Article

Epidemiology of Sports-Related Eye Injuries in the United States

November 2016
Jama Ophthalmology 134(12)

DOI:10.1001/jamaophthalmol.2016.4253

Authors:

Richard Sterling Haring

Vanderbilt University

Joseph Canner

Johns Hopkins Medicine

Eric B Schneider

Johns Hopkins Medicine

Importance: Ocular trauma can lead to lifelong sequelae, and sports-related ocular injuries have been shown to disproportionately affect the young. Studies quantifying and characterizing the incidence and type of injuries seen with sports-related ocular trauma may be useful for resource utilization, training, and prevention efforts. Objective: To examine the emergency department (ED) burden of sports-related ocular trauma in the United States. Design, setting, and participants: This retrospective, cross-sectional study examined the Nationwide Emergency Department Sample, containing data from approximately 30 million ED visits annually at more than 900 hospitals nationwide, from January 1, 2010, to December 31, 2013, to determine factors associated with sports-related ocular trauma. Main outcomes and measures: Annual incidence of sports-related ocular trauma, broken down by age, sex, mechanism of injury, and related activity, as well as factors associated with short-term impaired vision. Results: During the study period, 120 847 individuals (mean age, 22.3 years [95% CI, 21.9-22.7]; 96 872 males, 23 963 females, and 12 with missing data) presented with sports-related ocular trauma, which was the primary diagnosis in 85 961 patients. Injuries occurred most commonly among males (69 849 [81.3%]; 95% CI, 80.6%-81.9%) and occurred most frequently as a result of playing basketball (22.6%; 95% CI, 21.7%-23.6%), playing baseball or softball (14.3%; 95% CI, 13.7%-14.9%), and shooting an air gun (11.8%; 95% CI, 10.8%-12.8%). Odds of presentation to the ED with impaired vision were greatest for paintball and air gun injuries relative to football-related injuries (odds ratio, 4.75; 95% CI, 2.21-10.19 and 3.71; 95% CI, 2.34-5.88, respectively; P < .001). Conclusions and relevance: In our study, approximately 30 000 individuals presented annually to EDs in the United States with sports-related eye injuries; in more than 70% of these cases, eye injuries were the primary diagnosis. Activities involving projectiles pose the greatest risk for visual impairment in the short term, although long-term outcomes were unavailable.

Epidemiology and outcome of Sports-related Ophthalmic Trauma from lower middle-income countries using The International Globe and Adnexal Trauma Epidemiology Study (IGATES) registry

Preprint

Full-text available

May 2024

Purpose Aims to identify patterns in sports-related ophthalmic injuries, their clinical findings, and final visual outcomes from a large international multicenter eye injury registry. Methods Retrospective and prospective analysis of patients with sports-related ophthalmic trauma from the International Globe and Adnexal Trauma Epidemiology Study (IGATES) registry from January 2020 to March 2022 was conducted. Results 322/3200 patients presented with sports-related ophthalmic trauma. Males (282, 87.6%) was the majority patients. The mean age was 24.6 ± 14.0 years old and 99.6% cases were unilateral. The common injuries were closed globe injury (CGI) (244/318) followed by open globe injury (OGI) (63/318). Only two patients used eye protection. Mean initial visual acuity (VA) was 0.81 ± 0.89 LogMAR and final VA was 0.57 ± 0.84 LogMAR (P < 0.001). Injuries to the anterior chamber (AC) (171/320), iris (124/314), and cornea (121/321) were the dominant clinical findings. Cricket (53) and Badminton (47) were the majority cause. Surgical intervention reported for 77 with 36 primary globe repairs. Using univariate analysis, initial VA, injuries to lens, sclera, posterior segment and retinal detachment, intraocular pressure (IOP), type of injury, surgery, and ocular trauma score (OTS) (P < 0.001), injuries to cornea, iris and AC (P < 0.05), were significantly associated with final VA. Initial VA, scleral injury (P < 0.001), injuries to cornea, iris, AC, lens and posterior segment (P < 0.05) were significantly associated with final VA in multivariate analysis. Conclusions Cricket and CGI were the majority cause of sports-related ophthalmic trauma. Initial VA followed by injuries to cornea, iris, AC, lens, sclera and posterior segment were associated with final VA.

