Background: Perforating ocular injuries due to exploding beverage bottles are well known. However, bottle caps alone may also induce severe ocular damage due to ocular contusions while opening carbon dioxide-containing beverage bottles. We studied this type of ocular contusion.
Patients and methods: Retrospectively, we examined all findings, operations, and tension profiles of 400 consecutive patients with ocular contusion who had been hospitalized in the Department of Ophthalmology, University Erlangen-Nürnberg, using the Erlangen ocular contusion registry (EOCR).
Results: Seven patients were injured by bottle caps (1.8%) while attempting to open a beverage bottle. The bottle caps were screw caps in six patients and crown corks in one patient. The patient age was 34 +/- 22 years (range: 16-68 years). Four patients were female, three male. We found the following morphological changes: hyphema (seven patients), iridodialysis (two patients), traumatic cataract (two patients), vitreous prolapse (one patient), vitreous hemorrhage (two patients), and retinal detachment (two patients). Intraocular pressure was higher than 21 mmHg in three patients. Visual acuity was hand motion in two patients, lower then 0.4 in two, and 1.0 in three on the admission day. Five patients read 1.0 on the day of discharge.
Conclusions: Bottle cap injuries are not as harmless as supposed. Bottle caps may induce severe ocular damage due to the high-impact energy.