Serious Eye Injuries From Paintball Games Rising in Younger Patients

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Jan. 19, 2000 (Indianapolis) -- More than a million people in North America play war games using small paintballs fired from specially made guns. Although commercial paintball arenas have become safer, the increasing availability of backyard paintball games has led to an increase in eye injuries, according to a study in the January edition of the Archives of Ophthalmology.

In these war games, two competing teams attempt to capture their opponent's flag. The paintballs are small capsules filled with a nontoxic paint that are fired from guns powered by carbon dioxide. When a paintball strikes a player, it releases the paint and marks the player as being hit and out of the game.

"We noted over time that the number of these paintball-related injuries had been increasing, and the age of the participants had been decreasing," says lead author Mitchell S. Fineman, MD, clinical instructor in ophthalmology at the University of Pittsburgh School of Medicine. "We also saw that the settings were changing from the commercially run paintball facilities to much less structured games at home. While the arenas required special goggles for eye protection, many teens were not wearing proper protection in their backyards."

The researchers analyzed 35 patients who came to an eye hospital between January 1985 and September 1998. All patients were male, and their average age was 22. Roughly 75% were legally blind in at least one eye on examination, and 46% continued to have poor vision throughout their follow-up. The injuries were similar to those found after other forms of blunt trauma.

Those injuries occurring after 1995 were nearly 6 times more likely to occur during noncommercial play than those occurring in 1995 or before. This coincides with the adoption of better protective devices in commercial facilities and the growing availability of cheap paintball guns in sporting goods and discount stores.

"It should be emphasized that you need to use goggles that are made to specific standards to play paintball safely," says Fineman. "Goggles that are used in painting or when using industrial equipment often have openings in the side that allow the paint to have contact with the eyes. Also they are not made to resist the impact of a projectile that can have a velocity of up to 300 feet a second. In fact, in two of our patients, the paintball got behind their racquetball goggles and injured them severely."

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Ronald P. Danis, MD, associate professor of ophthalmology at the Indiana University School of Medicine, says that the researchers also point out a common problem, in that even when people have appropriate eye wear, they may remove it because it gets fogged or the paint interferes with vision.

"These can be very serious injuries with many patients ending up legally blind in at least one eye," Danis tells WebMD in an interview seeking an objective analysis of the study. "When looking for eye protection, the participants and their parents should also consider treating the goggles with an antifogging agent. Using clear acetate strips over the outside lenses that can be removed when paint gets on them is another excellent idea."

Paul Vinger, MD, a member of the sports safety committee of the American Academy of Ophthalmology, tells WebMD that the consumer should be very careful to buy and use only eye protection devices that conform to industry standards.

"Paintball can be very safe if you take precautions," says Vinger. "Somewhere on the box, it should say that the goggles conform to the American Society for Testing and Materials (ASTM) standard 1776. This means that they have passed a rigorous test and minimize the chance a paintball or fragments can come in contact with the eyes."

According to Fineman, none of the patients in their study were wearing goggles that met the current standards.

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