Ocular Injuries From Drive-by Paintball Shootings

Abstract

Purpose: To characterize ocular injuries from drive-by paintball shootings with a focus on the severity of injuries sustained, clinical management, and visual outcomes.

Design: Retrospective, interventional case series.

Methods: Setting: University practice and emergency department.

Patient population: Patients evaluated by the ophthalmology service for paintball injuries.

Observation procedure: Age, sex, eye laterality, mechanism of injury, initial best-corrected visual acuity (BCVA), and initial diagnosis.

Main outcome measures: Clinical intervention(s), BCVA at last follow-up visit, and severity of injuries with a focus on ruptured globes.

Results: Twenty patients suffered unilateral ocular injuries from drive-by paintball shootings between January 2020 and December 2021. The median follow-up interval was 7.1 weeks (range: 3 days to 11.4 months). The average patient age at presentation was 36.6 years (range: 13-64 years). Fourteen patients (70%) had an initial BCVA of counting fingers or worse. Six patients (30%) suffered a ruptured globe injury requiring surgical repair, of whom 3 (15%) underwent subsequent evisceration. Twelve patients (60%) suffered ocular injuries requiring surgical intervention. Fifteen ocular surgeries were performed on 9 patients (45%) at our institution with 3 patients referred to outside providers for definitive surgical management due to insurance. BCVA at last follow-up visit was no light perception in 5 patients.

Conclusions: The severity of injury after paintball-induced ocular trauma is higher in this case series than what has previously been reported in the literature. Paintball guns can cause devastating ocular injury when used as an assault weapon, and their use in unregulated settings bears further scrutiny.