Mazhar Ishaq, Hannan Masud, Mushtaq Ahmad Baig.
Blunt Ocular Trauma by empty Bullet case.
Pak Armed Forces Med J Jan ;52(1):32-7.

Combat soldiers are not provided with protective goggles on the firing range and bullet case coming out of the rifle accidentally hits the eye of the coacher resulting in blunt ocular trauma. A retrospective study of the last five years was conducted in Combined Military Hospital Kharian and Military Hospital Rawalpindi. A total of 235 patients reported with blunt ocular trauma. Out of these, 24 patients were included in the study that gave history of blunt ocular trauma by empty bullet case while performing the dut of coacher on the firing range. All patients were male with an average age of 30 years. Visual acuity was reduced to counting fingers in 8 (33.33%), 6/60 in 10 (41.66%) and 6/36 in 6 (25%). Conjunctival laceration in 14 (58.33%), corneal abrasion in 22 (91.66%), hyphaema in 18 (75%), increased intraocular pressure in 10 (41.66%) and mydriasis in 8 patients (33.33%). Vitreous haemorrhage and avulsion of the vitreous base was seen in all of the 24 patients. Retinal dialysis was seen in supranasal quadrant in 14 (58.33%), infratemporal 6 (25%) and infranasal in 4 patients (16.66%). These patients were hospitalized and treated with cryotherapy, circumferential scleral buckling surgery and drainage of subretinal fluid. Postoperatively, retina was flat in all of the 24 patients with 100% success. Visual acuity improved to 6/12 in 14 (58.33%), 6/60 to 6/18 in 6 (25%) and counting finger in 4 patients (16.66%). Follow-up for an average period of twelve months showed that retina remained flat in all cases. We strongly recommend that single-piece polycarbonate eye shield should be used as a protective eyewear on the firing range as a prophylactic measure against blunt ocular trauma.

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