Eye Injuries From 'Less-Than Lethal' Weapons During US Protests

By Linda Carroll

December 07, 2020

(Reuters Health) - Across the United States, protesters sustained eye injuries, including blindness, from "less than lethal" munitions used by law enforcement during protests following the May 2020 death of George Floyd, a new study finds.

The responses from 22 ophthalmology residency programs queried in June and July described 41 patients with ophthalmic injuries caused by less-than-lethal rounds during the protests. The most common injuries were hyphema (reported by 12 programs), orbital fractures (11 programs), and ruptured globe (10 programs), according to the report published in JAMA Ophthalmology.

"I was surprised at how frequently this happened," said study coauthor Dr. Prem Subramanian, a professor of ophthalmology, neurology and neurosurgery at the University of Colorado School of Medicine in Aurora. "It's not only that when you lose an eye it's a major loss, it's also that eye injuries were reported throughout the country. It was not an isolated occurrence in one, two or three cities."

After six patients showed up at the Denver Health Medical Center with eye injuries involving less-lethal weapons sustained during the protests, Dr. Subramanian and his colleagues decided to see if their experience was unique or if other programs were seeing similar protest-related eye injuries.

The researchers emailed surveys to 115 ophthalmic residency programs and 82 responded, with 22 reporting they had cared for patients with ophthalmic injuries related to the protests. Sixteen indicated at least one injury that was caused by less-lethal weapons, with a range of one to 10 per program and nine reporting only one patient.

Projectiles retrieved from the local Colorado protest sites included rubber baton rounds, foam grenades and pepper balls. Ten joules of force transferred to the eye will cause it to rupture, Dr. Subramanian said. Less-lethal munitions generally land with a force of 12 to 15 joules, he said. "If it hits your arm it hurts; if it hits your eye, it destroys it," he added.

Among the six patients treated at the Denver Health Medical Center, four reported being struck by projectiles fired by law enforcement; the other two could not identify the source of their injuries. Two ended up blind in the injured eye.

Written law enforcement policies typically prohibit firing these weapons at close range and at vulnerable areas of the body, Dr. Subramanian said, adding those include the head, eyes, throat, neck, female breasts, genitalia and spinal column.

The findings highlight the need for better training on the use of these munitions, Dr. Subramanian said. Unfortunately, these weapons have been marketed to law enforcement as safe. "They are sold as a benign crowd control measure that is safe," he said.

Some have suggested that protesters should wear eye protection, Dr. Subramanian said. "I don't think that is the right solution," he added. "The outcome I would want from this is for police to say, 'that is not what we wanted to do, and we don't want it to happen again.'"

The new study shines a spotlight on the damage that can be caused by these kinds of munitions, said Dr. Albert Wu, an internist and a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

"Although these weapons used to be called 'non-lethal weapons,' they can still maim and kill," Dr. Wu said. "This study adds to the evidence that they can cause catastrophic eye injuries, reporting blinding trauma in at least 10 instances."

"The high prevalence of eye injuries caused by police suggests a pattern of use of 'less-lethal weapons' that is careless at best," Dr. Wu said. "Written policies typically forbid firing at vulnerable areas of the body, but this was obviously not observed."

The paper highlights a disturbing trend, Dr. Wu said in an email.

"The use of these weapons by police against crowds has increased over the last several decades," he said. The findings of this study "suggest a pattern of over-reaction that caused greater civilian harm than it purported to prevent. There is great room for improvement in procedures for their use."

SOURCE: https://bit.ly/2VBgGks JAMA Ophthalmology, online December 3, 2020.