Ophthalmologists and vitreoretinal key opinion leaders worldwide are joining efforts to raise awareness on the use of sight threatening crowd control devices, asking for a downscaling of violence, rethinking the concept of less lethal weapons and advocating for an enhanced training of police in order to avoid injuries as much as possible.

Following the murdering of George Floyd on the 25th of May 2020, social unrest in the US saw an increase of severe eye trauma on civilians caused by crowd control devices such as rubber bullets, pepper spray and tear gas.
Prompted by ophthalmologist Alejandra de Alba, professor at the University of California, San Francisco, a petition calling for an end to the use of rubber bullets on protestors was signed by 370 colleagues and was immediately embraced by the American Academy of Ophthalmology (AAO).
On the 4th  of June, the AAO, endorsed by the American Academy of Allergy, Asthma and Immunology, the American Academy of Family Physicians, the American College of Surgeons, the American Geriatrics Society, the American Society of Nephrology, the Council of Medical Specialty Societies, the Sociedad Chilena de Oftalmología (Chilean Society of Ophthalmology), and the Society of Interventional Radiology, published a statement “calling on domestic law enforcement officials to immediately end the use of rubber bullets to control or disperse crowds of protesters”

The AAO launched the social media campaign #NoRubberBullets, #NotOneMoreEye, asking  all physicians, public health officers and the public opinion to firmly condemn any use of these weapons, and defending the right to protest and congregate publicly without fear of blindness

According to Dr. George A. Williams, former president of the American Academy of Ophthalmology, “the Academy felt that a statement on this issue was well within our mission and our mission is protecting sight and empowering lives.  Based on our clinical experience with some absolutely horrendous injuries in individuals that were clearly not behaving unlawfully, we felt that we had to make a statement”, he said in an interview with Intravitreal Experts Group.
“The Academy felt that it was important that everyone understands that there are significant potentially blinding events associated with the use of these technologies,” he adds.

Similar ocular traumas were already seen during the social unrest in Kashmir in 2016. At the time, India police forces were using the less lethal weapons known as pellet guns.
“I was  called to join the team of Dr. Tariq Qureshi at the GMC Srinagar and we repaired 200-300 ocular traumas related to the unrest,” said Dr. S. Natarajan, Professor and Chairman, Aditya Jyot Eye Hospital, Mumbai, India, and worldwide renown expert in ocular traumatology. “I saw eyes with corneal tears, traumatic cataracts, vitreous haemorrhages, and subretinal haemorrhages,” Natarajan says. “Sometimes the pellet had gone lodged in the vitreous, sometimes it managed to hit and damage the retina. It was always a complicated case and most of the  patients we took care of  had only  light  perception  or  hand motion vision. Most of them were 15 to 21-year old”, he pointed out.
“My advice is that face and especially eye protection are needed when joining  a public demonstration, in order to minimize the possibility of getting injured.  But the most important thing is to avoid any form of violence on both sides, hoping that peace can prevail. If you are injured,  cover your eye and immediately seek medical attention,” he concluded.

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