Lens subluxation after use of a percussion massage gun: A case report

Abstract

Rationale: To report the first case of lens dislocation and secondary acute angle-closure glaucoma (AACG) following use of a percussion massage gun (PMG) around the eye.Patient concerns: A 69-year-old Chinese man had been using a PMG around his right eye for 2 months in order to relieve headache. After eye pain and blurred vision for 5 days, he went to the ophthalmological emergency department. His bestcorrected visual acuity at distance was counting fingers. Diagnosis:The patient was diagnosed with lens subluxation, secondary AACG and pterygium in the right eye. Cataracts were diagnosed in both eyes. Interventions:The patient underwent phacoemulsification and anterior vitrectomy. After surgery, the patient was given eye drops containing tobramycin, dexamethasone, 0.1% bromfenac sodium hydrate ophthalmic solution and Mydrin-P for 1 month.Outcomes: At 3-month follow-up, uncorrected visual acuity in the right eye was counting fingers. The outcome of optometry in the right eye was +11.50 DS/−0.50 DC * 110°, with corrected-distance visual acuity of 4/20. IOP was 20.7 mm Hg in the right eye and 15.7 mm Hg in the left. Endothelium in the right cornea showed endothelial damage. Nevertheless, the patient reported no right eye pain anymore, and he indicated that he was satisfied with his situation.Lessons: Caregivers, sports professionals and the general public should be aware of the dangers of PMGs and the need to use them appropriately and safely, for example during self-massage and rehabilitation therapy. In particular, we recommend not using PMGs above the neck, which should be clearly indicated in instruction manuals.Abbreviations: AACG = acute angle-closure glaucoma, AS-OCT = anterior segment optical coherence tomography, IOP = intraocular pressure, PMG = percussion massage gun, UBM = ultrasound biomicroscopy.

Consumer Perceptions of Home-Based Percussive Massage Therapy for Musculoskeletal Concerns: Inductive Thematic Qualitative Analysis

“…While this percussive massage therapy device has specific safety and user education components, including a user manual and automatic shutdown feature, it is imperative to further evaluate the safety and efficacy of such unregulated, at-home modalities. Previous case reports have discussed the consequences of inappropriate usage of these devices, which include rhabdomyolysis, vertebral artery dissection, and lens dislocation alongside secondary acute angle-closure glaucoma [ 49 - 51 ]. When considering at-home therapy options such as percussive massage therapy, users may not have essential medical knowledge and therefore may be unaware of certain anatomical structures including tissue, bones, and vasculature.…”

“…While this percussive massage therapy device has specific safety and user education components, including a user manual and automatic shutdown feature, it is imperative to further evaluate the safety and efficacy of such unregulated, at-home modalities. Previous case reports have discussed the consequences of inappropriate usage of these devices, which include rhabdomyolysis, vertebral artery dissection, and lens dislocation alongside secondary acute angle-closure glaucoma [49][50][51].…”

“…This highlights the possibility of a lack of user education as well as unregulated use of the device. The authors of the noted case reports equally advocated for detailed evaluation of the safety of such devices in order to better define guidelines for indications and contraindications [49][50][51]. More comprehensive user education of at-home percussive massage therapy may dissuade such inappropriate usage and consequential traumatic complications while contributing to greater beneficial impacts.…”

Traumatic cataract induced by improper use of a percussion massage gun

“…4 Concurrently, utilization of massage guns on and around the eyes have led to a number of adverse ocular events, including lens subluxation, acute angle closure glaucoma, retinal detachment, and iris neovascularization. 5 , 6 , 7 , 8 , 9 Here, we report a case of traumatic cataract caused by improper use of a percussion massage gun around the periorbital area, highlighting the severe danger this product imposes on ocular health.…”

The Effects of Massage Guns on Performance and Recovery: A Systematic Review

“…While massage guns are generally considered safe, there are some contraindications or situations where their use may not be recommended [49,59,[76][77][78][79][80]: (1) recent scars, open wounds, sunburns, rashes, bruises, bleeding or skin infections, as this can further damage the affected tissue(s) and increase the risk of infection; (2) recent fractures or bone chronic conditions (such as osteoporosis or rheumatoid arthritis), as the percussive force can interfere with the healing process or increase the risk of fracture; (3) deep-vein thrombosis or blood clotting disorders, as the pressure might dislodge blood clots and cause serious health complications; (4) diabetes and neuralgias, as it can result in numbness or loss of sensation, limiting the detection of further injury; (5) avoid using on sensitive areas of the body, such as the face, eyes, ears, head, neck, chest, spine, superficial nerves and vessels, or surgery/joint replacement (plates, metal pins, corneal or cochlear), as this can lead to serious injury and pain; (6) do not use repeatedly and aggressively, on the same area, for long periods of time (e.g., >30 min), as it can lead to muscle fiber damage, blood vessel dissections and internal bleeding (such as intra-muscular, hemartrosis, hemothorax or rhabdomyolysis); (7) for some medical conditions, its use can also be limited, such as pregnant women, fibromyalgia, migraines, hernias, hypertension, epilepsy, cancer/tumor, seizures or individuals with an implanted medications or medical devices (such as a pacemaker).…”