Perforating BB gun injuries of the globe

BACKGROUND AND OBJECTIVE: To determine the visual and anatomic outcomes of eyes with perforating BB gun injuries. PATIENTS AND METHODS: The authors reviewed the surgical management and final visual outcome of seven patients with BB gun-related perforating injuries of the globe seen by them between 1980 and 1995. Six patients underwent surgery, and one patient refused intervention and was lost to follow-up. Scleral buckles, lensectomies, and vitrectomies were performed in these six cases. RESULTS: Five patients had a final visual acuity of 5/200 or better, with four patients achieving 20/200 or better and two of them having 20/70 or better. A posterior perforation involving the macula or an area-temporal to the macula was associated with poor visual outcome. The visual acuity and the relative afferent pupillary defect at presentation or after the initial repair did not correlate with the final visual outcome. In addition, the presence of subretinal blood did not necessarily portend a poor prognosis in these young patients. CONCLUSIONS: At least some eyes with perforating injuries can retain good visual acuity with aggressive surgical management using modern vitrectomy techniques. Visual acuity should nor necessarily be used as the only exclusion criterion for intervention or enucleation.