Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions.

Electronic cigarette (EC) usage is on the rise in the United States since being introduced to the market in 2006. An estimated 3.7% of Americans are regular users based on recent data from the Centers for Disease Control and Prevention.1 ECs are battery-powered devices that vaporize a chemical mixture called “e-liquid” to simulate cigarette smoking. The Food and Drug Administration (FDA) does not currently regulate ECs, although new regulations have been proposed.2 The proposal includes the prohibition of sale to minors and a requirement that ECs carry a warning regarding nicotine content. Notably, the proposal does not include a warning regarding facial, oral, or sight-threatening ocular injuries. Among the safety concerns surrounding ECs, fires and explosions have been reported in various media outlets; in most of these cases, the presumed mechanism is battery malfunction. Here, we describe 2 cases of patients who suffered multiple injuries from EC explosions. The first patient's ocular injuries included a penetrating corneoscleral laceration with iris prolapse, hyphema, an additional partial-thickness corneal laceration, and bilateral thermal and/or chemical corneal burns. The second patient also suffered bilateral corneal burns. To our knowledge, these are the first cases of ocular injury from ECs to be reported in the scientific literature.