Gun Shot Wounds

Approximately half of the patients presenting themselves at the emergency department suffer from ocular trauma. The spectrum of eye injuries could vary from very mild to extremely serious resulting in blindness. One of the major causes of eye injuries in children is toys. Most of the parents do not consider eye safety while buying toys for their kids. Although marketed as game-playing devices intended to simulate real combat situation, toy guns are one of the biggest causes of toy related ocular injuries.

Some of the common eye injuries are caused by BB guns, airsoft guns, shot gun pellets and paint gun balls. BB gun and airsoft gun can easily destroy the eye and cause permanent damage to the eye. The BB gun can penetrate through the cornea and cause extremely gruesome damage to the eye.

The most common injuries caused by airsoft guns are to the anterior side of the eye and include hyphema, corneal abrasion and corneal edema. Hyphema is defined as the accumulation of blood in the portion between the cornea and the colored iris. If not treated on time, it can lead to glaucoma in later life. Corneal abrasion and corneal edema are also seen in two-thirds of the cases with airsoft gunshot injury.

Shot guns propel pellets with enough energy that can actually penetrate the {human} eye. As BB gun and pellet guns fire velocities at a much higher speed, they have the ability to produce eye tissue damage similar to that caused by conventional firearm. Air gun pellets cause an intense force over a small area of scleral surface, which can cause rupture of the underlying choroid and retina. Further damage can lead to vitreous and sub-retinal hhemorrhage along with damage to photo receptors.

Injury by the paintball can completely destroy the eyeball. Paintballs cause blunt trauma to the eye which can be severe enough to cause blindness.

Consequences of eye injury-

Eye injury by gunshot bullets can cause different types of symptoms depending upon the type of toy used.

• Iritis is defined as the inflammation of the colored part of iris and is caused by the blunt injury to the eye.
• Sclopetaria is defined as a contusion lesion of the retina caused from a BB or shot pellet.
• Traumatic cataract occurs seconding to penetrating trauma by the BB or air soft gun.
• Hyphema occurs when there is puddle of blood in the anterior chamber of the eye between the eyes and cornea.
• Globe rupture is a medical emergency characterized by full thickness injury to the cornea and sclera. It is caused by a penetrating object traveling at considerable velocity to perforate the globe directly.
• Traumatic optic neuropathy- Direct injury to the eye can damage the optic nerve and cause blindness