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ARTICLES
Year : 1978  |  Volume : 26  |  Issue : 3  |  Page : 17-18

Retained intra-ocular foreign body from bursting of the barrel of a gun


Reader in Ophthalmology, Medical College, Jodhpur (Raj.), India

Correspondence Address:
A S Mehrotra
Reader Ophthalmology, Medical College, Jodhpur, (Raj.)
India
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Source of Support: None, Conflict of Interest: None


PMID: 738774

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How to cite this article:
Mehrotra A S, Ignatius N K. Retained intra-ocular foreign body from bursting of the barrel of a gun. Indian J Ophthalmol 1978;26:17-8

How to cite this URL:
Mehrotra A S, Ignatius N K. Retained intra-ocular foreign body from bursting of the barrel of a gun. Indian J Ophthalmol [serial online] 1978 [cited 2019 Dec 14];26:17-8. Available from: http://www.ijo.in/text.asp?1978/26/3/17/31190

Though rare but, sometimes in civil life also, there are war like injuries. A variety of substan­ces, magnetic and non magnetic, may penetrate the eye. Of these, steel and iron from hammer and chiesel are common in civil life[2],[3]. Fragments entering the eye as a result of explosion are rare in civil experience[2]. The features of eye injuries are markedly variable, depending upon the cir­cumstances which cause them, and may present any degree of tissue damage from a miniature abrasion to complete disruption of the eye[3].

Here is a civil case similar to military injury, though caused by a gun, but not by the bullet. It was bursting of the barrel of an old gun which acted like a shell injuring the eye of the patient as well as causing injury to some others standing close by.


  Case Report Top


M.A., aged 22 yrs. was admitted on 6.6.77 to the emergency with the history of injury both eye, and fore-head while firing with a gun 50-60 yrs. old. He used to fire with this gun earlier too but on the day of accident when the patient was firing the gun, after load­ing it with gun powder and some lead balls on a group of birds, the barrel of the gun suddenly burst out with a loud noise injuring his eye and face. Three of his friends, standing nearby, also got minor injuries and were discharged from O.P.D. after necessary treatment, and dressing.

On examination in O.P.D. lacerations were seen on the right eyebrow, both lids of the right eye, left eyebrow, left upper lid and the middle of fore-head. Right eye showed much chemosed conjunctiva, lacerated and hazy cornea, and lacerated sclera covered with the conjunctiva. The deeper details of the eye could not be seen in the out-door. There was no perception of the light in this eye. On the fore-head there was a horizontal cut in skin and the muscle layers exposing the bone from the root of the nose to left eyebrow. Also there was a cut in the middle of the left upper lid. Left eye was normal.

X-Rays of the orbits were taken and a huge big radio-opaque shadow was seen in the P.A. and lateral views of the right No fracture was detected. [Figure - 1].

The patient was taken to the operation theatre and was operated under general anaesthesia. While exploring the right eye, multiple cuts in the cornea and the sclera were seen. The conjunctiva was undermined and cornea with 4-5 mm. of the adjoining lacerated sclera was excised. The foreign body could now be seen easily. This was occupying almost whole of the cavity of the right eye ball. It was removed from the eye ball. The foreign body measured 25x24x8 mm. in size. No cut could be seen in the posterior wall of the eye ball so the remaining uveal tissue was curetted from the eye ball and the scleral wound was stitched by 4 (O) chromic cat-gut. The conjunctiva was stitched by 6 (O) silk continuous sutures.

Lids and fore-head wounds were stitched in layers and dressing was done. Right eve was packed with gauze and Terramycin ointment (Photo No. 3). Patient was put on systemic antibiotics and anti-inflammatory drugs. The swelling gradually subsided in two weeks time. The patient was discharged and was followed for one month after which he was advised for the prosthesis.


  Discussions Top


The commonest intra-ocular foreign body, in civil life is from hammer and chise[2],[3]. The size of usual matalic foreign body varies from 25 to 2mm[1]. It is quite rare to see a big foreign body in the eye. Stallard (1976) reported foreign bodies ranging from less than I mm. to 12x8x4 mm. in size, where as Sorsby (1972) reported average size of foreign body to be 15.2 mm 3 with range from 0.58 to162 mm 3 from machine tool accidents.

The present case is peculiar in itself mainly due to the type of injury and size of foreign body. Such type of gun shot injury is quite rare in the civil or even in the military life, i.e. one caused by the bursting of a gun barrel. The size of foreign body is still another important factor in this case. It meas­ured 25x24x8 mm. and was occupying almost the whole cavity of the eye ball. Such a big foreign body can not enter the eye ball unless it comes with a very great velocity. It is therefore perhaps the biggest foreign body as compared to the foreign bodies reported by others.


  Summary Top


A case report of a unusually big metallic intra-ocular foreign body (25x24x8 mm.), which entered the right eye ball from bursting of the barrel of an old gun while shooting. Such a big size of a foreign body perhaps has not been reported earlier.

 
  References Top

1.
Duke-Elder, 1972, System of Ophthalmology, Henry Kimpton. P. 481. vol xiv part I, London.   Back to cited text no. 1
    
2.
Sorsby, A. 1972, Modern Ophthalmology, 3, Butterworth, London. 457.  Back to cited text no. 2
    
3.
Stallard, H.B., 1976, Eye Surgery, John Wright & Sons, London. 772.  Back to cited text no. 3
    


    Figures

  [Figure - 1], [Figure - 2]



 

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