Clinical presentation and outcome of perforating ocular injuries due to BB guns: A case series

PurposeTo describe the clinical presentations and treatment modalities of a series of BB gun-related perforating ocular injuries.MethodsClinical records of all consecutive cases of perforating BB gun injuries to the globe seen between September 2004 and September 2008 were reviewed retrospectively. At the time of the trauma and after final treatment, all patients underwent a complete ocular examination, including visual acuity, applanation tonometry for intraocular pressure, slit lamp biomicroscopy, indirect ophthalmoscopy and fundus photography, if possible. In all cases, primary globe repair was performed in the first session, and then appropriate surgery took place based on the individual situation.ResultsIn this study, 13 patients (11 males and 2 females) with a mean age of 20.8 years (range 9–50 years) were enrolled. The mean follow-up period was 7.2 ± 4.3 months (range 1–25 months). Initial visual acuity (VA) ranged from no-light perception (NLP) to finger counting (CF). Vitreous haemorrhage and retinal detachment were present in all involved eyes. Hyphema (30.76%), uveal and retinal prolapse (30.8%), retinal incarceration (30.8%) and retinal haemorrhage (53.8%) were other ocular findings. VA remained stable in 46.2% of the patients (6 cases). The best achieved final VA was CF at 2 m in one case after 6 months follow-up. After several surgical procedures, enucleation was necessary in only 2/13 (15.4%) cases.ConclusionDespite several surgical procedures which decreased the number of enucleations, BB gun-perforating ocular injuries still lead to a grim visual outcome. This implies the importance of political strategies targeting on education of parents and restriction for children to access to these guns.