Ocular Injury, Vision Loss Result from Drive-By Paintball Shootings

Paintball gun with pink ball splash.
A case series shows the devices can result in a variety of ocular injuries.

The use of paintball guns as a weapon in an unregulated environment can lead to severe ocular injuries and vision loss, according to research published in the American Journal of Ophthalmology. 

Researchers retrospectively assessed 20 patients (mean age 36.6 years, 75% men) who sustained unilateral injuries during drive-by paintball shootings between 2020 and 2021. Primary outcome measures were changes in best corrected visual acuity (BCVA) and assessment of injury severity. 

Overall, 14 patients (70%) had presented with a BCVA of counting fingers or worse. Among this subgroup, 4 individuals lacked light perception. A total of 2 participants had a BCVA between 20/70 and 20/50, and 4 patients attained a BCVA of 20/40 or better. Among the 13 patients included in the follow-up analysis conducted a median 7.1 weeks after baseline, 5 had no light perception, 1 achieved counting fingers, 1 had a BCVA of 20/300, and 6 achieved a BCVA of 20/60 or better.  

The team noted that 6 patients (30%) experienced a ruptured globe, and 3 of these individuals underwent evisceration. 

Other injuries sustained by the cohort included vitreous hemorrhage (45%), traumatic hyphema (40%), corneal abrasion (30%), traumatic iritis (25%), commotio retinae (25%), traumatic cataract (15%), choroidal rupture/ detachment (10%), and orbital fracture (5%).  

“Ultimately, the use of paintballs and paintball guns bears further scrutiny given the potential for devastating ocular injury up to and including loss of the eye,” according to the researchers. The team suggests that “increased awareness of the public, law enforcement, and providers may help drive better regulation of paintball guns outside of formal settings and an improvement in safety features by manufacturers.”

Study limitations include a small sample size and high loss to follow-up.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures


Amin SV, Otti VE, Farooq AV, Shah HA. Ocular injuries from drive-by paintball shootings. Am J Ophthalmol. Published online May 17, 2022. doi:10.1016/j.ajo.2022.05.004