- Design
- Retrospective observational case series, single tertiary centre
- Population
- 20 eyes of 18 patients with carbide-gun thermochemical injury, India
- Primary outcome
- Epithelial healing, visual acuity and complications
- Effect
- All eyes epithelialised (mean 22.5 days); logMAR 1.77 to 0.77 at 3 months; repeat graft 21%
Carbide guns — improvised devices that ignite acetylene from calcium carbide and water — have become a cause of combined thermal and chemical eye injury during Diwali. An Indian tertiary centre reported 20 eyes in 18 patients, all male, mean age about 20, most injured using the device themselves.
All had immediate irrigation, grading by Dua's classification (median grade III), standard medical treatment and early overlay amniotic membrane transplantation. Every eye fully epithelialised, in a mean of about three weeks. Vision improved from logMAR 1.77 to 0.77 at three months and pain fell sharply. A fifth needed repeat membrane. No eye developed secondary glaucoma, but the one eye that presented late progressed to phthisis.
The series has no comparison group, so it cannot show that membrane grafting made the difference. What it does show is that these injuries are severe, alkaline as well as thermal, and that delay is costly. The festival season is the time to prepare emergency departments and warn families.
- Irrigate carbide-gun eye injuries immediately and check pH before examination.
- Grade the injury using Dua's classification to guide treatment.
- Consider early amniotic membrane transplantation for moderate to severe burns.
- Warn families and young people about carbide guns ahead of Diwali.
- Refer late presenters urgently; the only eye lost in this series presented late.
Why it matters
A new festival injury is producing severe burns in young men, and delay decides the outcome.
Don't overread it
With 20 eyes and no comparison group, the benefit of amniotic membrane cannot be separated from good overall care.
The statistics, in plain English
A fall in logMAR from 1.77 to 0.77 is roughly from counting fingers to about 6/36. Wide standard deviations show outcomes varied a great deal between eyes.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for ophthalmology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free