Characterization of Ocular Injuries Caused by Orbeez Hydrated Gel Pellet Projectiles: Clinical Insights and Implications.

PURPOSE: To examine the clinical characteristics of patients who have experienced blunt ocular injuries from "Orbeez" hydrated gel pellets (Spin Master Corp.), and to describe ocular morbidity, visual acuity (VA), and intraocular pressure (IOP) after Orbeez-related ocular trauma. DESIGN: Retrospective, institutional, observational case series. METHODS: Patients sustaining Orbeez-related ocular trauma at a single institution over a 13-month period were identified. Clinical parameters including VA, IOP, and anterior and fundus examination findings were assessed upon initial and final presentation. Basic statistical testing was performed to compare differences within this cohort. RESULTS: A total of 17 eyes from 17 patients with Orbeez-related trauma were identified. Orbeez-related blunt ocular injuries included corneal abrasion (n = 7), hyphema (n = 9), commotio retinae (n = 5), intraretinal hemorrhage (n = 3), preretinal hemorrhage (n = 1), vitreous hemorrhage (n = 2), and retinal tear (n = 1). Adolescents (14-18 years of age) showed higher rates of posterior segment complications compared to other ages (P = .0152). The presence of elevated IOP and hyphema upon initial examination correlated with increased likelihood of requiring invasive treatment following Orbeez impact (P = .0275). CONCLUSION: Orbeez-related ocular trauma may be associated with severe visual morbidity and varied anterior and posterior segment intraocular sequelae. Adolescents could be at increased risk for posterior segment complications following these injuries. Initial findings of elevated IOP and hyphema may indicate a need for more aggressive interventions. Prevention remains paramount in managing Orbeez-related ocular trauma; it is critical to raise awareness regarding the importance of wearing eye protection meeting high-impact standards and minimizing exposure to such projectiles.

An investigation into the mechanisms causing antipodean strabismus.

BACKGROUND: Antipodean strabismus is a rare clinical entity in which a patient manifests an esotropia when fixating with one eye and an exotropia when fixating with the other eye. It has been described in the settings of marked uncorrected anisometropia, dissociated strabismus or combinations of paresis, and mechanical restriction of eye movement. METHODS: A retrospective review of four patients with antipodean strabismus. RESULTS: All patients demonstrated a unique and uncommon pattern in which there was esotropia with one eye fixating and exotropia with the other eye fixating. None of the patients demonstrated anisometropia or signs of dissociated horizontal deviation. One patient developed antipodean strabismus after prior surgery to correct a traumatic sixth nerve palsy. Another patient had an associated pseudotumor cerebri. The other two patients had no pertinent medical history and, on clinical examination, demonstrated markedly asymmetric accommodative convergence/accommodation (AC/A) ratios. CONCLUSIONS: Antipodean strabismus is an atypical heterotropia, which can be associated with a variety of clinical findings. This article demonstrates the uniqueness of this clinical entity and illustrates the first association of this pattern with a markedly asymmetric AC/A ratio.