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Recently I started using Logitech Ergo M575 trackball mice and it has been total game changer, I can even play FPS games quite well with it. I highly recommend trackball for those with accessibility issues like me and certainly welcome more open hardware competitors in the space like Ploopy as customisation is crucial for accessibility.
Ironically I think the fact that they open source their designs probably helps sales. My first reaction is to scoff at the $144 price tag but I know that if I go look at what it will take to build one myself I’m sure the $144 price tag will become much more reasonable.
Just using your thumb for all navigation seems like an RSI waiting to happen.
Also I don't know who in the last couple years decided it's a "Trackball Mouse" it's just a Trackball in the same way it's just a "Trackpad" and not a "Trackpad Mouse"