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June 04, 2020
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Q&A: Rubber bullets and tear gas: What ophthalmologists should know

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Reports of police using tear gas and rubber bullets to disperse protesters are becoming more commonplace throughout the country after the death of George Floyd in Minneapolis.

Linda Tirado, a freelance photographer covering the Minneapolis protests, was shot in the eye, and Philadelphia police officers have used both options against protestors.

Ann P. Murchison, MD, PhD

But how much damage can the nonlethal options cause to the eye? Healio/OSN discussed the methods and their potential for ocular damage with Ann P. Murchison, MD, MPH, director of the Wills Eye Hospital Emergency Department in Philadelphia.

Q: What damage can a rubber bullet do to an eye? How is this injury typically treated?

A: Rubber or plastic bullets can be made of different materials, some with metal cores. The material, shape and velocity are some of the factors that impact the extent of injuries to the eye. The injuries to the vulnerable tissues of the eye and surrounding tissues vary from the more common lacerations of the eyelids, bleeding inside the eye (hyphema) and cuts of the eyeball (ruptured globe) to slightly less common retinal injuries and eye socket (orbital) fractures. The treatment depends on the extent of the injury; it can range from treatment with eye drops for a hyphema to one or more surgeries.

Q: What damage can tear gas do to an eye? How is that typically treated?

A: There are several different chemicals that can be used as “tear gas,” and all have ocular effects. Longer exposure time and more direct exposure, such as spray straight on an eye, have increased potential for damage. The gases themselves generally cause irritation to the eyes and significant tearing and temporary redness. The initial treatment is generally copious irrigation to remove any residual chemical and prevent further irritation or damage. In some cases, an abrasion of the cornea can occur and requires treatment with eye drops and has the potential for scars of the cornea, which can lead to decreased vision. The canisters for the gases can also impact the eyes, particularly if thrown, and lead to other injuries.

Q: How many ocular injuries have you seen at Wills Eye from the recent protests? Are you treating more than normal right now?

A: Thankfully, we have only seen a few. Our emergency medicine colleagues have treated some of the patients without severe ocular concerns in their facilities. We have seen lacerations around patients’ eyes sustained in the recent unrest.