The edition · Ophthalmology
Carbide gun eye injuries: severe burns in teenage boys, ahead of another festival season
An Indian centre saw 37 carbide gun eye injuries in ten days last October, two-thirds of them severe. Plus ocular surface toxicity from HER2 antibody-drug conjugates and organism-specific outcomes in endogenous endophthalmitis.
The edition in brief
Today's ophthalmology edition ends on an Indian outbreak. An ambispective study in the Indian Journal of Ophthalmology (2 October) describes 37 patients with carbide gun eye injuries seen at one tertiary centre over ten days in October 2025. All were male, median age 15, injured at home, mostly while looking into the device after it failed to fire. Almost two-thirds had severe burns (Dua grade IV–VI) with deep stromal calcium deposits; 81% had early amniotic membrane transplantation, vision improved at one week, and early limbal stem cell deficiency appeared in severe burns by four weeks. A prospective study of 21 patients receiving HER2-targeted antibody-drug conjugates found ocular surface toxicity in 86%, starting about four weeks in, with vortex keratopathy and corneal nerve loss that was partly reversible. A 12-year multicentre cohort of 305 eyes with culture-positive endogenous endophthalmitis found presenting vision the strongest predictor of outcome, and enucleation most frequent with gram-negative organisms, especially Serratia. A population study of 1,224 Hispanic/Latino adults with diabetes found retinopathy in 34.7% and linked hypertension to sight-threatening disease. The pearl is irrigating first and examining second.
HER2 antibody-drug conjugates caused ocular surface toxicity in most patients, starting at about four weeks
Examine the ocular surface of patients on HER2 antibody-drug conjugates within the first month, and treat dry eye and keratopathy early.
Endogenous endophthalmitis: presenting vision predicted outcome; Serratia carried the highest risk to the eye
In endogenous endophthalmitis, blood cultures and the systemic source often guide treatment more than eye samples, and gram-negative infection carries the highest risk to the globe.
One in three Hispanic/Latino adults with diabetes had retinopathy, and hypertension tracked with sight-threatening disease
At diabetic eye screening, check and act on blood pressure; hypertension was linked to sight-threatening retinopathy.
Chemical eye injury: irrigate first, examine second
Irrigate a chemical eye injury at once, clear the fornices of particles, and continue until the pH is neutral.
Carbide gun injuries: two-thirds were severe burns in teenage boys looking into a misfire
Treat carbide gun eye injuries as severe chemical burns — irrigate, grade, consider early amniotic membrane — and warn families before the festival season.
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