After four days of chaotic and violent protests in Indian-administered Kashmir, at least 24 people are dead and hundreds injured. Doctors at the main hospital in Srinagar, the region's capital, have struggled to cope with the casualties. Many of the wounded are lying two to a bed.

Violence periodically flares up in Kashmir. The mountainous region is claimed by both India and Pakistan and has been a source of dispute since 1947. Much, if not most, of the Muslim-majority population in the region harbors a decades-old resentment against what they see as Indian occupation.

This time, the provocation was the killing of a popular young militant in a gunfight with Indian paramilitary troops near his home village. Burhan Wani, 22, was a poster boy for Hizb ul-Mujahideen, the largest group in Kashmir's constellation of separatist outfits. The U.S. State Department has designated Hizb ul-Mujahideen a terrorist group.

If the cycle of violence has a predictability to it, so does a smaller, less noticed aspect of it: gunshot wounds inflicted by Indian security forces. These injuries occur mostly above the waist, often in the protesters' eyes.

"Seventy-seven persons have been hit by pellets in their eyes," a doctor told Caravan magazine on Monday. That article leads with the story of a 9-year-old girl who was shot in the eye while watching the protests through a window at home. The pellet was still lodged in her eye as of Tuesday.

"We have already operated on 92 patients. Every hour, more young men arrive with pellet injuries to the eyes. We are overburdened," another doctor at the same hospital told the Indian Express on Tuesday. Yet another doctor said, "We have never seen anything of this magnitude. Everyone who came here has pellet wounds above the chest."

Both doctors said the rate of eye injuries was unprecedented. They also said that the majority of injuries overall involved upper-body wounds. Accounts from the hospital indicate that most of the wounded are young men, though numerous children also were being operated on. One widely circulated photo showed an 11-year-old boy with multiple upper-body injuries.

Since the last major outbreak of violence, which occurred in 2010, Indian police and paramilitary forces have been using pellet guns to suppress protests and riots. These weapons are intended to be "non-lethal." They are certainly useful in dispersing crowds.

But being blinded, of course, has severe consequences for the victim and their family. It is not like being shot in the arm or anywhere else on the body, where healing might be easier. Someone whose eyes are hit by pellets may never see light again.

Death tolls attract media attention, which is partly why India has shifted to using non-lethal force in Kashmir. But each pellet cartridge contains 500 tiny iron balls. Few die after being shot by them, but many are maimed.

Health-care providers in Kashmir haven't been spared violence, either. On Sunday, security forces reportedly fired tear-gas shells inside the Shri Maharaja Hari Singh hospital, which is where the three doctors quoted above work. On Monday night, the same thing happened. Local newspapers reported that at least 25 ambulances carrying injured protesters had been attacked by security forces between Saturday and Monday.

Protesters, meanwhile, have been accused of preventing police personnel from accessing medical treatment, contributing to a tense atmosphere in Srinagar's hospitals.

India stations at least a half-million troops in Kashmir, making it the world's most heavily militarized region. The simmering insurgency, as well as flare-ups like the ongoing one, have left more than 10,000 dead since 1990.

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