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 attr ibutable 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 af filiated Children's Hospital of Eastern Ontario (Ottawa), Ottawa Gener al Hospital and Ottawa Civic Hospital. In addition, information on air gun injuries from April 1990 to December 1993 was obtained from the C anadian Hospitals Injury Reporting and Prevention Program (CHIRPP) dat abase, with data from 10 pediatric and 5 general hospitals across Cana da. Patients: All patients aged 18 years or less who underwent enuclea tion between Jan. 1, 1974, and Dec. 31, 1993. Results: Eighty-five pat ients were identified as having undergone enucleation. Trauma accounte d for 51 cases (60%), of which 13 (25%) were caused by air guns, the l argest single cause of enucleation secondary to trauma. Overall, air g un injuries accounted for 15% of enucleation procedures, whereas retin oblastoma 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 injur ies 7 had ocular perforation and 6 had ocular penetration, In all case s the intraocular structures were severely disrupted. The CHIRPP datab ase 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 muzz le velocities capable of causing death or serious injury, especially t o the eye. We feel that air guns should be licensed only to people age d 16 to 18 years or older and that education in their use should be ma ndatory.