Purpose: To report the type and severity of ocular and orbital injuries caused by rubber bullets.

Methods: A total of 42 consecutive patients seen over a 3-month period with ocular and orbital rubber bullet injuries were assessed clinically and radiographically within 1 day of injury, and the findings were recorded. Clinical outcomes following treatment were also recorded up to 6 months postinjury.

Results: A total of 90% of the patients were male. The mean age of patients was 25.0 years (4-60). Of the patients, 54% had lid or skin lacerations, 40% hyphaema, 38% ruptured globe, 33% orbital fracture, 26% retinal damage, and 21% retained rubber bullet in or around the orbit. At follow-up, 53% of the patients had a visual acuity of less than 6/60, 7% less than 6/18 to 6/60, and 40% 6/18 or better.

Conclusions: The term 'rubber bullet' is misleading. 'Rubber bullets' cause a wide variety of ocular and periocular injuries. Orbital fractures are common. The tissues of the orbit are easily penetrated. If the globe is hit, it is rarely salvageable.