Sports Eye Injuries (Espanol-click)

Reviewed: 8/31/05
Last Updated: 8/31/05
Revised: 8/31/05

Sports and recreational activities cause more than 40,000 eye injuries each year, according to the American Academy of Ophthalmology – and most of these accidents are preventable. Indeed, Prevent Blindness America reports that 90% of sports-related eye injuries can be prevented.

Basketball and baseball cause the most eye injuries, followed by water sports and racquet sports.

The majority of all eye injuries occur in persons under thirty years of age. Children are especially vulnerable as they often have underdeveloped depth perception and may have difficulty judging the position of a flying ball.  It’s not uncommon for a child to misjudge a ball in flight, miss it, and take a blow to the face instead.  Safety goggles are advised for children who play softball and baseball.

The severity of sports-induced eye injuries varies from mild scrapes of the cornea to severe trauma that can cause visual impairment or even blindness.

Types of injury
Three types of eye trauma can result from sports injuries: corneal abrasion, blunt injuries and penetrating injuries.

Corneal abrasion, a scrape of the outer surface of the eye, usually is painful but not severe. The most common cause, in sports and recreation, is a scratch from a fingernail. Many professional basketball players wear goggles when they play to protect themselves from such an injury.

Blunt injuries occur when impact from an object (tennis ball, racquet, fist, elbow, etc.) causes sudden compression of the eye.

Mild blunt injuries sometimes only result in bleeding of the eyelids, or a black eye. Also, a subconjunctival hemorrhage may develop. This involves bleeding from the delicate blood vessels of the conjunctive, which lie on top of the white outer coat of the eye. Neither of these types of bleeding poses a threat to the eye itself. However, these injuries may be seen in more severe cases in which the eye is damaged. As symptoms of severe injury are not always obvious, it is crucial that all cases of eye trauma get a thorough eye examination from an ophthalmologist.

One of the common results of more severe blunt trauma is bleeding in the front of the eye between the clear cornea and colored iris. This condition is known as a hyphema. In addition, blunt injury may cause a cut or tear of the eyelids, which may need special suturing. Also, the bony walls surrounding the eye may be fractured by severe blunt trauma. Severe blunt trauma also may damage important structures inside the eye, such as the retina or optic nerve, resulting in potentially permanent visual loss. Therefore, if you suffer a blunt injury to the eye, see an ophthalmologist as soon as possible.

Penetrating injuries occur when a foreign object pierces the eye. A common cause of these injuries in children is BB pellets. Also, a piece of glass from spectacles shattered during sports play sometimes can penetrate the eye. Penetrating injuries often cause severe, sight-threatening damage; they are true emergencies and must be evaluated promptly by an ophthalmologist.

Symptoms and evaluation
The warning signs of potentially serious eye injury include:

• Visual loss

• Bleeding on the surface or inside the eye

• Tears in the outer ocular walls

• A foreign body inside the eye

The evaluation of sports-related eye injuries is the same as for other types of eye trauma. More emergent injuries, such as head trauma with loss of consciousness, are always treated first.

Treatment
Prompt first aid after eye injury may greatly improve the chance of preserving vision. The recommended first aid involves placing a protective cover over the eye to prevent further damage. (If no shield is available, tape the bottom of a paper cup over the eye.) Seek emergency care as soon as possible.

The type of treatment given depends on the injury. Surgery may be required to repair blunt or penetrating injuries.

Prevention
The best treatment is prevention, as the old adage goes. The best prevention of eye injury while involved in sports and recreation is to wear specially designed protective eyewear. Such eye guards, while they cannot eliminate risk, greatly reduce the chance of ocular injury. Regular eyeglasses and contact lenses do not offer adequate protection from sports injuries. As already mentioned, glass lenses may even shatter and cut the eye.

Racquet sports—Stricter standards for eyewear for racquet sports have helped reduce the number of eye injuries from these activities. Research done at the UIC Eye Center and elsewhere has led to the improvement of these eye protection devices.

Today, the standard eye guard designed for use in sports such as racquetball, baseball and basketball is made of polycarbonate (plastic) and has closed lenses and sports frames. Avoid open lenses, as a small ball traveling at high speed can be compressed through the opening and cause severe eye damage.

Collision sports—Total head and face protection is essential for any collision sport, for example, a helmet in football and a face mask in hockey. In hockey the risk of eye injury is not so much from collision as from a flying puck. The standardization and use of face masks in organized amateur ice hockey in Canada led to a 66 percent reduction in eye injuries.

The identification of patterns in sports eye trauma is important in helping prevent many of these injuries. The National Eye Trauma System (NETS) is collecting data on the frequency and types of eye injuries, including those due to sports. The UIC Eye Center is one of 50 regional eye trauma centers that are sending the data to NETS.

"Eye Facts" is intended as an informational series and should not be used as a substitute for medical advice.

The Comprehensive Ophthalmology Service is located in the Eye and Ear Infirmary at 1855 W. Taylor Street , Chicago IL 60612. For eye appointments, call (312) 996-4356.