Childhood ocular trauma in the Copenhagen area from 1998 to 2003: eye injuries caused by airsoft guns are twice as common as firework‐related injuries

Editor, Children suffer from different forms of ocular trauma than adults. Saudi Arabian children have been shown to be at risk of serious eye injuries from running into pointed door handles (Chaudhry et al. 2005); in Norway and Canada, air-gun pellets have been shown to be a major cause of serious eye injuries in childhood (Takvam & Midelfart 1993; Marshall et al 1995). In recent years, a new type of firearm, the airsoft gun, has been introduced to the Danish market. In this study, we examined the incidence of ocular trauma in children caused by these guns, as well as the general pattern of ocular injury mechanisms in patients aged 0–15 years.The study is a retrospective analysis of registered ocular trauma at the Ophthalmology Department of the University Clinic of Rigshospitalet, Denmark. The department is in charge of ophthalmic emergencies, covering 71% of the days of a year and servicing a region of approximately 1.8 million people. A search for all patients discharged with an ICD-10 ocular trauma diagnosis was performed for the 5-year period January 1998 to December 2002. In order to focus on the serious eye injuries only, patients diagnosed with superficial corneal abrasion, with or without foreign body, were excluded from the study. One hundred and sixty-eight patients aged 0–15 years were registered; medical files containing description of injury mechanism were found for 138 of these patients, and they were included in the study. A subgroup (n = 24) of the patients has been published earlier (Saunte & Saunte 2006). One hundred and one children (73.2%) were aged 8–15 years, and 28 (20.3%) were girls (Fig. 1). The patients most prone to serious eye injuries were boys aged 6–15 years. The 12 most frequent injury mechanisms are listed in Fig. 2. Number of eye-injury patients listed by age group and sex. The 12 most frequent activities/objects causing serious ocular trauma in children aged 0–15 years in Copenhagen between 1998 and 2002. Airsoft gun accidents [n = 24 (17.4%)] proved to be by far the most common injury mechanism, occurring more than twice as often as the second most frequent trauma mechanism, fireworks [n = 9 (6.5%)]. Fifteen patients (10.9%) had penetrating eye injuries (Tables 1 and 2). None of the airsoft gun traumas caused penetrating injury. Airsoft guns are 1 : 1-scale replicas of actual firearms using compressed air to fire the projectiles. They are mainly used by boys aged 12–14 years playing war games in the woods or in the local neighbourhood. It is likely that the airsoft 6 mm round plastic pellets of only 0.2 g leave people with the impression that this type of firearm is harmless compared to other firearms, tempting parents and retailers to ignore the 18-year age limit to buy and use airsoft guns. Airsoft guns seem to replace the traditional air guns, which fire 0.5 g metal bullets, and also differ from the paintball guns with projectiles of 3.5 g, which are used mainly in special closed battlefields. In our study, 33 (23.9%) patients suffered injuries caused by presumed illegal activities or incautious behaviour related to airsoft guns, fireworks or air guns. In Denmark, there has been a decline in firework-related eye injuries over the last three decades (Thygesen 2005), which is the result of a well-organized national campaign towards teaching children to wear eye protection when participating in celebrations with fireworks. Our next aim seems be a reduction of the serious eye injuries among children caused by airsoft gun pellets.

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