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Mitchell S. Fineman, MD; David H. Fischer, MD; John B. Jeffers, MD; David G. Buerger, MD; Carolyn Repke, MD

Arch Ophthalmol. 2000;118:60-64.

Objectives  To describe the type and severity of ocular injuries caused by paintballs, to summarize the outcomes, to determine if the injury occurred in a commercial or noncommercial setting, to compare the number of injuries in each setting as a function of time, and to ascertain whether eye-protective devices were worn and why they were removed.

Design  Retrospective analysis of 35 patients who sustained ocular injuries caused by paintballs and underwent evaluation and treatment at an eye hospital from January 1, 1985, to September 30, 1998. Thirty-five eyes of 35 patients underwent a complete ocular examination, diagnostic testing, and surgical intervention when indicated.

Results  All patients were male (average age, 22 years). Twenty-six patients (74%) had an initial visual acuity of 20/200 or worse, and visual acuity in 16 (46%) remained 20/200 or worse on follow-up (range, 2 weeks to 22 months). Traumatic hyphema was seen in 21 patients (60%). Twenty-two patients (63%) had access to goggles, 7 (33%) of whom removed them due to fogging before the injury. Injuries sustained after 1995 were 5.8 times (relative risk, 5.8; 95% confidence interval, 1.5-22.4) more likely to occur during a noncommercial war game than those occurring in 1995 or before.

Conclusions  As the popularity of war games increases, so does the potential for serious ocular injury caused by paint pellet guns. Most injuries seen after 1995 occurred in noncommercial war game settings, where the use of eye-protective devices is not required. Industry standards for eye protection have been developed recently and should be implemented.

From the Retina Service (Drs Fineman and Fischer) and Emergency Department (Dr Jeffers), Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pa; Pittsburgh Oculoplastic Associates, Ltd, Pittsburgh, Pa (Dr Buerger), and Philadelphia Eye Associates, Philadelphia (Dr Repke). Dr Fineman is now with Retina Vitreous Consultants, Pittsburgh. None of the authors have a proprietary interest in any of the products mentioned in this article.

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