Paintball-related eye injuries treated at emergency departments across the United States dropped by 84.5% between 2005 and 2025, according to a research letter published online November 5 in JAMA Ophthalmology.
Data from the National Electronic Injury Surveillance System (NEISS) shows annual injury estimates fell from 1,167 in 2005 to 181 in 2025. This represents a mean annual decline of 9.7%. Researchers identified 256 specific paintball-related eye cases within a broader sample of 106,098 eye injuries recorded over the two-decade period.
The data indicates that males are significantly more likely to sustain these injuries. Males accounted for 236 of the 256 cases reviewed, representing 92.1% of the sample. Male patients had 4.63 times the odds of suffering a paintball-related eye injury compared to female patients.
Age is also a critical factor in these incidents.
National estimates derived from the study suggest that 50.6% of injuries occurred in individuals aged 10–19 years, while 36.9% involved people aged 20–39 years.
“These findings suggest that continued promotion of protective eyewear and adherence to established safety practices are needed to reduce the burden of vision-threatening injury,” researchers Tasha Miller and Andrew Mihalache, of the Temerty Faculty of Medicine at the University of Toronto, reported.
Corneal abrasions were the most frequent diagnosis, accounting for 25.7% of the recorded cases. Hyphema, or bleeding in the front of the eye, followed at 20.2%, while blunt trauma and contusions made up 17.9% of the incidents.
Severe injuries, such as globe rupture, retinal detachment, vitreous hemorrhage, and traumatic lens dislocation, were more common in the earlier years of the study.
Of the 20 severe cases identified, 17 occurred prior to 2015, with three reported between 2015 and 2025.
The study did not track long-term outcomes, as researchers lacked data on follow-up care or surgical intervention. Because the study relied on narrative descriptions within the NEISS database, cases where paintball was not explicitly mentioned in the medical record may have been excluded from the analysis.
What is the most common type of paintball-related eye injury?
Corneal abrasion is the most frequently reported injury, comprising approximately one-quarter of all cases identified in the study.
Who is at the highest risk for these injuries?
Males aged 10–19 years represent the demographic most frequently treated in emergency departments for paintball-related eye trauma.
Did the study track the use of protective gear?
No, the study did not record whether patients were wearing protective eyewear at the time of their injury, limiting the ability to draw direct conclusions about the efficacy of specific equipment brands.