A nationwide retrospective study of toy-related ocular injuries in children presenting to emergency departments in the United States.

BACKGROUND

Toy-related ocular injuries are a significant cause of preventable eye trauma in children. This study examined the epidemiologic trends and risk factors associated with toy-related eye injuries in US children.

METHODS

Data from the National Electronic Injury Surveillance System (NEISS) were analyzed for pediatric toy-related ocular injuries (code 77: eyeball) between 2003 and 2022. Descriptive statistics and multivariable logistic regression were used to identify risk factors and trends.

RESULTS

An estimated 131,094 toy-related ocular injuries occurred in children presenting to US EDs from 2003 to 2022. The annual incidence rate of 8.9 per 100,000 remained statistically stable during the study period. Common diagnoses included contusions/abrasions (56.4%), "Others/Not Stated" diagnoses (27.1%), and dermatological/conjunctival injuries (5.3%). Free-text review showed that the "Others/Not Stated" diagnoses included injury, pain, hyphema, subconjunctival hemorrhage, iritis, trauma, and chemical exposure. Vision-threatening conditions, including blunt eye trauma, ruptured globe, vision disturbance, retinal detachment, and commotio retinae, were uncommon. Toy guns with projectiles (9.2%), balls (4.4%), and nonprojectile toy weapons (3.3%) were frequently implicated. In multivariable analysis, younger age and male sex were associated with higher odds of injury, whereas Black or African American race (vs White race) was associated with lower odds. Injuries occurring outside the home and those requiring hospital admission were less likely to be toy-related.

CONCLUSIONS

Despite efforts to improve toy safety, the relatively constant number of toy-related ocular injuries and the higher prevalence of certain types of toys associated with these injuries highlight the need for increased education and awareness.