Gun-related eye injuries: A primer

Erickson, Benjamin P.; Feng, Paula W.; Ko, Marcia G.; Modi, Yasha S.; Johnson, Thomas E.

doi:10.1016/j.survophthal.2019.06.003

Cited by 11 publications

(4 citation statements)

References 77 publications

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“…According to the US Eye Injury Registry Database GSWs account for only 7.4% of all penetrating injuries to the eye 34 . Ocular injuries occur in almost 30% of GSWs to the H&N and half result in permanent visual deficit 35 . This is higher than our report of eye injury reported here as 14.4%, which of course only includes inpatient hospital admissions.…”

Section: Discussioncontrasting

confidence: 60%

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A Nationwide Analysis of Gunshot Wounds of the Head and Neck: Morbidity, Mortality, and Cost

Menezes

Batra

Zhitny

2023

Journal of Craniofacial Surgery

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Background: Gun violence in the United States rose continuously from 2010 to 2022, spiking during the pandemic, and peaking in 2021 at 48,830 deaths (14.8 per 100,000). Previous reports investigated health and financial burden associated with gunshot wounds (GSWs) during 2004 to 2013; however estimates related specifically to head and neck (H&N) injuries have been lacking. This population-based study aims to examine incidence, morbidity, mortality, and health resource utilization of H&N injuries utilizing the Nationwide Inpatient Sample database. Methods: A population-based study was undertaken using the National (Nationwide) Inpatient Sample (NIS) database (2015Q4-2017Q4). The International Classification of Diseases, Tenth Revision (ICD-10) codes were used to create a composite variable (inclusive of brain, eye, facial nerve, and facial fractures) resulting from GSW to the H&N. Incidence per 100,000 hospitalizations and case fatality rates were calculated to determine the health burden of H&N injuries. Length of hospital stay, and inflationadjusted hospital charges were compared among H&N and non-H&N injuries. Χ 2 (classical and bootstrapped) and Mann-Whitney tests were used to compare groups. Results: Of 101,300 injuries caused by firearms, 16,140 injuries (15.9%) involved H&N region. The average incidence of H&N injuries was 20.1 cases per 100,000 hospitalizations, with intentional injuries having the highest case fatality rates of 32.4%. Patients with H&N injuries had extreme loss of function (33.4% versus 18.3%, P < 0.001) and extreme likelihood of mortality (27.0% versus 11.3%, P < 0.001) than non-H&N injuries. Statistically significant differences in the median length of stay (4.8 d versus 3.7 d; P < 0.001) and median inflationadjusted hospital charges ($80,743 versus $58,946, P < 0.001) were found among H&N and non-H&N injuries. Conclusions: Injuries due to GSW remain an inordinate health care and financial burden, with trauma to the H&N carrying an especially high cost in dollars, morbidity, and mortality.

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Section: Discussioncontrasting

confidence: 60%

“… 34 Ocular injuries occur in almost 30% of GSWs to the H&N and half result in permanent visual deficit. 35 This is higher than our report of eye injury reported here as 14.4%, which of course only includes inpatient hospital admissions.…”

Section: Discussioncontrasting

confidence: 60%

A Nationwide Analysis of Gunshot Wounds of the Head and Neck: Morbidity, Mortality, and Cost

Menezes

Batra

Zhitny

2023

Journal of Craniofacial Surgery

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“…Although less frequent than other causes of ocular trauma, firearm-associated ocular injuries often is associated with poor visual outcomes. [ 10 ] In one of the few epidemiologic studies, Chopra et al . found that 44% of patients from two New York City hospitals who survived firearm injury suffered a long-term visual disability.…”

Section: Introductionmentioning

confidence: 99%

Utilization of Ophthalmic Management in Patients with Head-and-Neck Trauma Secondary to Firearms

Niear

Tang

Nguyen

et al. 2023

Journal of Emergencies, Trauma, and Shock

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Introduction: This retrospective cohort study presents the epidemiology of severe firearm-related ophthalmic injury and the level of ophthalmology involvement in the multidisciplinary management of head-and-neck gunshot injuries. Methods: A retrospective study identified 207 patients with firearm-related injuries involving the head and neck treated at an Academic Tertiary Care Institution from 2010 to 2020. Results: Ophthalmology consulted on 29% of patients with head-and-neck firearm injuries. At least one of the services managing facial trauma (plastic surgery and otolaryngology) consulted on 71.5% of cases (P < 0.001). Of patients evaluated by ophthalmology, 93.3% survived to discharge; 78.2% of patients who were not evaluated survived to discharge (P = 0.009). Ophthalmology consulted on all patients with open globe injury (10.6%) (P < 0.001), all of which were evaluated by the facial trauma service (P = 0.002), 77.3% by otolaryngology (P = 0.42), 50% by neurosurgery, 36.4% by plastic surgery, 13.6% by orthopedic surgery, and 4.5% by vascular surgery. Ophthalmology consulted on 76.5% of patients with orbital fracture (32.9%) (P < 0.001); 83.8% were evaluated by the facial trauma service (P = 0.006), 69.1% by otolaryngology (P = 0.014), 54.4% by neurosurgery, 27.9% by plastic surgery, 10.3% by orthopedic surgery, and 2.9% by vascular surgery. For patients with orbital fractures, 92.3% survived when ophthalmology was consulted (P = 0.698); 43.8% survived when not consulted (P = 0.001). Conclusions: Firearm-related injuries of the head and neck frequently involve ocular and orbital structures, often causing serious vision-threatening injuries. Multispecialty management is common and early ophthalmology specialist evaluation and co-management are indicated to best identify ophthalmic injuries.

