Hyphema Associated with Water Bead Projectile Toys: A Retrospective Comparative Study

Superabsorbent water beads can be used in projectile toy guns. We aimed to characterize water bead-related hyphema and compare the prevalence with other causes of traumatic hyphema.

In this 10-month retrospective review, we identified 35 consecutive patients with traumatic hyphema presenting to the emergency department. Cases were grouped by injury mechanism, water bead-related compared with all other causes. Clinical data on initial presentation and subsequent visits were compared.

In the patients with traumatic hyphema, 8 (23%) cases were due to water bead trauma. Bead-related cases involved significantly younger patients (16 ± 9 years) compared with other cases (32 ± 21 years; p = 0.004). No statistically significant differences were found in peak intraocular pressure (p = 0.14) or need for surgical intervention (p = 0.3). The proportion of hyphema related to water bead injuries was higher in pediatric (42%) compared with adult patients (10%). The odds ratio of water-bead hyphema in pediatric compared with adult patients was 6.44 (95% CI:1.15-57.1; p = 0.021).

In this study, approximately a quarter of patients with traumatic hyphema during the study period were water bead-related, with approximately six-fold increased risk in younger patients. These findings suggest a need for public health awareness about water bead projectile injuries.