Carbide gun-related ocular trauma: Clinical profile and early management outcomes from an acute outbreak

To describe the clinicodemographic profile, early clinical findings, and short-term outcomes in patients with carbide gun-related ocular trauma.

This ambispective study included 37 patients presenting with carbide gun-related ocular trauma at a tertiary eye center over 10 days in October 2025. Demographic data, mechanism of injury, clinical findings, grading of ocular surface burns, adnexal involvement, and management details were recorded. The best-corrected visual acuity (BCVA) and corneal thickness (CT) were assessed at presentation and during follow-up. All patients were managed based on injury severity.

All patients were male with a median age of 15 years. All injuries occurred at home, predominantly during device inspection after ignition failure. The right eye was involved in 89.2%. Severe burns (Dua's grade IV-VI) were observed in 64.8%. Deep stromal calcium deposits and corneal edema were common. Early amniotic membrane transplantation (AMT) was performed in 81%. Mean BCVA improved from 2.09 ± 0.79 at presentation to 0.80 ± 0.44 logMAR at 1 week, and mean CT reduced from 798.5 ± 141.9 µm to 537.5 ± 39.7 µm. Early signs of limbal stem cell deficiency (LSCD) were seen in severe burns at 4 weeks. Most eyelid burns healed well with collagen sheet application.

Carbide gun-related ocular trauma causes severe, vision-threatening thermochemical ocular injuries predominantly in children and adolescents. Early AMT improves short-term outcomes, but severe grade burns carry a high risk of LSCD. Public awareness, regulation of calcium carbide availability, and social media control are needed to prevent avoidable blindness.