Discrepancy of eye injuries in mechanism, clinical features, and vision prognosis by different causative sports

Article

Full-text available

Oct 2023

Objective To investigate the epidemiological and clinical characteristics of sports-related eye injuries in China, as well as how they differ depending on the sport or other specific factor that caused them. Methods Consecutive medical records from 2015 to 2019 of sports-related eye injuries from a standardized database in nine tertiary referral hospitals in China were retrospectively reviewed and analyzed. Results A total of 377 eyes in 376 inpatients (mean age, 22.5 ± 7.3 years; men:women 15.4:1) were included. Soccer (46.8%), basketball (27.1%), and badminton (16.8%) were the top three sports that caused injury. Ball strikes (74.7%), physical collision (13.8%), and racket/equipment beating (9.0%) were the common specific causes of injury. Blunt force injuries (95.8%) and close globe injuries (95.1%) accounted for the majority of injuries. Open globe injuries occurred more in basketball (8.3%) than in other sports, mainly due to physical collision (12.8%) and racket/equipment beating (11.8%). Basketball (13.4%) or physical collision (21.3%) caused Zone I injuries more frequently than other sports. Soccer (60.5%) and basketball (54.6%) caused more injuries to the posterior segment of the eyeball than other sports, mainly due to ball strikes (96.6%). Badminton (69.8%) and racket beating (61.8%) caused more Zone II globe injuries than other sports. In badminton, the percentage of hyphema (85.7%), the most typical symptom of eye damage, and ultimate visual acuity (VA) ≥20/40 (88.9%) was the greatest. A final low vision score of (≤4/200) was observed in 10.6% of all participants, including three participants who had an eye removed due to rupturing. The final VA was positively correlated with the presenting VA (r = 0.421). Conclusion Sports can lead to high proportions of ocular contusion injury and low vision. VA prognosis is closely related to initial VA following ocular sports trauma, which is directly determined by the causative sports and/or the specific causes. Effective eye protection is imperative to avoid or reduce visual impairments of sports participants.

Article

Full-text available

Apr 2022
Emerg Med

Objective: To describe the demographics and outcomes of sports-related ocular injuries in an Australian tertiary eye hospital setting. Methods: Retrospective descriptive study from the Royal Victorian Eye and Ear Hospital from 2015 to 2020. Patient demographics, diagnosis and injury causation were recorded from baseline and follow-up. Outcomes included visual acuity (VA), intraocular pressure (IOP), ocular injury diagnosis, investigations and management performed. Results: A total of 1793 individuals (mean age 28.67 ± 15.65 years; 80.42% males and 19.58% females) presented with sports-related ocular trauma. The top three injury-causing sports were soccer (n = 327, 18.24%), Australian rules football (AFL) (n = 306, 17.07%) and basketball (n = 215, 11.99%). The top injury mechanisms were projectile (n = 976, 54.43%) and incidental body contact (n = 506, 28.22%). The most frequent diagnosis was traumatic hyphaema (n = 725). Best documented VA was ≥6/12 at baseline in 84.8% and at follow-up in 95.0% of cases. The greatest risk of globe rupture/penetration was associated with martial arts (odds ratio [OR] 16.22); orbital blow-out fracture with skiing (OR 14.42); and hyphaema with squash (OR 4.18): P < 0.05 for all. Topical steroids were the most common treatment (n = 693, 38.7%). Computed tomography orbits/facial bones were the most common investigation (n = 184, 10.3%). The mean IOP was 16.1 mmHg; 103 (5.7%) cases required topical anti-ocular hypertensives. Twenty-six individuals (1.45%) required surgery with AFL contributing the most surgical cases (n = 5, 19.23%). Conclusion: The top three ocular injury causing sports were soccer, AFL and basketball. The most frequent injury was traumatic hyphaema. Projectiles posed the greatest risk.

