Pages: 24-34

Abstract

Background- Pellets are destructive when they enter into the eye. They are categorized into lead and non-lead based on substances they are manufactured with. The latter, are usually made of steel, tin or plastic materials. Since Lead pellets (LP) possess appropriate weight, targeting accuracy, malleability, density and affordability, they are the most common item to be used. Considering their head shape, they are divided into wad cutter, pointed, round-nose and hollow-point pellets. Many studies have been carried out concerning ocular trauma, but none has focused in details on ocular pellet gunshots in Northern India. To fill in this gap in knowledge, we evaluated all the negative impacts of pellet to the eye in a cross section of patients from Kashmir, a conflict zone in Northern India. Aim- To assess detrimental effects of ocular pellet injury and their management in a cohort of Indian patients who visited our hospital from Kashmir. Material and Method- Records of all patients who had ocular pellet injury (OPI) from 2014 to 2016 were reviewed retrospectively for effects of pellet injury on the eye and their management. Patients’ demographic data, indications for surgery, initial and last best corrected visual acuities (BCVA), complications, number of surgeries and length of follow up were collected and analyzed. Results- 33 eyes of 32 patients (30 males and 2 females) were identified. Mean age at presentation was 19.9+5 years (range 10-35 years) with a mean follow up period of 6.6+4 months (range 1 to 18 months). 54.55%, 42.42% and 3.03% of eyes had improvement, maintenance and worsening of the final BCVA, respectively. Eleven (33.33%) of 33 eyes had postoperative complications with ocular hypertension being the most common. Conclusion- OPI causes serious visual decline due to vitreous hemorrhage, cataract and retinal detachment. Although visual prognosis depends massively on presenting BCVA, location of pellet, exit wound on the retina and type of pellet, and it is generally guarded. Patients should know about