Pepper-Ball-Related Ocular Injury

Year 2021, Volume: 3 Issue: 1, 12 - 15, 23.04.2021

Joseph Chacko , Joseph Fong , Romona Davis

Abstract

The pepper-ball is a less-than-lethal projectile that releases a plume of PAVA (capsaicin II) pepper upon impact to incapacitate the target. To our knowledge, there are no reports of direct or indirect ocular injuries from this weapon in the medical literature despite several reports from the mainstream media. We report a middle-age male who presented with a pepper-ball injury to the right eye, resulting in a 10-millimeter scleral rupture with uveal prolapse and no light perception (NLP) vision at presentation, total retinal detachment, full-thickness eyelid lacerations and tissue damage, medial orbital wall fracture, and severe retro-bulbar hemorrhage due to direct trauma and capsaicin-induced chemical injury. Globe exploration and repair were performed, and the vision remained NLP. The patient declined early vitreoretinal surgery to attempt repair of the retinal detachment due to his guarded prognosis.

Keywords

ocular trauma, pepper ball injury, globe trauma, ballistic ocular trauma, less than lethal

References

• 1. Kıvanç S, Akova B. Prognostic factors for traumatic visual impairment and blindness in special groups. Clin Exp Ocul Trauma Infect. 1 (2019): 15-24.
• 2. PepperBall: How it Works. https://pblifelite.com/pages/how-it-works. Accessed 22 Nov 2020.
• 3. Hay A, Giacaman R, Sansur R et al. Skin injuries caused by new riot control agent used against civilians on the West Bank. Med Confl Surviv. 2006 Oct-Dec;22(4):283-91. doi: 10.1080/13623690600945180.
• 4. Haar RJ, Iacopino V, Ranadive N, et al. Death, injury and disability from kinetic impact projectiles in crowd-control settings: a systematic review. BMJ Open 2017;7:e018154. doi: 10.1136/bmjopen-2017-018154.
• 5. Ifantides C, Deitz GA, Christopher KL et al. Less-Lethal Weapons Resulting in Ophthalmic Injuries: A Review and Recent Example of Eye Trauma. Ophthalmol Ther. 2020;9(3):1-7. doi:10.1007/s40123-020-00271-9.
• 6. Nemet AY, Asalee L, Lang Y et al. Ocular Paintball Injuries. Isr Med Assoc J. 2016 Jan;18(1):27-31.
• 7. Epstein RJ, Majmudar PA. Pepper spray in the eye. Ophthalmology. 2001 Oct;108(10):1712-3. doi: 10.1016/ s0161-6420(01)00732-1.
• 8. Bhagat N, Turbin R, Langer P et al. Approach to Management of Eyes with no Light Perception after Open Globe Injury. J Ophthalmic Vis Res. 2016 Jul-Sep;11(3):313-8. doi: 10.4103/2008-322X.188388.
• 9. Manhas NS, Stahl D, Schellenberg M, et al. Non-lethal weapon: Injury patterns and imaging correlates for firearm alternatives. Clinical Imaging. 79 (2021): 165-172