Finite Element Analysis of Soccer Ball-Related Ocular and Retinal Trauma and Comparison With Abusive Head Trauma

Article

Full-text available

Feb 2022

Purpose Trauma to the eye by a soccer ball is a common sports-related injury. Although the types of ocular pathology that result from impact have been documented, the underlying mechanics and pathophysiology are not as well-studied. The purpose of this study was to evaluate the biomechanical events following the collision of a soccer ball with the eye to better understand the pathophysiology of observed ocular and retinal injuries and compare them to those observed in abusive head trauma (AHT). Design Computer simulation study. Participants None. Methods A finite element model of the eye was utilized to investigate the effects of a collision of a soccer ball on the eye. Main Outcome Measures Intraocular pressure and stress. Results Impact of the soccer ball with the eye generated a pressure wave that traveled through the vitreous creating transient pockets of high and negative pressure. During the high frequency phase, pressure in the vitreous near the posterior pole ranged from 39.6 kPa to -30.9 kPa. Stress in ocular tissue was greatest near the point of contact with a peak of 66.6 kPa. The retina experienced the greatest stress at the vasculature, especially at distal branches where stress rose to 15.4 kPa. On average, retinal stress was greatest in the subretinal layer, but was highest in the preretinal layer when only considering vascular tissue. Conclusions The high intraocular pressure and stress in ocular tissue near the point of soccer ball impact suggest that injuries to the anterior segment of the eye can be attributed to the direct transmission of force from the ball. The subsequent propagation of a pressure wave may cause injuries to the posterior segment as the positive and negative pressures exert compressive and tractional forces on the retina. The linear movement of the pressure wave likely accounts for localization of retinal lesions to the posterior pole or superior temporal quadrant. The primarily linear force in soccer ball trauma is the probable cause for the more localized injury profile and lower retinal hemorrhage incidence compared to AHT, in which repetitive angular force is also at play.

Epidemiology of Sports-Related Eye Injuries Among Athletes in Tianjin, China

Article

Full-text available

Sep 2021

Purpose: To investigate the incidence, characteristics, and risk factors of sports-related eye injuries among athletes in Tianjin, China. Methods: A cross-sectional study was carried out from March 2018 to October 2018. In this study, the athletes from Tianjin University of Sports, Tianjin Vocational College of Sports, and Tianjin provincial sports teams were selected for general investigation. In total, 1,673 athletes were invited and 1,413 participated in the study (response rate of 84.5%). Results: In total, 1,413 athletes were enrolled; 151 had suffered from sports-related eye injuries, with an incidence of 10.7% (95% CI : 9.1–12.0%). Handball (38.5%) was the sport with the highest incidence of eye injuries, followed by water polo (36.4%) and diving (26.7%). Overall, 42.4% of the athletes were injured by ball and 22.5% of injuries came from teammates. The eye injuries usually occurred during training (64.2%) and competitions (14.6%). Adnexa wound (51.7%) was the most common type of injury. About 11.9% of the athletes with eye injuries had the impaired vision; 66.7% failed to see doctors on time. The athletes <18 years of age had a higher risk of eye injuries (odds ratio [ OR ] =1.60, 95% CI : 1.06–2.40). The athletes with lower family income (<1,000 RMB) were at risk population for sports-related eye injuries ( OR = 3.91, 95% CI : 2.24–6.82). Training >4 h a day increased the risk of eye injuries ( OR = 2.21, 95% CI : 1.42–3.43). Conclusion: The incidence of sports-related eye injuries among athletes was 10.7% in Tianjin, China. Handball, water polo, and diving were the most common activities of injury. Age, family income, and training time were the risk factors for sports-related eye injuries.

The Role of Social Media in Sports Vision

Article

Full-text available

May 2021
Int J Environ Res Publ Health

Background: Sports vision is a relatively new specialty. The objective is to provide ophthalmological and optometric care services for the care of vision in the sports field. An increasing number of athletes and coaches are trying to improve visual skills and they seek information on social media. The current excess of information has made it increasingly difficult to identify high quality articles. For this reason, alternative metrics are useful tools to identify publications that draw attention to society. This research aims to study the influence of social networks on the importance of vision in sport. Methods: Altmetric Explorer was used to perform a search using "sport", "vision" and "eye" as keywords. The 100 outcomes with the most attention were analyzed and correlated with the number of citations in the Web of Science (WoS) using the Spearman correlation coefficient. Results: The 100 best Altmetric Attention Scores (AASs) were published in 67 journals and had a mean AAS value of 30.22 ± 62.37 The results were discussed mainly on Twitter, with a mean of 113.99 ± 43.86 tweets and retweets and a mean of 75.92 ± 79.92 readers in Mendeley. There was no correlation between AAS and WoS Cites for the top 100 outcomes and the correlation was low if we considered the total research results rather than the top 100. Conclusions: The citations are not related to the impact of scientific articles on social networks. Sports vision is a specialty with a growing interest in social media.

