe, Shotgun, Pellet, Visual Outcome.

References