Eye Injury in Sports

Aka: Eye Injury in Sports, Sports Related Eye Injury

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II. Epidemiology

  1. Trauma is the most common cause of non-congenital blindness in age <20 years

III. Risk Factors: Sports with High Risk of Eye Injury

  1. Basketball (most common cause Eye Injury ages 15-64)
  2. Baseball (most common cause Eye Injury age <15 years)
  3. Boxing
  4. Football
  5. Fencing
  6. Hockey
  7. Martial arts
  8. Water polo
  9. Wrestling
  10. Racquet sports (most common cause of Eye Injury age 25 to 65 years)
    1. Squash (ball speed 140 MPH)
    2. Badminton (ball speed 135 MPH)
    3. Racquetball and Tennis (ball speed 110 MPH)

IV. Risk Factors: Sports with Low Risk of Eye Injury

  1. Track and field
  2. Swimming
  3. Gymnastics
  4. Cycling

V. Causes: Eye Injury in Sports

  1. Blunt Eye Trauma
    1. Orbital Wall Fracture or blowout Fracture
    2. Eyelid Contusion
    3. Eyelid Laceration
    4. Ruptured Globe
    5. Hyphema
    6. Retinal tear or detachment
    7. Retinal or Vitreous Hemorrhage
    8. Corneal Abrasion
    9. Subconjunctival Hemorrhage
  2. Penetrating injury
    1. Broken eyeglasses
    2. Fish hook injury
    3. Finger injury to medial canthus (Canalicular injury)
  3. Radiation Injury: UV Keratitis
    1. Seen in snow Skiing and water Skiing

VI. Exam

  1. See Eye Injury

VII. Approach: Guidelines for Sports Participation of Monocular Athletes

  1. Monocular criteria: Best corrected acuity <20/40
  2. Sports Eye Protection always required
  3. Sports that are contraindicated for monocular athletes
    1. Boxing
    2. Wrestling
    3. Full-contact martial arts

VIII. Approach: Criteria for Return to Play Following Severe Eye Injury

  1. Requires ophthalmology exam and clearance
  2. Eye must be pain free with return of Visual Acuity
  3. Eye Protection required
  4. No ocular Anesthetics may be used to return to play

IX. Prevention

  1. See Sports Eye Protection

X. References

  1. Dreis (2020) Crit Dec Emerg Med 34(7):3-21
  2. Catalano (1993) Pediatr Clin North Am 40:827-39 [PubMed]
  3. Napier (1996) Surv Ophthalmol 41:229-44 [PubMed]
  4. Rodriguez (2003) Am Fam Physician 67(7):1481-96 [PubMed]

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