Consumer Products Nerve Injuries Among Patients Products Presenting to United States Emergency Departments Between 2012 and 2021: A Nationwide Cohort

Article

Full-text available

Jan 2025

Introduction Nerve injuries and resultant pain are common causes of emergency department (ED) visits in the United States. Injuries often occur either due to activity (ie sports related injury) or due to consumer products such as stairs or bedframes. We investigated the incidence of consumer product-related nerve injuries (CPNIs) in patients who presented to the ED in the United States. Materials and Methods The National Electronic Injury Surveillance System was queried to identify patients presenting to US EDs between 2012 and 2021 with CPNIs. The cohort was categorized by age: 1) 0–17-year-olds, 2) 18–64-year-olds, 3) and 65+ year-olds. The primary outcomes were the type of injury and the location of injury. Results A total of 14,410 CPNIs were reported. There was an increase in yearly CPNIs (β = 4763, (95% confidence interval 1940–7586); P = 0.004). The majority (11,547/14,410, 80.1%) of injuries were among adults. Elderly females encountered more CPNIs than males (52.5% vs 47.8%, P = 0.002). Stairs were most involved in nerve injuries among adults (8.21%) and children (3.96%) whereas beds or bedframe injuries were most frequent (12.0%) among the elderly. Sciatica was the most common diagnosis (≥60%) followed by radiculopathy (≥20%) in adults >18 years of age. Among adults aged 18 to 29, the upper trunk, lower arm, and wrist was more frequently involved, while these areas were less commonly involved in adults aged 40 to 49. Compared to adults, the pediatric and elderly patients presented with more traumatic spinal cord injuries. Conclusion Sciatica, radiculopathy, and traumatic spinal cord injury were the most common diagnoses following CPNIs. Children and the elderly tended to present with more severe CPNIs than the general adult population. Further investigations exploring interventions to lower the burden of CPNIs, improve consumer product safety, and reduce potentially chronic and debilitating injuries are necessary.

Visual Awareness and Its Impact on Sports Performance of Basketball Players in the Maldives

Article

Full-text available

Nov 2024

Objective: This study aimed to assess the visual awareness and its impact on basketball performance among Maldivian basketball players. Material and Methods: A 16-item questionnaire about visual and ocular problems, perception towards eye health, and sports performance was distributed electronically to basketball players in the Maldives through various basketball organizations. Data collected were analyzed using descriptive statistics and the Chi-Square test in Statistical Package for the Social Sciences. Results: Eighty two Maldivian basketball players aged between 10-40 years, with sixty males, participated in this study. Data showed that only 30.5% of the respondents wore vision correction when playing basketball, none had undergone any visual training, and 20.7% never had any eye examination.Majority of those who underwent eye examination had more than two years since their last eye checkup. Visual difficulties during games were reported by 41.5% of the respondents, with blurry vision and eye injury being the most commonly reported visual symptom and ocular problem, respectively. Moreover, 70.7% of the players experienced inconsistent performance level and loss of concentration during games. There was a significant relationship between experiencing visual difficulties and inconsistent sports performance χ 2 (1, N=82) =5.95, p-value=0.02. Conclusion: The visual awareness among Maldivian basketball players is generally low and this seems to be associated with their sports performance. Importance of using corrective/protective eyewear and attending regular eye examinations should be cultivated among athletes in the Maldives, aiming to improve the sports field in this country.

Awareness of ocular hazards among welders in Bindura, Zimbabwe

Article

Full-text available

Sep 2024

Occupational health issues are the highest among workers in developing nations. This study aimed to assess the awareness of ocular hazards among welders in Bindura. An observational cross-sectional design with a validated structured self-administered questionnaire was used to assess the awareness of ocular hazards among 400 welders. Among the 400 welders, 397(99.3%) were males and their ages ranged from 19 – 56 with a mean age of 36 ± 8 years. Most (35%) of them, 140 had been involved in welding for 6-10 years. The most common type of welding among the participants was arc welding (87.8%). Majority (99.3%) of the welders were aware that welding without the use of protective equipment is a potential source of ocular hazards. Many welders had access to protective face shields and used them all the time (84.5%). The most common condition was ocular foreign bodies (17.7%), followed by Arc eye (4.8%). Awareness about welding as a source of ocular hazard depends on the type of welding used (p < 0.05). The awareness of ocular hazards among welders in Bindura is high. Although, protective devices are provided, regular utilization needs to be encouraged and enforced.

