Owners are modifying their Nerf guns to make them shoot harder, faster and further.

Paintball guns, BB guns and airsoft guns (which shoot 6-mm plastic bullets) are well known to cause eye injuries in children — and they are doing so in increasing numbers.

Nerf dart guns may now need to be added to that list.

In an article published earlier this week in the journal BMJ Case Reports, a team of British eye doctors describe three recent cases in which patients appeared in the emergency room of their London hospital with serious eye injuries caused by darts shot from Nerf guns.

This series of cases underscores “the seriousness of ocular injury from Nerf gun projectiles and calls into consideration the need for protective eyewear with their use,” write the doctors.

“It also calls for reconsideration of the safe age limits for Nerf gun use in children,” they add. 

A common denominator

One of the patients was an 11-year-old child whose right eye was damaged by a Nerf dart shot by another child from a distance of about six feet. The injury caused internal bleeding in the child’s eye (hyphema), as well as swelling of the eye’s outer layer (cornea) and inner layer (retina). It also caused considerable pain.

The other two patients were adults, but their eye injuries were also caused by a child playing with a Nerf gun. A 43-year-old woman was shot in her right eye from a distance of about three feet, while a 32-year-old man was shot from a distance of about 26 feet. They also experienced hyphema, and both complained of pain and blurred vision.

All three patients were treated with eye drops. Within a month, the bleeding and other symptoms had gone and their vision had returned.

But they were fortunate, say the doctors, for any projectile traveling at high speeds can lead to permanent vision loss. 

Cheaper, harder darts

One of the adult patients told the eye doctors that the Nerf dart or “bullet” that caused his injury (or her injury — the report doesn’t say which patient it was) had been purchased online. These generic-brand bullets are about one-tenth the price of the official Nerf ones.

They are also much firmer.

The doctors don’t know if the other two injuries also involved generic bullets. Still, they stress that there’s no evidence that the injuries would have been less severe if they had involved the official bullets.

Although it doesn’t seem to have been a factor in those three cases, another worrisome trend is that children are modifying their Nerf guns to make them shoot harder, faster and further. Numerous online videos show children how to do this, the doctors point out.

Parents, however, may be unaware that their children have altered the guns in such ways.

What parents can do

The American Academy of Ophthalmology (AAO) has compiled a list of recommendations for parents and other caregivers to help prevent eye injuries in children. Those tips include the following:

  • Do not allow your children to play with non-powder rifles, pellet guns or BB guns. They are extremely dangerous and have been reclassified as firearms and removed from toy departments.

  • Avoid projectile toys such as darts, bows and arrows, and missile-firing toys.

  • Children should wear sports eye protectors made with polycarbonate lenses for baseball, basketball, football, racquet sports, soccer, hockey, lacrosse, paintball.

  • All chemicals and sprays must be kept out of reach of small children.

  • Only purchase age-appropriate toys.

  • Look for toys marked with “ASTM”, which means the product meets the national safety standards set by  [ASTM International].

  • Do not allow children anywhere near fireworks, especially bottle rockets. These fireworks pose a serious risk of eye injury and have been banned in several states.

  • When very small children (age 4 and younger) are bitten by dogs, eye injuries occur about 15 percent of the time. The dog is usually one the child is familiar with, and second attacks by the same dog are likely to cause more serious injury. It is recommended that any dog that bites a child be removed from the household.

And if your child does experience an eye injury, have the eye examined as soon as possible, even if the injury appears to be minor at first.

“A serious injury is not always immediately obvious,” the AAO warns. “Delaying medical attention can cause the damaged areas to worsen and could result in permanent vision loss or blindness.”

For more information: You’ll find an abstract of the BMJ Case Reports article on the journal’s website, but the full article is, unfortunately, behind a paywall.

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