Gun trauma and ophthalmic outcomes

Abstract

PurposeThis retrospective cohort study assesses the visual outcomes of patients who survive gunshot wounds to the head.MethodsThe Elmhurst City Hospital Trauma Registry and Mount Sinai Data Warehouse were queried for gun trauma resulting in ocular injury over a 16-year period. Thirty-one patients over 16 years of age were found who suffered a gunshot wound to the head and resultant ocular trauma: orbital fracture, ruptured globe, foreign body, or optic nerve injury. Gun types included all firearms and air guns. Nine patients were excluded due to incorrect coding or unavailable charts. Statistical analysis was performed using a simple bivariate analysis (χ).ResultsOf the 915 victims of gun trauma to the head, 27 (3.0%) sustained ocular injuries. Of the 22 patients whose records were accessible, 18 survived. Eight of the 18 surviving patients (44%) suffered long-term visual damage, defined as permanent loss of vision in at least one eye to the level of counting fingers or worse. Neither location of injury (P=0.243), nor type of gun used (P=0.296), nor cause of gun trauma (P=0.348) predicted visual loss outcome. The Glasgow Coma Scale eye response score on arrival to the hospital also did not predict visual loss outcome (P=0.793).ConclusionThere has been a dearth of research into gun trauma and even less research on the visual outcomes following gun trauma. Our study finds that survivors of gun trauma to the head suffer long-term visual damage 44% of the time after injury.

Disparities in Vision Health and Eye Care

“…200,201 Limited data are available on the long-term visual outcomes of ocular trauma, but it is estimated that FAOI results in permanent visual loss in 44% of cases. 202 One study demonstrated that Black patients represent the majority of patients who undergo enucleation or evisceration after severe ocular trauma. 197 Furthermore, the average age at eye removal is also younger among Black and Hispanic patients than among White patients.…”

Which Individuals with Positive Family History of Gastric Can-cer Urgently Need Intensive Screening and Eradication of Heli-cobacter Pylori? A Systematic Review and Meta-Analysis

“…According to the quality assessment of papers, 15 studies ( 24 – 27 , 29 , 30 – 35 , 39 , 45 ,, 48 , 51 ) were considered as “high quality”; 10 studies ( 23 , 28 , 36 – 38 , 40 – 43 , 52 ) were assigned as “fair to good quality”, and 5 studies ( 44 , 46 , 47 , 49 , 50 ) were regarded as low quality.…”

“…Most registries evaluated also used terminologies and International Classification of Diseases System (Ocular Trauma Score, Birmingham Eye Trauma Terminology) to name, define and classify eye injuries ( 24 – 27 , 31 , 32 , 34 , 36 , 39 , 43 , 44 , 49 , 50 ) while only four registries have used the International Classification of Diseases Ninth Revision (ICD-9) coding systems. The International Classification of Diseases (ICD-10)) was used for classifying variety of injuries, medical interventions and treatments for eye injuries ( 30 , 31 , 33 , 37 , 40 ). The minimum data sets in the studied registries were classified into 12 data classes.…”

Terroristic sniper shot ocular injuries: military and police casualties: case series

“…Another possible cause of limited reports about GSOI and visual results could arise from accompanying serious brain injury and neurologic complications, limiting the degree of ocular testing that can be performed. A 2018 study about ocular gunshot trauma and ophthalmic outcomes reported that 44% of patients (8 of 18) suffered from long-term visual damage 3. Of the 915 victims of gun trauma to the head described, 27 (3.0%) sustained ocular injuries but only 18 (67%) individuals survived 3.…”

“…A 2018 study about ocular gunshot trauma and ophthalmic outcomes reported that 44% of patients (8 of 18) suffered from long-term visual damage 3. Of the 915 victims of gun trauma to the head described, 27 (3.0%) sustained ocular injuries but only 18 (67%) individuals survived 3. The authors found that neither the location of injury nor the type of gun used predicted visual loss outcome.…”