Eye injuries sustained during paint ball games can be severe, but most can be prevented by wearing the proper protective gear, a new study suggests.

In a review of 36 patients seen at their eye institute for paint ball-related eye injuries, researchers found that the eye trauma was frequently severe — including eyeball ruptures in 28 percent of patients — and led to vision loss in many cases.

Paint ball is a "war game" in which opponents try to splatter each other with small, paint-filled capsules shot out of guns powered by compressed gas. Research suggests that eye injuries from paint ball have been on the increase in recent years, and games played outside of organized, commercial venues seem to carry the biggest risk.

Of patients in the current study, all were injured in informal settings and only two were wearing any kind of eye protection at the time of the injury, the researchers report in the American Journal of Ophthalmology.

"Eye injuries secondary to high-velocity paint balls can cause tremendous damage to vital ocular structures often requiring extensive surgical intervention," lead researcher Dr. Kyle J. Alliman, of the University of Miami Miller School of Medicine, said in a written statement.

"Unfortunately," he added, "visual loss is often permanent."

Overall, 81 percent of the study patients required surgery, and half ended up with visual acuity worse than 20/200, the definition of legal blindness.

"Awareness of the severe nature of paint ball-related eye injury is paramount," Alliman said, particularly for people who play in non-commercial settings.

"That no injuries occurred in the current study in an organized setting attests to the effective safety precautions of manufacturers and organized groups," he and his colleagues write.

It is a "tragedy," they add, that the vast majority of severe eye injuries sustained in paint ball might have been avoided through proper eye protection.

In this study alone, Alliman noted, protective gear might have prevented 97 percent of the injuries.