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

Ahmadabadi, M Nili; Karkhaneh, Reza; Valeshabad, Ali Kord; Tabatabai, A.; Jager, Martine J.; Ahmadabadi, Elham Nili

doi:10.1016/j.injury.2010.11.006

Cited by 15 publications

(16 citation statements)

References 12 publications

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“…It is well known that airsoft gun ocular injury is a frequent cause of blunt ocular trauma in children. [8][9][10] Ocular injuries caused by airsoft guns including BB guns have been widely reported in the literature recently, [1][2][3][4][5][6][8][9][10] but there are only a few studies evaluating the clinicopathological mechanism of airsoft gun ocular injuries. Two studies have been reported; one evaluated different projectiles in matched experimental eye impact simulations, 11 and one performed numerical modeling of paintball impact ocular trauma.…”

Section: Introductionmentioning

confidence: 99%

<p>Finite Element Analysis of Changes in Tensile Strain by Airsoft Gun Impact on Eye and Deformation Rate in Eyes of Various Axial Lengths</p>

Takahashi¹,

Okamura²,

Tsukahara-Kawamura³

et al. 2020

OPTH

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We have carried out three-dimensional finite element analysis (FEA) to determine the physical and mechanical response in several ocular injuries. We applied this FEA model to evaluate an airsoft gun impact on an eye and the deformation rate of eyes of various axial lengths at various velocities. Methods: This study was carried out on a human eye model using an FEA program created by Nihon, ESI Group. The airsoft gun pellet was set to impact the eye at initial velocities of 45, 60 and 75 m/s with the addition of variation in axial length of 20 mm (hyperopia), 22 mm (emmetropia), 24 mm (myopia) and 26 mm (high myopia). Deformation of the eye was calculated as the decrease rate of the volume of the eyeball and the decrease rate of the axial length.Results: In all emmetropic cases, the cornea reached its strain threshold during the impact, and scleral strain showed a patchy strength distribution in the simulation. The deformation was most evident in the anterior segment, while deformation of the posterior segment was less. The decrease rate of the volume of the eyeball and decrease rate of the axial length were highest in the hyperopic eye, followed by the emmetropic eye and myopic eye, and the high myopic eye showed the lowest decrease rates among the four axial lengths in all impact velocity simulations. Conclusion: These results suggest that hyperopic eyes are most susceptible to deformation by an airsoft gun impact compared with other axial length eye models in this simulation. The considerable deformation by an airsoft gun impact shown in this study might indicate the necessity of ocular protection to avoid permanent eye injury. FEA using a human eyeball model might be a useful method to analyze and predict the mechanical features of ocular injury by an airsoft gun.

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Section: Introductionmentioning

confidence: 99%

<p>Finite Element Analysis of Changes in Tensile Strain by Airsoft Gun Impact on Eye and Deformation Rate in Eyes of Various Axial Lengths</p>

Takahashi¹,

Okamura²,

Tsukahara-Kawamura³

et al. 2020

OPTH

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show abstract

“…Same mechanisms by baro-trauma (Energy/area density) was proposed in airsoft gun and BB gun injuries [15]. Iris sphincter rupture, corneal rupture, traumatic keratopathy, lens subluxation, and vitreous hemorrhage have been also reported in these injuries [16,17]. Thus, we suggest that the further study for determining the minimum velocity necessary to penetrate the eyes in blank cartridge model is needed.…”

Section: Discussionmentioning

confidence: 69%

Penetrating ocular trauma associated with blank cartridge

Moon

Lim

2014

BMC Ophthalmol

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BackgroundBlank cartridge guns are generally regarded as being harmless and relative safe. However recent published articles demonstrated that the gas pressure from the exploding propellant of blank cartridge is powerful enough to penetrate the thoracic wall, abdominal muscle, small intestine and the skull. And there has been a limited number of case reports of ocular trauma associated with blank cartridge injury. In addition, no report on case with split extraocular muscle injury with traumatic cataract and penetrating corneoscleral wound associated with blank cartridge has been previously documented. This report describes the case of patient who sustained penetrating ocular injury with extraocular muscle injury by a close-distance blank cartridge that required surgical intervention.Case presentationA 20-year-old man sustained a penetrating globe injury in the right eye while cleaning a blank cartridge pistol. His uncorrected visual acuity at presentation was hand motion and he had a flame burn of his right upper and lower lid with multiple missile wounds. On slit-lamp examination, there was a 12-mm laceration of conjunctiva along the 9 o'clock position with two pinhole-like penetrating injuries of cornea and sclera. There was also a 3-mm corneal laceration between 9 o'clock and 12 o'clock and the exposed lateral rectus muscle was split. Severe Descemet's membrane folding with stromal edema was observed, and numerous yellow, powder-like foreign bodies were impacted in the cornea. Layered anterior chamber bleeding with traumatic cataract was also noted. Transverse view of ultrasonography showed hyperechoic foreign bodies with mild reduplication echoes and shadowing. However, a computed tomographic scan using thin section did not reveal a radiopaque foreign body within the right globe.ConclusionTo our best knowledge, this is the first case report of split extraocular muscle injury with traumatic cataract and penetrating ocular injury caused by blank cartridge injury. Intraocular foreign bodies undetectable by CT were identified by B-scan ultrasonography in our patient. This case highlights the importance of additional ultrasonography when evaluating severe ocular trauma. And ophthalmologists should consider the possibility of penetrating injury caused by blank ammunition.

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“… 1 , 2 ONA has been reported as a result of many forms of trauma including motor vehicle accidents, sports injuries, falls, and eye gouges. 1 , 2 While BB projectiles usually cause vision loss through penetrating injuries to the cornea and retina, 3 to the best of our knowledge, this is the first case report in the literature of ONA from a metal BB projectile. Furthermore, the capture of ONA on both B-scan and MRI modalities in the same patient was not reported before, with one case in the literature capturing ONA on MRI.…”

Section: Discussionmentioning

confidence: 83%

MRI visualization of optic nerve avulsion due to ocular perforation from BB gun projectile

Barnard

Ajlan

2018

American Journal of Ophthalmology Case Reports

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

Cited by 15 publications

References 12 publications

<p>Finite Element Analysis of Changes in Tensile Strain by Airsoft Gun Impact on Eye and Deformation Rate in Eyes of Various Axial Lengths</p>

<p>Finite Element Analysis of Changes in Tensile Strain by Airsoft Gun Impact on Eye and Deformation Rate in Eyes of Various Axial Lengths</p>

Penetrating ocular trauma associated with blank cartridge

MRI visualization of optic nerve avulsion due to ocular perforation from BB gun projectile

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