Impact of 777 Pellet Gun Ocular Injuries in Kashmir

Abstract

Purpose : This study reports the incidence, clinical findings and management of 777 patients with pellet gun-related ocular injuries.

Methods : This was a retrospective case series of 777 patients who were admitted to Shri Maharaja Hari Singh Hospital, a tertiary hospital with an ophthalmology service in Srinagar, India between 18^th June 2016 and 18^th November 2016, for ocular injuries resulting from pellet guns. Demographics, clinical records, investigation results and surgical reports were reviewed.

Results : A total of 777 patients were seen and managed over a period of 3.01 days. Vast majority (593 patients, 98.7%) of patients who required surgical intervention received treatment on the day of admission or the next day. The mean duration to initial treatment procedure was 0.21 days. The mean age of the victims was 22.32 (± 7.20) years. Most of them were male (97.7%) and under 30 years old (90.3%). Monocular injury occurred in 728 patients (93.6%), of which 74.7% had open globe injury. There were 44 patients (5.8%) with binocular injury, of which 88.6% sustained open globe injury in one or both eyes. Computed tomography was done in 662 patients (85.2%) and showed intraorbital foreign bodies in 199 patients (68.2%) and intraocular foreign bodies in 70 patients (24.0%). Ultraround B scan was performed in 151 patients (19.4%). Primary repair in an emergency setting was performed in 33.2% of closed globe injuries and 83.0% of open globe injuries. Definitive surgical intervention in the form of cataract extraction, vitrectomy or combined lensectomy and vitrectomy, were performed in 18 cases of closed globe injury and 373 of open globe injuries.

Conclusions : Victims who sustained pellet gun-related ocular injuries were mostly young males with open globe injury. Treatment often required one or more surgeries. Despite early surgical intervention, visual prognosis for most patients remained poor.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.