Israel Medical Association Journal

Background: Pepper spray and tear gas are chemical irritants causing ocular, dermal, and respiratory injury. Data specific to pediatric emergency department (PED) presentations remain limited.

Objectives: To characterize the epidemiology, clinical presentation, and short-term outcomes of chemical irritant exposure in children presenting to a tertiary PED.

Methods: We conducted a retrospective cohort study of patients aged 0–18 years of age presenting to a single tertiary PED between 2016 and 2024 following civilian-grade chemical irritant exposure. Cases were identified using ICD-9 codes and free-text electronic medical records search. Demographic characteristics, clinical findings, treatment, and disposition were analyzed using descriptive statistics.

Results: We included 84 pediatric patients (median age 12.5 years, IQR 6.0–15.6; 69.0% male). Exposures occurred most commonly at home (44.0%) and school (36.9%). Ocular involvement was common. Superficial punctate keratitis was identified in 54.5% of patients who underwent fluorescein examination by ophthalmologist (21.5% of the total cohort). Respiratory and dermal symptoms were mild and self-resolving. No severe complications were documented; 96.4% were discharged home.

Conclusions: Civilian-grade chemical irritant exposures in children were predominantly self-limited and managed successfully with conservative ED care, supporting decontamination-based protocols while highlighting home and school settings as priorities for prevention.

Background: One of the most alarming ocular injury trends in recent years has been the proliferation of paintball guns and the proportional increase in the number of ocular eye injuries caused by paintballs.

Objectives: To describe five cases of paintball eye injuries that resulted in loss of functional vision in four of them.

Methods: We conducted a retrospective interventional case series of the clinical course of five patients with paintball eye injuries treated in the ophthalmology departments of two medical centers. 

Results: Five young males were evaluated for paintball injuries caused by blunt trauma. There was one case of full-thickness laceration (globe rupture). Four patients required one to five surgical interventions: three of these involved the removal of traumatic cataract including two eyes with significant zonular dehiscence treated by lens capsule conservation using anchoring devices, one retinal surgery and two glaucoma filtration surgeries. However, final visual outcome was not favorable due to irreversible retinal damage.

Conclusions: Paintball trauma often results in significant ocular injury and loss of functional vision despite successful surgical interventions. Most injuries are easily preventable and occur in under-supervised settings. Improved safety measures, strict regulation enforcement and appropriate public education could prevent such serious damage.