Carbide-gun explosions are burning adolescents' eyes

Design

Ambispective single-centre outbreak case series

Population

37 patients (all male, median age 15) with carbide-gun ocular trauma

Primary outcome

Clinical profile and short-term visual and corneal outcomes

Effect

Severe burns (Dua IV-VI) in 64.8%; vision 2.09 to 0.80 logMAR at one week after early amniotic membrane transplantation in 81%

Carbide guns, improvised noise-making devices powered by calcium carbide, cause severe ocular injury when they misfire and are inspected at close range. This outbreak series captured 37 such injuries presenting to one Indian tertiary centre over ten days in October 2025, around the festival season.

Every patient was male, with a median age of 15, and all were hurt at home, usually checking the device after an ignition failure. The right eye was involved in 89.2%, and severe ocular surface burns (Dua grade IV-VI) occurred in 64.8%, with deep stromal calcium deposits and corneal oedema common. Early amniotic membrane transplantation, done in 81%, was followed by improvement in mean vision from 2.09 to 0.80 logMAR at one week and a fall in corneal thickness, but early limbal stem cell deficiency appeared in severe burns by four weeks.

The clinical message is to treat these as serious thermochemical injuries: immediate irrigation, early grading, and early amniotic membrane transplantation for significant burns, with counselling that severe grades threaten long-term vision. The larger message is prevention, through awareness and regulation of calcium carbide sold for these devices.

• Outbreak of 37 carbide-gun ocular injuries at one Indian centre over ten days in the festival season.
• All patients were male, median age 15, and all were injured at home inspecting a misfired device.
• Severe ocular surface burns (Dua grade IV-VI) occurred in 64.8%, with deep corneal calcium deposits.
• Early amniotic membrane transplantation (81%) improved short-term vision (2.09 to 0.80 logMAR at one week).
• Severe burns still risked limbal stem cell deficiency; prevention and regulation are the real fix.

Why it matters

It identifies a specific, preventable cause of festival-season blindness in children and adolescents that regulation and awareness could stop.

Don't overread it

This was a short-term, single-centre case series; early amniotic membrane transplantation improved vision at one week, but severe burns still carry a high risk of long-term limbal stem cell deficiency and vision loss.

The statistics, in plain English

These are short-term outcomes from a small single-centre outbreak series, so the early visual improvement is encouraging but does not capture the long-term toll of limbal stem cell deficiency seen in the worst burns.

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