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 Researchers examined data on 8,715 firearm-related eye injuries
reported to the National Trauma Data Bank, the largest national
registry of hospitalized trauma cases in the U.S., between 2008 and
2014. Overall, 1,972 cases, or almost 23%, involved patients under
21, and 12.2% of these patients died in the hospital.
"Males, adolescents and black patients were disproportionately
affected," said Dr. Joyce Mbekeani, senior author of the study and a
researcher at Jacobi Medical Center and Montefiore Medical
Center/Albert Einstein College of Medicine in New York City.
"Most injuries were sight-threatening and associated with severe
injury-severity scores and traumatic brain injury and due to
assault," Mbekeani said by email.
Firearm injuries are what's known as penetrating traumas, and
patients generally have a high risk of severe and disabling
injuries, researchers note in JAMA Ophthalmology.
Common eye injuries in these cases included ruptured globe and open
wounds or fractures around the eye area, but optic nerve and visual
pathway damage had the greatest association with severe injuries and
brain injuries.
"Firearm-related eye injuries caused by high-velocity, penetrating
projectiles to the head can be expected to result in visual
impairment," Mbekeani said. "Pediatric patients are more vulnerable
to head injuries than adults and survivors have potential for
lifelong disability and compromised physical, academic and social
development."
Young victims in the study were 15 years old, on average, and 85%
were male.
Roughly 39% of the injuries occurred at home; another 25% happened
in the street.
Patients up to age 3 were more than four times as likely to
experience accidental, rather than intentional, injuries. They were
also more than five times as likely to be injured at home versus
other locations.
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The oldest study subjects - teens and young adults ages 19 to 21 -
were more than twice as likely to be injured in assaults compared to
other situations causes of injury and 61% more likely to be injured
in the street compared to other locations.
Black patients were more than four times as likely to be injured in
assaults compared with other causes, and white patients were more
than seven times as likely to have self-inflicted injuries, the
study also found.
One limitation of the study is that it only included patients who
were admitted to the hospital or were pronounced dead upon arrival,
not people who died from their injuries in the field, the study team
notes. This may underestimate the number or severity of
firearm-related eye injuries.
Still, the results expand on previous research on gun injuries tied
to recreational activities like paintball and target shooting, said
Joseph Canner, co-author of an editorial accompanying the study and
a researcher at Johns Hopkins University School of Medicine in
Baltimore. The current study includes only injuries from traditional
firearms that use gunpowder to discharge bullets.
"Eye injuries due to powder guns can be extremely destructive and
cause significant disability," Canner said by email. "Moreover,
these injuries can occur in a variety of settings, including (among
others) accidental discharge while a child is playing with an
adult's gun, accidental discharge while an adult is using a gun in
the presence of a child, attempted suicide using an adult's gun, and
as an innocent bystander in an attempted homicide."
SOURCE: https://bit.ly/35H47rZ and https://bit.ly/2VOg3Dq JAMA
Ophthalmology, online October 10, 2019.
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