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

Clin Ophthalmol. 2026 Jul 10;20:624067. doi: 10.2147/OPTH.S624067. eCollection 2026.

ABSTRACT

PURPOSE: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

PMID:42454272 | PMC:PMC13367631 | DOI:10.2147/OPTH.S624067

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