Paintball injuries are sending more and more patients to the emergency room every year

Sep 16 2004

Paintball injuries are sending more and more patients to the emergency room every year, including one teenager who wandered into his neighbor's backyard at just the wrong moment.

Shahzad I. Mian, M.D., cornea and cataract surgeon at the University of Michigan Kellogg Eye Center, treated the teen. Now he warns other patients that this is a high-risk sport that can cause injuries ranging from bleeding to the loss of an eye.

The teenager was an innocent bystander to a game of “backyard” paintball. “The paintball hit him in the eye and caused a laceration to the cornea,” says Mian. “We rushed him in for emergency surgery the same day as the injury.” He later developed a cataract, due to trauma to the eye from the initial impact.

Mian performed another surgery to remove the cataract and replaced it with a permanent intraocular lens implant. In the beginning stages of his recovery, the teenager could detect only hand motions with his injured eye. In time, his vision in the injured eye improved to 20/30. “After the injury and subsequent surgeries, I would say he was one of the lucky ones,” says Mian.

The incidence of paintball eye injuries treated in emergency rooms has risen from an estimated 545 in 1998 to approximately 1,200 in 2000, according to a recent report in the journal Pediatrics. Many of these injuries result when people – mainly young people – play paintball without protective eyewear in an unsupervised setting.

Of the 42,000 sports-related eye injuries that occur each year, most paintball injuries occur when players are hit with the small, gelatin capsules. These projectiles are filled with nontoxic water-soluble paint and are fired from guns at a velocity of 300 feet per second.

The size (diameter of 17 millimeters and weight of 3.5 grams) and speed of the paintball make it a particularly dangerous projectile. About the size of a marble, the paintball is small enough to bypass the protective bones surrounding the eye, and can hit the eye itself with full force.

“To avoid these types of injuries, one thing you can do is play on a regulated field and keep your facemask on until the game is complete and you are off the field,” explains Mian. “I would prefer to tell my patients not to play the game but, if they do choose to play, I recommend they use eyewear that is designed specifically for paintball and meets industry standards.”

There are 2,500 commercial paintball fields in the United States, and most have tightened their safety rules. Yet, Dr. Mian treated a man in his 30s who briefly removed his facemask while still on the field of play and was struck in the eye. “The force of the paintball caused bleeding inside the eye.

Once the blood was absorbed back into the eye, a healing process that can take a period of days to weeks, he also developed a cataract,” says Dr. Mian. Much like the other patient, he initially could detect only hand motions with his injured eye. However, eventually he regained 20/20 vision.

If you suffer an eye injury from paintball, Dr. Mian recommends seeing an ophthalmologist or visiting the nearest emergency room as soon as possible, even if the injury seems minor at first.

To minimize damage immediately following the injury, follow these sight-saving tips:

• Do not rub the eye. If any tissue is torn, rubbing may cause more damage.
• Cover the eye. To do this, secure a shield against the bones surrounding the eye.
• Do not apply ointment or medication to the eye. These medications may not be sterile.
• Avoid aspirin, ibuprofen or other non-steroidal, anti-inflammatory drugs. These drugs can thin the blood and may increase bleeding.

The U-M Kellogg Eye Center is a nationally recognized center for vision care and research. As a part of the University of Michigan Health System, Kellogg attracts top funding for research to save vision, offers professional and community education, and provides routine and highly specialized eye care to some 100,000 patients each year.