We read the article titled "Ocular Injuries Caused by Airsoft Guns" by Fleischhauer et al1 with great interest. We would like to provide some additional information about patients in Japan who have sustained ocular injuries from toy guns. As in other nations, so-called BB guns, or "airsoft" guns, are popular toys among boys in Japan, and it is not uncommon for Japanese ophthalmologists to encounter patients with ocular injuries caused by them. A review of the Japanese literature of 50 patients with ocular air gun injuries showed that none of those patients sustained perforating injuries, and all but one had a final visual acuity better than 20/32 OU.2 This review included some cases of ocular BB gun injuries. Additionally, our recent article published in the British literature3 describes a patient with cyclodialysis caused by a BB gun whose visual acuity was fully restored. It should be emphasized that all toy bullets, so-called BBs, in Japan are made of plastic because manufacturing metallic toy bullets is prohibited by the Japanese government. The weight and diameter of the plastic bullet most commonly available is 0.2 g to 0.43 g and 6.0 mm, respectively. Kinetic energy generated by the BB guns has been self-imposed to be 0.4 J or less by the air gun manufacturers' cooperation, controlling about 90% of the Japanese toy gun market. However, it should be noted that a small number of companies not belonging to the cooperation began to produce air guns with kinetic energy higher than 4.0 J in the early 1990s, and the sales of these guns are increasing gradually. Additionally, some enthusiasts themselves remodel "softgun" toy weapons to generate more energy.
Endo S, Ishida N, Yamaguchi T. The BB Gun Is Equivalent to the Airsoft Gun in the Japanese Literature. Arch Ophthalmol. 2000;118(5):732. doi: