Less-Lethal Weapons Resulting in Ophthalmic Injuries: A Review and Recent Example of Eye Trauma

Abstract

Introduction: Prior reports have highlighted the dangers of crowd control weapons suchas rubber bullets, paintball guns, and pepper spray. Many of these reports werewritten decades ago and outside of the USA. We summarize a review of the literatureand discuss a contemporary case of a ruptured globe and facial trauma secondary to aprojectile weapon. This case serves to highlight the severity of eye trauma caused byless-lethal weapons; severe morbidity or even mortality can occur. Clinical Description: A civilian presented after a projectile weapon reportedly fired byDenver law enforcement struck his face during one of the recent protests in May 2020in Denver. Upon ophthalmic examination, we observed no light perception (NLP) vision,periorbital ecchymosis, and devastating globe trauma. Primary Diagnosis, Interventions, and Outcomes: Further examination revealed a severely ruptured globe with extensivehemorrhage and extrusion of intraocular contents. Attempts to repair the rupturedglobe failed because of the lack of remaining scleral tissue and expulsion ofintraocular contents. Postoperatively, the visual acuity remained NLP and the eye wasunable to hold pressure. Subsequently, the patient elected for enucleation. Conclusion: Despite the purported safety advancements of less-lethal weapons, wecontinue to see high levels of morbidity and mortality. Permanent vision loss, lossof the eye, and death caused by these weapons have been reported. We hope that thisinformation will serve as an example to help promote judicious use of these weaponsby the proper authorities. Additionally, protesters and bystanders should be aware ofthese dangers and utilize high-quality eye protection.