Ocular Injuries from Carbide Guns: Public Health Risk in the Social Media Era

INTRODUCTION Fireworks, long regarded as a symbol of celebration and prosperity, are widely used during festivals and joyous occasions across the world.[1–5] However, these festivities are often accompanied by a surge in firework-related injuries, many of which are vision-and life-threatening.[1–5] Children constitute a major proportion of the victims, with the face, eyes, and hands being the most frequently affected sites.[2,6] Ocular trauma may range from minor superficial abrasions to severe complications such as corneal laceration, intraocular foreign body, retinal detachment, or posttraumatic infection, often resulting in permanent visual loss.[1–6] Unsupervised handling of firecrackers by children remains a key contributor to such incidents. Moreover, improvised use of fireworks, such as igniting them inside bottles or metal/plastic containers, has led to blast-like injuries comparable to those caused by small explosive devices.[7] Recently, the influence of social media platforms, particularly video-sharing sites, has led to the alarming re-emergence of the “carbide gun,” a device originally used by farmers to scare away birds.[8] These homemade contraptions, constructed easily from inexpensive materials, are now being promoted online as makeshift firecrackers. Multiple pediatric ocular injuries linked to these devices have been reported from different parts of India. This emerging trend underscores the urgent need for public awareness, parental supervision, and regulation of hazardous online content that promotes the construction of such explosive devices. Strengthened preventive strategies are essential to curb the recurrence of these avoidable, vision-threatening injuries during festive seasons. CARBIDE GUN DEVICE The carbide gun is a crude, improvised explosive device typically assembled using two interlocking polyvinyl chloride plastic tubes – an outer tube with a narrow lumen and an inner tube with a wider lumen connected to a gas lighter for ignition. A small perforation in the inner tube allows insertion of calcium carbide, followed by the addition of water. The ensuing chemical reaction produces acetylene gas and calcium hydroxide. When the accumulated acetylene gas is ignited using the lighter, it undergoes rapid combustion, generating a loud explosion accompanied by intense heat and chemical by-products. This results in thermochemical injuries caused both by the high temperature and the alkaline calcium hydroxide formed during the reaction. The device, though simple and inexpensive, can cause severe ocular and facial trauma due to the combined blast, thermal, and chemical effects. OCULAR INJURIES WITH CARBIDE GUN Fischer first reported ocular injury associated with carbide exposure in 1950.[9] Early reports of carbide gun-related ocular trauma described it primarily as an occupational hazard among farmers who used the device to scare birds in agricultural fields.[10,11] In recent years, however, the use of these devices has spread beyond occupational settings to the general population, leading to a significant rise in ocular injuries.[12,13] Most of the recent incidents have involved homemade carbide guns constructed using instructions from social media tutorial videos, while others were assembled using devices purchased from local vendors.[14,15] Injuries typically occur due to faulty installation or failed ignition when individuals look directly into the barrel or cylinder to inspect the device. The sudden explosion releases intense heat and calcium hydroxide, causing severe burns to the face and eyes, with characteristic periocular skin burns, eyelash singeing, and thermochemical ocular injury [Figure 1].Figure 1: Face photograph of a 15-year-old boy who sustained carbide gun injury showing periocular skin burn (eyelid, nose and forehead) with singeing of eyelashesClinically, patients present with acute pain, redness, watering, and profound visual loss immediately after the explosion. Peri-ocular burns, singeing of eyelashes and multiple impacted foreign bodies on the skin are observed. The ocular findings include corneal epithelial defects, stromal opacification, embedded foreign bodies in the cornea and conjunctiva, limbal ischemia, and conjunctival necrosis[12,13] [Figures 2-4]. Advanced injuries may result in corneal perforation, corneal melt, scleral melt, intraocular foreign bodies, or secondary infection [Figure 5].Figure 2: Slit lamp photograph of the left eye under (a) diffuse and (b) focal slit illumination showing stromal haze with mild edema and multiple superficial corneal foreign bodies (green arrows)Figure 3: Slit lamp photograph of the right eye under diffuse illumination showing stromal haze with overlying epithelial defect (red arrow), multiple superficial corneal and conjunctival foreign bodies (green arrows) with diffuse conjunctival congestionFigure 4: Slit lamp photograph of the left eye under diffuse illumination showing stromal haze, multiple superficial corneal and conjunctival (a 10x, b 16x) foreign bodies (green arrows) with diffuse conjunctival congestion and conjunctival blanching (blue arrows)Figure 5: Slit lamp photograph of the left eye under diffuse illumination showing tri-radiate corneal perforation (red arrow), traumatic cataract with ruptured anterior lens capsule (yellow arrow) and multiple superficial corneal and conjunctival foreign bodies (green arrows)MANAGEMENT Prompt and appropriate management during the acute phase is crucial, as it largely determines the final visual outcome in carbide gun-related ocular injuries. A comprehensive ocular examination should be performed first to exclude any globe perforation before initiating irrigation. The ocular surface should then be thoroughly irrigated with normal saline or Ringer’s lactate solution until the pH is neutralized. Medical management is directed toward reducing inflammation and promoting re-epithelialization, following established protocols for chemical eye injuries.[16] Treatment includes topical corticosteroids, broad-spectrum antibiotics, lubricants, cycloplegics, sodium ascorbate, and sodium citrate, along with oral Vitamin C and doxycycline (a collagenase inhibitor).[16] In moderate-to-severe burns, amniotic membrane transplantation with a symblepharon ring and, where necessary, temporary tarsorrhaphy is recommended during the acute phase to facilitate epithelial healing and prevent cicatricial sequelae.[16,17] OUTCOME Arora et al. reported a retrospective case series of 28 eyes from 23 patients with carbide gun-associated ocular injuries.[13] Approximately 30% of cases resulted from recreational use, while the remainder were linked to agricultural activities. Severe ocular burns (Dua’s Grades IV–VI) were noted in over 40% of eyes, while the rest presented with milder Grades (I–III). Amniotic membrane transplantation was required in more than 70% of cases, alongside intensive medical therapy. The most common complications noted on follow-up were corneal opacity (68%), limbal stem cell deficiency (53%), and phthisis bulbi (7%). The median final visual acuity was 20/200 in eyes with severe burns and 20/32 in those with milder injuries.[13] These outcomes underscore the poor visual prognosis associated with severe thermochemical ocular burns from carbide gun explosions and highlight the pressing need for public education, strict legislative measures, and responsible regulation of social media content that disseminates instructions for the creation or use of such hazardous devices. CONCLUSION The reemergence of carbide gun-related ocular injuries, fueled by social media exposure, is a cause for serious concern. There is an urgent need to promote digital literacy, enforce content moderation, and discourage the circulation of such hazardous trends. Children and adolescents are particularly vulnerable as they are driven by curiosity, experimentation, and peer influence. The easy availability of inexpensive raw materials and ready-made devices further amplifies the risk. These injuries result not only in acute ocular morbidity but also in long-term visual impairment and psychosocial distress. Effective public awareness campaigns, parental supervision, and accountability of digital platforms are essential preventive measures. Clinicians should remain vigilant for this emerging pattern of injury, recognize the combined thermal and chemical mechanisms, and initiate prompt ocular surface management to optimize visual outcomes. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.