Changing trends in paintball sport-related ocular injuries

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-protec tive 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 hosp ital from January 1, 1985, to September 30, 1998. Thirty-five eyes of 35 pa tients underwent a complete ocular examination, diagnostic testing, and sur gical intervention when indicated. Results: All patients were male (average age, 22 years). Twenty-six patient s (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 mont hs). 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 bef ore 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 non commercial war game than those occurring in 1995 or before. Conclusions: As the popularity of war games increases, so does the potentia l for serious ocular injury caused by paint pellet guns. Most injuries seen after 1995 occurred in noncommercial war game settings, where the use of e ye-protective devices is not required. Industry standards for eye protectio n have been developed recently and should be implemented.