Long-term functional and structural outcomes after large chorioretinectomy for ruptured globe following blunt trauma

Article

Full-text available

Aug 2023

Background The purpose of this study was to present a modified surgical technique involving pars plana vitrectomy with large chorioretinectomy for eyes with rupture of the globe due to severe ocular blunt trauma. Methods This retrospective study included consecutive patients with rupture of the globe due to blunt trauma who were treated at the King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia). All patients underwent 25-gauge pars plana vitrectomy with large chorioretinectomies involving all the tissue around the posterior scleral wounds. Outcome measures included best-corrected visual acuity (BCVA), anatomical success and globe survival, rates of complications. Results 15 eyes of 15 patients were included. Mean BCVA was 2.88 ± 0.13 logMAR at presentation, and significantly improved to 0.83 ± 0.28 logMAR (P < 0.001), with 10 patients (67%) achieving a final BCVA ≥ 20/200. Anatomical success and globe survival were achieved in 11 (73%) and 15 (100%) of eyes, respectively. Postoperative complications included retinal detachment in 6 eyes (40%), epiretinal membrane in 6 (40%), hypotony in 4 (26%), PVR in 2 (13%). Conclusions Pars plana vitrectomy with large chorioretinectomy is an effective treatment for globe rupture following severe blunt trauma, yielding good visual outcomes and anatomical success rates.

Clinical evaluation and management of badminton-related eye injuries: a retrospective case series

Article

Full-text available

Jun 2023
BMC Ophthalmol

Background To describe the clinical features, visual outcomes, management, and complications of ocular injury in badminton and investigate risk factors associated with visual impairment. Methods Data on patients injured while playing badminton admitted to Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University between January 2018 to December 2020.The relationship between visual acuity (VA) and demographic and clinical variables was also analyzed. Patients were managed medically or surgically as per their needs, followed up for at least 18 months. The visual outcomes were predicted using ocular trauma score (OTS), predicted outcomes were compared with actual outcomes using statistical tests. Results This study involved 102 patients (78 men, 24 women) with a mean age of 43.8 ± 16.1 years (7–71 years). Of these, 93 patients had closed-globe injuries and 9 had open-globe injuries. Vision-threatening findings included lens subluxation(31.4%),retinal detachment(13.7%),hyphema(12.7%). Open-globe injury had significantly lower presenting VA and final VA (P= 0.0164, 0.0053).Final VA was found to be correlated with presenting VA, maculopathy, retinal detachment, and OTS (P=0.0000, 0.0494, 0.0001, 0.0000 respectively), it was worse in patients who were under 20 years of age and were female. OTS prediction was not significantly different when compared with actual visual outcomes postoperatively in OTS3, OTS4, and OTS5 (P > 0.05),while the prognosis of patients with OTS1 and OTS2 was better than OTS study (P=0.001, 0.007, respectively). Conclusion Badminton-related closed-globe injuries were more frequent; open-globe injuries were usually more serious. Younger and female patients have poorer visual recovery prognoses. OTS was found to be a reliable tool for predicting visual outcomes.

Characteristics of pediatric ocular trauma in a pediatric emergency department in Japan

Article

May 2023
AM J EMERG MED

Introduction: Pediatric ocular trauma is a common complaint in pediatric emergency departments (ED) and is a major cause of acquired monocular blindness. However, data on its epidemiology and management in the ED are lacking. The objective of this study was to describe the characteristics and management of pediatric ocular trauma patients who visited a Japanese pediatric emergency department (ED). Methods: The present, retrospective, observational study was conducted in a pediatric ED in Japan between March 2010 and March 2021. Children younger than 16 years who visited our pediatric ED and received the diagnosis of ocular trauma were included. ED visits for follow-up examinations for the same complaint were excluded. The patients' sex, age, arrival time, mechanism of injury, signs and symptoms, examinations, diagnosis, history of urgent ophthalmological consultation, outcomes, and ophthalmological complications were extracted from electronic medical records. Results: In total, 469 patients were included; of these, 318 (68%) were male, and the median age was 7.3 years. The incident leading to trauma occurred most frequently at home (26%) and most often involved being struck in the eye (34%). In 20% of the cases, the eye was struck by some body part. Tests performed in the ED included visual acuity testing (44%), fluorescein staining (27%), and computed tomography (19%). Thirty-seven (8%) patients underwent a procedure in the ED. Most patients had a closed globe injury (CGI), with only two (0.4%) having an open globe injury (OGI). Eighty-five (18%) patients required an urgent ophthalmological referral, and 12 (3%) required emergency surgery. Ophthalmological complications occurred in only seven patients (2%). Conclusion: Most cases of pediatric ocular trauma seen in the pediatric ED were CGI, with only a few cases leading to emergency surgery or ophthalmological complications. Pediatric ocular trauma can be safely managed by pediatric emergency physicians.

