Dec 20, 2016
Seeing Is Believing

Each sport comes with its own risk of injury. But while issues like concussions, fractures, and sprains get most of the attention, one area that is often overlooked is injuries to the eye. A new study published in JAMA Ophthalmology has found that sports-related eye injuries are especially common in ball sports and increasingly affect athletes younger than 18.

Ocular trauma refers to a range of eye injuries, all the way from a black eye to fractured bones in the orbit. These types of injuries can have long-term consequences that affect quality of life for years, potentially predisposing individuals to further injury, depression, and disease.

“There’s not an aspect of your life that this wouldn’t touch,” R. Sterling Haring, DO, MPH, the study’s lead author and Research Fellow at the Center for Healthcare Quality and Patient Safety at the University of Lugano, Switzerland, told

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The study took place from 2010 to 2013 and involved 120,847 individuals, with an average age of 22 years old. Visits to emergency departments (EDs) in 900 hospitals across the United States were examined. The results showed roughly 30,000 patients visited emergency rooms every year with sports-related eye injuries. According to Dr. Haring, the number of patients seen would have been even higher if visits to urgent care facilities, ophthalmologists, or other physicians were taken into account.

“We have found that [eye] injuries represent a substantial burden in EDs in the United States, accounting for approximately 30,000 ED visits annually—an estimate substantially higher than previously reported,” the study authors wrote. “Presenting patients tended to be young, and incidence peaked during adolescent years for both male and female patients. This differential burden on the young highlights the potential for long-term loss of quality-adjusted life years.”

Data has shown that 60 percent of the males and 67 percent of the females who were treated for a sports-related eye injury in the study were 18 years of age or younger. This suggests that a lack of education, regulation, and supervision may have contributed to a higher occurrence of ocular trauma. Without implementing proper safety precautions, youth and adolescent athletes are likely to remain at a higher risk for eye injuries, according to the study authors.

For males, the sports or sports-related activities most commonly linked to eye injuries in the study were basketball (26 percent), baseball or softball (13 percent), and air guns (13 percent). While the majority of these injuries were considered superficial or minor, more than 20 percent of baseball-related injuries were blowout fractures of the orbit. The sports that most commonly caused ocular trauma for females were baseball or softball (19 percent), cycling (11 percent), and soccer (10 percent).

“In basketball, people are jumping, and it could be a lot of elbows or fingers, whereas in baseball, it’s going to be a baseball,” Dr. Haring said.

Other serious injuries, such as impaired vision, were rare but strongly affiliated with recreational projectile-firing devices like paintball and air guns. Unlike paintball, air guns are typically used without any protective equipment, increasing the risk for an eye injury.

Dr. Haring and his colleagues understand the potential dangers of ocular trauma and hope that this study will shed light on the importance of making sports safer. Though it is not completely clear how to best address the issue of sport-related eye injuries in order to reduce their frequency, Dr. Haring and his team suggest that it be looked at on a school and policy level.

“Sports enthusiasts, parents, school officials, sports officials, health officials, government representatives, and industry representatives need to be at the table to discuss the next step, what needs to be done, and how we can do it,” Dr. Haring said.

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