Which sports are most associated with eye injuries?

Sports cause more than 40,000 eye injuries each year. More than 90 percent of these injuries can be prevented. Overall, basketball and baseball cause the most eye injuries, followed by water sports and racquet sports.

How are sports classified?

When it comes to eye injuries, sports can be classified as low risk, high risk, and very high risk. Low-risk sports do not use a ball, puck, stick, bat, or racquet, and have no body contact. Some low-risk sports are track and field, swimming, gymnastics, and cycling.

High-risk sports use a ball, puck, bat, stick, racquet, or body contact. Some high-risk sports are baseball, basketball, hockey, football, lacrosse, tennis and other racquet sports, fencing, and water polo.

Very-high-risk sports do not use eye protectors. Some very-high-risk sports are boxing, wrestling, and contact martial arts.

What should I consider before playing sports?

Your family doctor should examine you before you play sports. Tell your doctor if you have any eye problems or if you have a family history of retinal problems. If you have any of these risk factors, you should be checked by an eye doctor before playing any high-risk or very-high-risk sports. Such risk factors increase your risk for serious injury.

What are the most common types of injuries?

Common types of eye injuries are blunt trauma, penetrating injuries, and radiation injury from sunlight.

Blunt trauma occurs when something hits you in the eye. Blunt trauma causes most sports-related eye injuries. Some serious examples are an orbital blowout fracture (a broken bone under the eyeball), a ruptured globe (broken eyeball), and a detached retina. Bruising of the eye and eyelid (“black eye”) looks bad but usually is a less serious injury.

Penetrating injuries occur when something cuts into your eye. These injuries are not very common. You can get a penetrating injury if your eyeglasses break while you are wearing them or if another person's finger scratches you in the eye. Injuries range from mild to deep cuts. Fishing hooks have caused penetrating eye injuries.

Radiation injuries are caused by exposure to ultraviolet light from the sun. These injuries are most common in sports such as snow skiing and water skiing, and other water sports.

How can I protect myself from eye injuries?

Your eye doctor can tell you how to protect your eyes. Wearing eye protection can reduce the number and severity of eye injuries. Only 3-mm polycarbonate lenses should be used in protective sports eyewear. These lenses are available in plain and prescription forms. Polycarbonate lenses are impact resistant. They also are the thinnest and lightest lenses available.

Never wear protective devices without lenses. Contact lenses and sunglasses will not protect your eyes from blunt or penetrating injuries. Wearing a helmet or faceguard cannot protect your eyes, because your eyes are still exposed to an opponent's fingers or other sports equipment. The helmet also can be knocked off, leaving your eyes vulnerable to injury. Your eye doctor can help you choose eye protection for your specific sport.

What is a one-eyed athlete?

A “one-eyed athlete” has less than 20/40 vision in one eye, even with corrective lenses, while the other eye has normal vision. If such an athlete loses vision in the good eye because of injury, he or she could become legally or totally blind. Before playing a given sport, the athlete must know the risks of that sport, how well protective devices work, and if a typical eye injury can be treated successfully.

During games and practices for all sports with the risk of eye injury, one-eyed athletes must wear eye protectors that meet the racquet sports standards of the American Society for Testing and Materials.

In sports that require a face mask, such as hockey, football, and lacrosse, the athlete must wear eye protectors under the face mask. The athlete should wear protective lenses at all times in case of non–sports-related trauma. One-eyed athletes should never participate in very-high-risk sports such as boxing, wrestling, and contact martial arts, because eye protection is not worn in those sports. The one-eyed athlete should be checked by an eye doctor before playing in any sport.

When can an injured athlete return to play?

Athletes with serious eye injury should be examined by an ophthalmologist and return to play only if the doctor says it is safe. The injured eye should feel comfortable and have adequate vision. The athlete should wear eye protectors.

For a less serious injury, the team physician can decide if the athlete can return to play based on the type of injury and how the athlete feels. Athletes should never use topical anesthetics so they can keep playing.