Carbide gun eye injuries ahead of the festival season, and why returning DME patients with stable vision gain little from retreatment

The edition in brief

In ten days of October 2025, one Indian tertiary eye centre treated 37 patients injured by improvised calcium carbide guns. All were male, median age 15, injured at home mostly while inspecting a device that had failed to fire; 65% had severe (Dua grade IV to VI) burns with deep stromal calcium deposits. Early amniotic membrane transplantation was done in 81%, and vision improved from mean logMAR 2.09 to 0.80 at one week, but severe burns showed early limbal stem cell deficiency by four weeks. In a registry of 976 patients with diabetic macular oedema who returned after six months or more lost to follow-up, those whose vision had held steady gained vision with retreatment far less often than those who had worsened (32.7% vs 62.0%), and those returning at 20/50 or better did not gain vision. In a UK paediatric service, 41% of children tested for anti-adalimumab antibodies were positive, positivity was more common without full-dose methotrexate (52.4% vs 21.1%), and titres fluctuated on repeat testing. A meta-analysis of 16 studies found greater pigment epithelial detachment height (by about 212 µm) and area associated with RPE tears in neovascular AMD, on very low-certainty evidence. The pearl: irrigate a chemical eye injury before anything else.