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P. J. Kelty, E. M. Bowie, J. Mills; Ocular Nail-Gun Injuries: Epidemiology and Visual Outcomes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):712.
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Nail-gun accidents have become a common reason for patients to present with penetrating ocular injuries. To date, there is only one small case series (four patients) in the medical literature of penetrating ocular injury due to nail-guns. The aim of this study is to describe the epidemiology and visual outcomes of patients presenting to a tertiary center with ocular injuries resulting from nail-guns.
This is an IRB-approved retrospective chart review of patients presenting to the Medical University of South Carolina after sustaining eye injuries secondary to the use of nail-guns. The records of 167 patients with penetrating eye injuries treated at the Medical University between July 2003 and June 2006 inclusive were reviewed. Nineteen patients (11%) had open globe injuries related to nail guns. Demographic data, ocular exam findings, surgical procedures, and visual outcomes were recorded.
Of the 19 patients identified, 13 were work-related; this represented approximately 68% of cases. All the patients were male, and the average age was 28.4 years (range 15 years to 51 years). Sixty-eight percent of the patients were non-English speaking. There was no record of any patient wearing safety glasses at the time of the injury. Five patients (26%) had an intraocular foreign body at the time of presentation. The visual acuity at presentation ranged from 20/25 to hand motion or worse. More than half (52%) of these patients had a presenting visual acuity of hand motion or worse. At last examination, 36% (7 patients) had visual acuity of 20/40 or better, 42% (8 patients) had visual acuity of counting fingers to hand motion, 0.05% (1 patient) 20/60, and three did not follow up after the initial surgical procedure.
Nail-gun injuries appear to be primarily work-related and could be prevented with required use of safety glasses. Initial and final visual acuity of these 19 patients, although dependent on site of impact, is better than what might be expected due to the nature of their injury.
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