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The Montreal Children's Hospital of MUHC warns parents of potential dangers

It was supposed to be a fun-filled day. Daniel Romagnolo was at a friend's birthday party at one of Montreal's indoor paintball ranges when disaster struck. While playing, the 10-year-old was shot in the face and got a mouthful of paint. His mask became loose and that's when the tragedy unfolded. A combatant crouched on the ground unleashed another volley of paintballs. They slammed into Daniel's right eye.

Daniel was writhing in pain and his eye was hemorrhaging badly. Not waiting for an ambulance, his mum, Laurie, scooped him up, jumped in the car and sped to the emergency department of the Montreal Children's Hospital of the McGill University Health Centre. Her terrified son was screaming in pain as he pressed an ice pack to his injury.

In the blink of an eye, the youngster's 20/20 vision was shattered. He had suffered what is known in medical terms as a traumatic cataract (the lens of his eye was damaged) and a hyphema (blood in the eye) — and in addition his iris was torn and his once round pupil distorted (it is now permanently elongated like the pupil of a cat).

Daniel was admitted to the Children's for 11 days; doctors wanted him as immobile as possible to prevent further damage from further bleeding inside his eye. Daniel has endured plenty since January. He missed two weeks of school and many more hours since his hospital release because he initially had as many as two doctor appointments each week. Every few hours, for weeks on end, he suffered pain as drops were put in his eye. For the last three months, he wore an eye patch 24 hours a day and spent recess and lunch hours in the school office to keep his activities to a minimum. On March 18, he underwent two-hour surgery to remove his cataract and insert an artificial lens.

"I was really scared. I didn't know what was going to happen to me, I didn't know if I was going to go blind in my right eye," says Daniel. "Today, I still can't play any contact sports, and I get more severe headaches and nausea, especially while playing Play Station or watching TV. I really felt sick for a very long time."

"Daniel is very lucky. He came very close to losing his eye. While it is still too early to say how much of his eyesight he will regain," says Dr. Rosanne Superstein, pediatric ophthalmologist, "Daniel will have to wear bifocals with dark lenses because bright lights even from indoor lighting will bother him. Throughout his life, he will also be at a very high risk of developing glaucoma as a result of this injury and will have to be followed on a regular basis for life."

THE CHILDREN'S WARNS PARENTS OF POTENTIAL DANGERS

Each year, the Children's treats about a handful of kids who have been injured while playing paintball, sustaining vision-threatening injuries. In addition to eye injuries, some of our pediatricians have reported cases of children presenting with impressive welts to other parts of their bodies.

"We don't need to treat a flood of children with injuries like Daniel's to realize the potential dangers — especially for very young children," says Debbie Friedman, head of the Pediatric and Adolescent Trauma Program at the Children's. "Today, with summer right around the corner, and with paintball becoming an increasingly popular indoor and outdoor activity, we are warning parents about this activity and its potential risks."

If parents choose to allow their children to participate in this activity, says Friedman, they need to ensure their children are being outfitted properly in equipment appropriate for their size and age, most important of which is eye protection and facemask that fits properly and meets approved standards. Also, they need to ensure there is close supervision to make sure kids follow the rules and safety measures such as never removing their eye protection while in play. Given all of these considerations one has to question how appropriate this activity is for children.

The Children's has brought this issue to the attention of the Canadian Pediatric Society and the Montreal Department of Public Health to raise our concerns and we encourage these bodies to come out with formal recommendations.