Objectives Eye injuries are relatively common following detonations. The majority of these are caused by secondary fragments. Primary blast injury to the eye (from the air-blast alone) has been described historically, but the differentiation of air-blast and fragment aetiologies in the reports is not clear. The aim of this review is to consider the evidence in the literature for true primary blast injury to the eye.

Methods A literature review using Medline, Pub-med and Web of Knowledge databases.

Conclusions Overall, there is little conclusive evidence that primary ocular blast injury occurs in survivors of explosions. However, some case reports do surmise its occurrence and it cannot be unequivocally ruled out. If it does occur, it is more likely to be at high overpressures that will produce life-threatening injuries. The development of enhanced blast weapons may result in an increased incidence. At present however, the most severe and damaging threat to the eyes from blast remains the impact of fragments and debris.