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“…ткрытая травма глаза (ОТГ) -наиболее частый результат многофакторного воздействия огнестрельного оружия на орган зрения. В начале ХХI века отмечен рост подобного вида травмы при боевых действиях и на производстве [1][2][3]. Для разработки новых методик лечения огнестрельной ОТГ необходимы экспериментальные модели, которые были бы стандартизированы, воспроизводимы, с возможностью прогнозирования течения и повторяемости исходов.…”

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Standardized experimental model of a gunshot open globe injury type A (without foreign body)

Kolbin¹,

Churashov²,

Kulikov³

et al. 2020

Medical news of the North Caucasus

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Военно-медицинская академия им. С. м. Кирова, Санкт-петербург, Российская Федерация 2 Главный военный клинический госпиталь им. академика Н. Н. Бурденко, филиал № 1, москва, Российская Федерация sTandardiZed eXperimenTal model of a gunshoT open gloBe inJurY TYpe a (WiThouT foreign BodY) Kol'bin a. a. 1 , churashov s. V. 1 , Kulikov a. n. 1 , Volkov V. V. 1 , Troyanovskiy r. l. 1 , danilichev V. f. 1 , Kopylov r. r. 1 , Kanevsky B. a. 2 1 s. m. Kirov military medical academy, st. petersburg, russian federation 2 Branch № 1 of n. n. Burdenko main military clinical hospital, moscow, russian federation Представлены результаты работ по созданию стандартизированной модели огнестрельной открытой травмы глаза (ОТГ) без внутриглазного инородного тела (ОТГ типа А) на основе пулевого ранения глаза кролика-кадавера, нанесенного снарядом из пневматического оружия. В ходе 4 серий экспериментов выполнен подбор параметров выстрелов в зависимости от энергетических, аэродинамических характеристик и массы снаряда. Проанализированы данные скоростей различных видов смоделированных и стандартных снарядов, характера их поведения при встрече с мишенью (пластилин, глаза кадаверов), вида полученных травм. По итогам работ модернизирован снаряд, определены параметры выстрела, удовлетворяющие требованиям создания модели огнестрельной ОТГ типа А. Выстрелы производились в зону склеры в 2-3 мм от лимба, с расстояния 30 см, модернизированным снарядом массой 0,54-0,55 г, после двух компрессий насоса пневматической винтовки, что обеспечивало скорость снаряда от 41 до 46 м/с. Получена модель ОТГ типа А (проникающее ранение без внутриглазного инородного тела (ВГИТ)), которая по характеру и степени повреждений анатомических структур глазного яблока аналогична огнестрельной ОТГ. Ключевые слова: пневматическая установка, стандартизированная экспериментальная модель, огнестрельная открытая травма глаза The paper presents the results of work on the creation of a standardized model of a gunshot open eye injury without an intraocular foreign body (open eye injury type A) based on a bullet wound to the eye of a cadaver rabbit caused by a projectile from an air weapon. In the course of 4 series of experiments, the parameters of shots were selected depending on the energy, aerodynamic characteristics and mass of the projectile. Data on the speeds of various types of simulated and standard projectiles, the nature of their behavior when meeting a target (plasticine, cadaver eyes), and the type of injuries were analyzed. According to the results of the work, the projectile was modernized, the parameters of the shot were determined that meet the requirements for creating a model of a type A firearm open eye injury. Shots were fired into the sclera zone 2-3 mm from the limb, from a distance of 30 cm, with a modernized projectile weighing 0.54-0.55 g, after two compressions of the air rifle pump, which provided the projectile speed from 41 to 46 m/s. A type A open eye injury Model (penetrating wound without an intraocular foreign body) was obtained, which is simila...

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Gun-related eye injuries: A primer

Cited by 11 publications

References 77 publications

A Nationwide Analysis of Gunshot Wounds of the Head and Neck: Morbidity, Mortality, and Cost

A Nationwide Analysis of Gunshot Wounds of the Head and Neck: Morbidity, Mortality, and Cost

Utilization of Ophthalmic Management in Patients with Head-and-Neck Trauma Secondary to Firearms

Standardized experimental model of a gunshot open globe injury type A (without foreign body)

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