Disfigured faces. Metal pellets lodged in skulls. Ruptured retinas. Permanent blindness. These are some of the stark reminders of the Iranian Government’s wanton and systematic misuse of crowd-control weapons against protesters.
The Woman, Life, and Freedom protests after the death of Mahsa Jina Amini led to a crackdown resulting in hundreds of deaths and injuries. The number of blinding eye injuries1
led scores of Iranian ophthalmologists to sign a petition demanding security forces end the use of pellets and other projectile weapons and cease reprisals against health workers who provided care to injured protesters.2
There are no official tallies due to the regime’s severe restrictions, but according to news reports citing local eye doctors, more than 500 people have been wounded by pellets, tear gas canisters, and paintballs since the start of the protests.1
Advocates allege Iranian security forces have used pellets not only to injure and intimidate protesters, but also to cause injuries that visibly disfigure and mark protesters.
Projectiles, such as pellets, although sometimes classified as less lethal weapons, can cause serious harm. For pellets, a single shot can spray hundreds of tiny 2–5 mm metal spheres or cylinders at high speed. From a close distance all projectiles can hit as hard as live bullets; from afar they can spread out and hit bystanders.
Lethal in Disguise, a 2023 report by Physicians for Human Rights and the International Network of Civil Liberties Organizations, documents the harm of such weapons and concludes that their use must be restricted.3
Published clinical evidence confirms pellets’ severe health effects, many of which result in “severe form[s] of ocular trauma with grave consequences in terms of functional and anatomical outcome”.4
As seen in Iran, pellets and other projectiles can cause multiple injuries to the face and eyes, including penetrating trauma, retinal detachment, optic nerve damage, hyphaema, damage to the globe and orbit, and different degrees of blindness.4
Pellets can break the fragile facial bones and lodge in the skin, sinuses, muscle tissues, and the scalp. The effect of such injuries can be long-lasting and pervasive.5
Facial disfigurement, vision loss, brain damage, and fractures can profoundly affect individuals’ quality of life, independence, mobility, and socio-economic functioning.
On this first anniversary of the protests in Iran, we must continue to demand an end to the targeting, killing, maiming, disfiguring, and blinding of protestors. Clinicians in Iran can only do so much to manage these injuries—the global medical community must advocate for their ability to provide health care without fear of reprisals.
A credible platform for documenting these violations and preparing pathways to justice is the UN-mandated Independent International Fact-Finding Mission on the Islamic Republic of Iran, which has been working hard to gather and preserve evidence of human rights violations despite the Iranian Government blocking its access. This commission must receive support, time, and resources from the international community.
We declare no competing interests. We thank the Abdorrahman Boroumand Center for Human Rights in Iran for their collaboration.

Source » thelancet