Ocular TASER Trauma

Abstract

Purpose : To report the ocular and adnexal injuries sustained by two patients with TASER injuries and discuss the management of these cases.

Methods : We describe the clinical course of two patients with TASER injuries to the eyes and adnexa. The management, outcomes, external photographs, computed tomography scans, Optos ultra-widefield color photographs, and optical coherence tomography images are provided.

Results : In our cohort, both patients were transported to the Emergency Room (ER) of a Level 1 Trauma Center by law enforcement – one was transferred from a nearby community hospital, while the other was brought directly from the field. In the former, the TASER body was stopped by the zygomatic bone, such that the point stopped approximately 2 mm short of the sclera without making contact with the globe. The TASER was removed under conscious sedation and local anesthesia in the ER. At 1 year follow-up the patient had visual acuity (VA) of 20/20, without cataract, retinopathy, or evidence of electrical injury to the eye. The latter patient presented with VA of 20/200 in the affected eye and suspected TASER-related open globe, and the TASER was removed from the orbit under general anesthesia in the operating room. The TASER could not be manually removed due to its depth of penetration into the zygomatic bone, and was removed by using a large hemostat as a lever, over a rolled up towel as the fulcrum. An inferotemporal triangular flap scleral laceration of ~5 mm in length, located 9 mm posteriorly from the limbus, was repaired and the prolapsed uveal tissue was reposited. The traumatic rhegmatogenous retinal detachment was secondarily repaired 3 weeks after globe repair, with vitrectomy, retinectomy, endolaser, and silicone oil. Two weeks later he developed a tractional retinal detachment from proliferative vitreoretinopathy and underwent scleral buckle, vitrectomy, membrane peeling, retinectomy, endolaser, and silicone oil placement. Six months later, the retina remained attached with VA of 20/400.

Conclusions : TASER injuries to the orbit are a rare and complex trauma. To date, only 9 such cases have been reported in the literature. Here, we report 2 new cases, with significantly different presentation, management, and outcomes. In our experience, these patients are at high likelihood of incarceration after initial repair of these injuries and medical care needs to be directly coordinated with the correctional facility to ensure that the patient is not lost to follow-up.

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