Carbide gun injuries: severe ocular burns in boys, with limbal damage emerging by four weeks

Design

Ambispective case series from an acute outbreak

Population

37 male patients (median age 15) with carbide gun ocular trauma, one Indian centre

Primary outcome

Clinical profile and short-term visual and corneal outcomes

Effect

Severe burns 64.8%; BCVA logMAR 2.09 → 0.80 at 1 week; early LSCD in severe burns at 4 weeks

An Indian tertiary eye centre described 37 patients seen over 10 days in October 2025 with injuries from carbide guns — improvised devices in which calcium carbide and water produce gas that is ignited to make a bang. All were male, median age 15, and every injury happened at home, usually when the user looked into the device after it failed to fire.

The right eye was involved in 89%. Two-thirds (64.8%) had severe ocular surface burns (Dua grade IV–VI), with deep stromal calcium deposits and corneal oedema. Early amniotic membrane transplantation was done in 81%. Mean vision improved from logMAR 2.09 to 0.80 within a week, and corneal thickness fell from about 799 to 538 µm, but early limbal stem cell deficiency was already visible in severe burns at four weeks.

This is a short-term descriptive series without a comparison group, so it cannot show that amniotic membrane changed the long-term result. It does show the pattern and severity to expect. With the festival season approaching, eye departments and emergency teams should be ready for these injuries and should be part of the warning to families.

• Expect carbide gun injuries in adolescent boys during the festival season, often in the dominant eye.
• Irrigate thoroughly and remove calcium carbide particles from the fornices before anything else.
• Consider early amniotic membrane transplantation for severe burns, as most patients in this series received it.
• Follow severe burns for limbal stem cell deficiency, which appeared within four weeks.
• Warn families and schools: injuries happened when users looked into a device that failed to fire.

Why it matters

These are new, preventable, blinding injuries in children that cluster in a predictable season.

Don't overread it

A short-term uncontrolled series — it does not show amniotic membrane improves long-term outcome.

The statistics, in plain English

A fall from logMAR 2.09 to 0.80 is a large early improvement, roughly from counting fingers to about 6/36. But there was no comparison group, and one week says nothing about long-term vision once limbal damage declares itself.

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