Clinical and Therapeutic Epidemiological Aspects of Ballistic Eye Trauma Cases Admitted to the Armed Forces Hospital Centre (CHA)

Abstract

Ballistic eye injuries are very rare ophthalmic emergencies, but they are potentially serious as they can lead to blindness. The prevailing insecurity in the Sahel has led to a multitude of cases that pose a problem in terms of treatment. The objective of the study was to describe the epidemiological, clinical, and therapeutic aspects of ballistic trauma cases at the Armed Forces Hospital (CHA). This was a descriptive, prospective study over six years, conducted from January 1, 2019, to April 30, 2024. All patients admitted to the CHA for ballistic eye trauma were included. The parameters studied were sociodemographic, the affected eye, the nature of the injuries, the causative agent, and the therapeutic modalities. Ten male patients of an average age of 24 years were included in the study. All of the patients were non-commissioned officers; seven of the patients (70%) belonged to the Nigerien Armed Forces. Eye trauma due to homemade mine explosions was the most common (n=9, or 90%). All patients had adnexal contusion (n=10). Three patients (30%) had globe rupture, five (50%) had corneal damage, and two (20%) patients had posterior segment damage. Evisceration was performed in 30% (n=3) of patients, and posterior segment surgery was performed in two patients. A dry eye syndrome occurred in 30 (n=3) patients. Six patients (60%) became monocular. Only one patient recovered without sequelae. Despite emergency treatment, ballistic eye injuries remain serious due to their severity and potential to lead to blindness. The limitation of the study lies in its small sample size, which is ten patients, and this low statistical power prevents any generalisation of the results to a larger population and reduces the ability to identify significant associations between injury characteristics, treatments, and prognoses. Therefore, it is recommended that larger, multicenter prospective studies should be developed to consolidate knowledge.