By Lisa Rapaport
(Reuters Health) – More than one in five victims hospitalized for gun-related injuries to the eyes are under 21 years old, a U.S. study suggests.
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.
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.