SRINAGAR, Kashmir — The street outside is patrolled by riot police officers in camouflage, bracing for the nightly spasm of violence, but it is quiet here inside the operating room. The surgeon’s knife slides into an eyeball as if it were a soft fruit.

The patient’s eyelids have been stretched back with a metal clamp, so his eyeball bulges out of glistening pink tissue. The surgeon sits with his back very straight, cutting with tiny movements of his fingers. Every now and then, a thread of blood appears in the patient’s eye socket. The patient is 8 years old.

“Very bad,” murmurs the surgeon, Dr. S. Natarajan. But then, all 13 cases he will see today will be very bad.

Since mid-July, when the current wave of protests against the Indian military presence started, more than 570 patients have reported to Srinagar’s main government hospital with eyes ruptured by lead pellets, sometimes known as birdshot, fired by security forces armed with pump-action shotguns to disperse crowds.