Air guns: the main cause of enucleation secondary to trauma in children and young adults in the greater Ottawa area in 1974-93.

OBJECTIVES

To determine the proportion of enucleation procedures attributable to injuries from air guns in people aged 18 years or less and to identify the associated pathological findings.

DESIGN

Case series.

SETTING

Ophthalmic Pathology Registry, University of Ottawa, and affiliated Children's Hospital of Eastern Ontario (Ottawa), Ottawa General Hospital and Ottawa Civic Hospital. In addition, information on air gun injuries from April 1990 to December 1993 was obtained from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database, with data from 10 pediatric and 5 general hospitals across Canada.

PATIENTS

All patients aged 18 years or less who underwent enucleation between Jan. 1, 1974, and Dec. 31, 1993.

RESULTS

Eighty-five patients were identified as having undergone enucleation. Trauma accounted for 51 cases (60%), of which 13 (25%) were caused by air guns, the largest single cause of enucleation secondary to trauma. Overall, air gun injuries accounted for 15% of enucleation procedures, whereas retinoblastoma accounted for 21%. All air gun injuries were in boys (median age 14 years, range 9 to 16 years). Of the 13 eyes with air gun injuries 7 had ocular perforation and 6 had ocular penetration. In all cases the intraocular structures were severely disrupted. The CHIRPP database included 165 air gun injuries; 32 were to the eye or ocular adnexa, resulting in 26 hospital admissions.

CONCLUSIONS

Air guns were the largest single cause of enucleation secondary to trauma in our study. These guns are widely available in Canada and are unrestricted at muzzle velocities capable of causing death or serious injury, especially to the eye. We feel that air guns should be licensed only to people aged 16 to 18 years or older and that education in their use should be mandatory.