Rising Sports-Related Ocular Injuries Demand Increased Awareness and Protection
The incidence of sports-related eye injuries is steadily increasing, highlighting the need for greater awareness and preventative measures. Prompt intervention and collaboration among medical professionals are crucial in addressing these injuries, many of which are preventable with appropriate eye protection.
The Growing Trend of Sports Eye Injuries
Recent data from Prevent Blindness, based on the National Electronic Injury Surveillance System (NEISS), revealed 43,379 sports-related eye injuries were treated in the United States in 2024, a 33% increase from the previous year [1]. This trend underscores a gap between recommendations for eye protection and actual practice.
The American Academy of Ophthalmology, Prevent Blindness, and the International Sports Vision Association all recommend activity-specific ASTM-certified eye guards, but awareness among patients, guardians, and eye care providers needs improvement [2].
Common Injury Patterns and Sports Involved
A study analyzing NEISS data from 2014 to 2023 reported 1,468 sports-related orbital fractures. The number of fractures gradually increased over the years, with a temporary dip during the COVID-19 pandemic followed by a rapid recovery [3]. Baseball (28.6%) and bicycling (23.1%) were the most frequently implicated sports. Injuries were more common in males (79%) and individuals aged 10-19 years.
Specific sports present unique risks. Baseball, for example, poses a risk of orbital fractures due to the size and velocity of the ball [3]. Bicycling injuries often result from falls and inadequate eye protection. Even seemingly low-risk activities like swimming can cause injury, as demonstrated by cases of eye injury from contact with other swimmers [3].
Types of Injuries and Mechanisms
The likelihood and severity of eye injuries depend on the level of contact in a sport. Sports involving hand activity, such as basketball or martial arts, carry a risk of direct impact to the eye. The size, speed, and density of sporting equipment also play a role. Larger objects cause more orbital trauma, while smaller, faster objects can penetrate the eye [3].
Vitreoretinal injuries, often caused by balls, can range from contusions to retinal detachments. Smaller balls, like those used in golf and paintball, are associated with more severe damage due to their high velocity [4]. Paintball injuries, in particular, have a high rate of impaired vision [4].
The Rise of Pickleball-Related Injuries
A recent cross-sectional study published in JAMA Ophthalmology investigated pickleball-related ocular injuries from 2005 to 2024. The study found an estimated 3,112 injuries, with 1,262 occurring in 2024 alone [5]. This increase correlates with the sport’s rapid growth in popularity (a 311% increase since 2020).
Adults over 50 are most at risk, accounting for 70% of injuries, potentially due to decreased muscle mass, bone density, and balance [5]. Injuries range from superficial abrasions to more serious conditions like retinal detachments and orbital fractures.
Prompt Intervention and Multidisciplinary Care
Effective management of ocular trauma requires prompt intervention and often a multidisciplinary approach. Depending on the injury, specialists such as anterior segment surgeons, retina surgeons, and oculoplastic surgeons may be needed [3]. A thorough eye exam, including dilation, is essential in the emergency room to identify all issues and determine the appropriate specialists.
Posterior injuries are particularly vision-threatening and require urgent assessment and treatment by a retina specialist.
The Importance of Protective Eyewear
The National Eye Institute estimates that 90% of sports-related eye injuries are preventable with appropriate protective eyewear [6]. However, the use of protective eyewear is not mandatory in most sports.
While USA Pickleball has considered mandating eye protection, challenges with enforcement have hindered implementation. The American Academy of Ophthalmology has published recommendations for appropriate eyewear for racket sports, including ASTM F3164 standards for impact resistance [2].
Optimizing Sports Vision
Beyond protective eyewear, optimizing sports vision through regular eye exams and vision training can enhance performance and reduce injury risk. Assessing binocular vision, depth perception, and peripheral awareness can identify areas for improvement. Vision training exercises can improve coordination, reaction time, and visual skills [7].
Key Takeaways:
- Sports-related eye injuries are increasing, emphasizing the need for preventative measures.
- Appropriate eye protection, such as ASTM-certified eye guards, can prevent the majority of injuries.
- Prompt medical intervention and multidisciplinary collaboration are crucial for effective management.
- Optimizing sports vision through regular exams and training can enhance performance and reduce risk.
As sports participation continues to grow, prioritizing eye safety is essential to protect athletes of all ages and skill levels.
References
- Eye care professionals need to increase patient education on importance of proper protective sports eyewear, survey shows. Published Feb. 11, 2023. Accessed Jan. 29, 2026.
- Sports eye safety. Published March 11, 2025. Accessed Jan. 29, 2026.
- Azar FM, et al. J Am Acad Orthop Surg. 2024;doi:10.5435/JAAOS-D-24-00151.
- Haring RS, et al. JAMA Ophthalmol. 2016:doi:10.1001/jamaophthalmol.2016.4253.
- Tsui JC, et al. JAMA Ophthalmol. 2025;doi:10.1001/jamaophthalmol.2025.3577.
- Sports and eye safety: Tips for parents and teachers. Updated Oct. 29, 2025. Accessed Jan. 29, 2026.
- Sports Vision Pros. Accessed Jan. 29, 2026.