Letter Highlights Underrecognized Eye Risks From Kinetic Impact Projectiles

In a letter responding to a narrative review of emergency department care during civil unrest, ophthalmologist Andreas Fierz highlights the risk of eye injury from kinetic impact projectiles (KIPs), including rubber projectiles. He argues that the eye may sustain permanent damage at lower energy levels than those required for penetrating injury, and that closed-globe injuries can cause lasting visual loss.

The author says the energy thresholds for permanent eye damage remain unclear, and that manufacturer-recommended firing distances may not ensure eye safety if they were based on penetration thresholds. He also notes that studies of police use of force often focus on hospitalisation or death, potentially missing ocular injuries, including cases managed with outpatient surgery. The letter calls for better research on medical risks to inform assessments of proportionality in police use of force. It presents no new data; the proposed risks and research gaps are discussed with reference to prior literature, and the author reports no competing interests.