Re: Lin et al.: Clinical outcomes after ocular trauma with Orbeez gel pellet projectiles (Ophthalmology. 2023;130:553–555)

We read with interest the article by Lin et al.1Lin B.R. Al-Khersan H. Rowsey T. et al.Clinical outcomes after ocular trauma with orbeez gel pellet projectiles.Ophthalmology. 2023; 130: 553-555Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar This case series detailed the concerning rise in incidence of ocular trauma from gel blaster guns, a relatively new category of toy guns that fire a rehydrated gel pellet at speeds up to 350 feet per second (fps). The increasing popularity of these guns, which are frequently marketed to children, has led to a proportionate increase in the incidence of blunt ocular trauma that carries the potential for significant short- and long-term morbidity.2Haavisto A.K. Sahraravand A. Puska P. Leivo T. Toy gun eye injuries - eye protection needed Helsinki ocular trauma study.Acta Ophthalmol. 2019; 97: 430-434Crossref PubMed Scopus (8) Google Scholar In general, there is a lack of awareness in the public regarding the risks posed from inadvertent eye injury with these toy guns.3Richards J.C. Murray A.D. Toy gun injuries--more than meets the eye.S Afr Med J. 2003; 93: 187-190PubMed Google Scholar We thank the authors for their work in bringing this important cause of ocular trauma into the spotlight. Adequate safety warnings on these guns are largely absent and, when present, do not sufficiently reflect the risks posed by irresponsible handling of these weapons. Our center also has an interest in these injuries and has recently reviewed the packaging of toy guns systematically, including the gel blasters referenced by the present article. In our survey of 232 distinct models of toy guns, including 133 distinct gel blasters, we found that only 65 of the 232 guns had a warning on their packaging. Of these, 36 (55.4%) displayed a general warning such as “do not aim at eyes or face”; only 29 (44.6%) had a specific warning recommending the use of eye protection. The median projectile speed of the gel blasters was 230 fps compared with 70 fps in the traditional toy guns group (P < 0.001). Despite this, the prevalence of warnings in the gel blaster group was significantly lower at 10.5% compared with the 51.5% of toys with warning labels in the traditional guns group (odds ratio, 0.11; 95% confidence interval, 0.056–0.219). These data demonstrate a clear disconnect between the potential of these toy guns to cause ocular trauma and the prevalence of safety warnings on their packaging. Although this article highlighted the importance of using eye protection when operating gel blasters to prevent ophthalmic injury, we note that all but one of the patients included in the study was aged between 12 and 22 years. This suggests that children and adolescents often lack a full understanding of the significant dangers associated with gel blasters. They may not fully comprehend the force, speed, and impact of the gel pellets, which can lead to serious injuries. Additionally, they may not appreciate the importance of wearing protective gear or following safety guidelines, increasing the risk of accidents. We contend there is a need for policy and enforcement in this area on a systemic level. Manufacturers and retailers of gel pellet guns need to be encouraged to include clear safety guidelines and warnings on their product packaging. These guidelines should emphasize the importance of wearing appropriate eye protection, safe shooting distances, and responsible handling. Gel pellet guns should also have appropriate age restrictions in place to ensure that they are used by individuals who can understand and follow safety guidelines. We thank the authors again for their contribution to this important and emerging area. We share their concern regarding the potentially blinding trauma that can result from the use of these guns, and call on ophthalmologists and the college to develop a unified position paper on the need for mandatory, clear safety warnings on packaging of toy guns as well as consideration of restriction of their sale to adults. Clinical Outcomes after Ocular Trauma with Orbeez Gel Pellet ProjectilesOphthalmologyVol. 130Issue 5PreviewOcular trauma is a leading cause of preventable vision loss worldwide.1 In studies examining sports-related ocular injury, paintball and air guns were shown to confer the greatest risk for visual impairment.2 More recently, gel blaster guns have been used to fire Orbeez (Spin Master) and similar gel pellets made of superabsorbent polymers that, when rehydrated with water, expand to around 6 to 8 mm in diameter while becoming soft and pliable. In 2022, the Orbeez challenge began trending on the popular social media platform TikTok (ByteDance). Full-Text PDF ReplyOphthalmologyVol. 130Issue 10PreviewWe thank Rogerson et al for their insights into the dangers of gel blaster guns in comparison with other traditional toy guns. We would be curious to learn which other categories of toy guns were included in their survey, such as foam dart guns, paintball guns, and airsoft guns. It would also be beneficial to know if the guns and packaging the authors surveyed are standardized internationally and if different countries have differences in their requirements for safety labeling. Full-Text PDF