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Editor,—‘Pogs and slammers’ is a very popular new game among children. ‘Pogs’ are round pieces of thick card, and ‘slammers’ are round or serrated edged pieces of plastic or metal, both of which are decorated with pictures or symbols (Fig 1). The ‘pogs’ are placed on the ground or any flat surface and the aim of the game is to hit them with the ‘slammers’ in an attempt to turn them over. In order to achieve this, children throw the ‘slammers’ with great force against the ground causing them to bounce back, frequently at high speed. Such repelled ‘slammers’ acting as missiles could potentially injure either player or bystander. A case of serious ocular injury caused by this new game is described.
A 10-year-old girl presented to the eye casualty department complaining of decreased vision in her left eye. She had been hit in that eye by a bouncing metallic ‘slammer’ a few hours earlier as she was walking past an area where some other children were playing ‘pogs and slammers’. On examination, her visual acuity (VA) was 6/6 in the right eye and 6/36 in the left. The left eye had two linear corneal abrasions and a microhyphaema in the anterior chamber (AC). The intraocular pressure (IOP) was 19 mm Hg, pupillary reactions were normal, and there were no signs suggestive of perforating eye injury. Funduscopy through the dilated pupil revealed a vitreous haemorrhage which obscured detailed fundus examination but the retina was flat. Examination of the right eye was unremarkable. She was treated conservatively with topical betamethasone/neomycin and atropine drops and bed rest was recommended. Upon review 2 weeks later, her left VA was 6/36 improving to 6/18 with pinhole, the cornea was clear, and the AC was quiet. The IOP remained normal but a central area of anterior subcapsular lens opacity was noted (Fig 2). The vitreous haemorrhage had settled and allowed complete retinal examination which was normal and the treatment was discontinued. On her last visit 3 months after the injury, her VA was 6/6 in the right eye and 6/24 improving to 6/18 with the pinhole in the left. The vitreous haemorrhage resolved and the retina remained flat. However, she still has a cataract for which no action has been taken but it is thought that surgery may be required in the future.
Eye injuries are a leading cause of monocular blindness in children, and often result in significant ocular morbidity less serious than blindness.1 Studies have shown that children are disproportionately liable to severe ocular injuries2 3many of which are preventable4 5 and usually occur in school age children.5 6 It is known that such injuries frequently result from playing with a dangerous toy3 6-9; however, few reports are available on toys potentially hazardous to the eye.8 9 In the USA, the Department of Health found toys to be responsible for approximately 600 000 injuries per year10 which stresses the importance of reporting such injuries.
This case describes the first reported incident of an ocular injury caused by ‘pogs and slammers’. The injury resulted in permanent visual impairment due to blunt trauma and cataract formation, but there is also clearly a risk of penetrating eye injury associated with the use of slammers with serrated edges. This report emphasises the potential risk and severity of eye injuries caused by this popular game, and underlines the need for better education to prevent such ocular hazards.