Ocular Injury from Nerf Toy Gun (Foam Dart Blasters): A Case Series

Abstract Purpose: To report clinical outcomes following ocular injury from Nerf guns - a spring-loaded toy guns that fire foam-coated darts or bullets at a relatively low velocity. These guns gained popularity in recent years among children and adolescents. Methods: Eleven patients with ocular injuries from Nerf guns were included in this retrospective, single-center study. Visual acuity (VA), intraocular pressure (IOP), and anterior segment, glaucoma-related, and vitreoretinal complications were recorded at each visit.Results: The average age at presentation was 13.4 years and 82% were male. Mean initial VA was 6/12 (range 6/6 – 1/18); On initial examination, nine patients (82%) had hyphema, three (27%) had corneal abrasions, three (27%) had vitreous hemorrhage, and two (18%) had traumatic mydriasis. Four patients (36%) experienced glaucoma-related complications, including three (27%) with angle recession and three (27%) with increased IOP. Three patients (27%) were diagnosed with posterior segment injuries, including three (27%) with commotio retinae and one (9%) with severe retinal photoreceptor damage. No patients required surgical intervention. Conclusion: Foam dart blasters (i.e. Nerf guns) can cause severe blunt ocular trauma and permanent visual loss, illustrating the need for eye protection when handling these toys.