Factors associated with final visual outcome in traumatic hyphema

Article

Full-text available

Dec 2022

Introduction: Hyphema is the accumulation of blood in anterior chamber of the eye that can directly affect our vision. Various factors play role in final visual outcome among patients with hyphema, and there are very few related studies. Therefore, this study aimed to determine the factors related to final visual outcome among patients with traumatic hyphema. Methods: This cross-sectional study was conducted among 62 cases of traumatic hyphema presenting to the emergency department of Tribhuwan University Teaching Hospital and outpatient department of Bisheshwar Prasad Koirala Lions Centre for Ophthalmic Studies from July 2018 to July 2019. A detailed clinical history was obtained, followed by an ophthalmic examination and relevant investigation. Data was analysed using descriptive and inferential statistics at 5% level of significance using IBM statistical package for the social sciences. Results: Projectile (54.8%) and fall injury (12.5%) were the most common mode and causes of trauma, respectively. The best visual acuity of the involved eye at presentation was 6/9 (6.5%), and the worst was non-perception of light (3.2%). At presentation, the most common grade of hyphema was grade I (48.4%), and the least common was microhyphema (6.5%). Grades of hyphema (p=0.014) were significantly associated with the final visual outcome. Anterior segment findings such as of lid (p<0.001) and lens (p=0.014) and posterior segment findings such as of vitreous (p<0.001) and retina (p=0.048) were also significantly associated with final visual acuity. Conclusions: For the most optimal visual outcome in traumatic hyphema, all associated periocular and intraocular findings must be prioritized and addressed accordingly.

Central Retinal Vein Occlusion Secondary to Ocular Trauma in a Young Patient: A Case Report

Article

Full-text available

Feb 2021

Ailia Ahmed

Central retinal vein occlusions (CRVO) occurring in young patients or due to a traumatic etiology is uncommon. This paper outlines the case of a 33-year-old Asian male who presented with a chief complaint of blurry peripheral vision and photophobia in his left eye, one week after sustaining blunt ocular trauma. He was diagnosed with a traumatic CRVO based on history and exam findings.

Afferent Visual Manifestations of Traumatic Brain Injury

Article

Jul 2021

Traumatic brain injury (TBI) causes structural and functional damage to the central nervous system including the visual pathway. Defects in the afferent visual pathways affect visual function and in severe cases causes complete visual loss. Visual dysfunction is detectable by structural and functional ophthalmic examinations that are routine in the eye clinic, including examination of the pupillary light reflex and optical coherence tomography (OCT). Assessment of pupillary light reflex is a non-invasive assessment combining afferent and efferent visual function. While a flashlight assessment is relatively insensitive, automated pupillometry marked 95% specificity and 78.1% sensitivity in detecting TBI-related visual and cerebral dysfunction with an area under the curve (AUC) of 0.69-0.78. OCT may also serve as a non-invasive biomarker of TBI severity, demonstrating changes in the retinal ganglion cell layer and nerve fiber layer throughout the range of TBI severity even in the absence of visual symptoms. This review discusses the impact of TBI on visual structure and function.

Five-year survey and management of sports-related eye injuries in Jakarta’s eye hospitals

Article

Full-text available

Mar 2021

: To examine the demographics and outcome of management in patients admitted with sports-related eye injuries in one of Jakarta’s eye hospitals. : Retrospective analysis 24 patients who admitted to a tertiary eye hospital in Jakarta with sports-related eye injuries between 2014 to 2019 was conducted. Standard descriptive statistical methods were used for analysis. : Out of 534 patients admitted to our hospital with ocular trauma between 2014 to 2019, 24 patients (4.5%) had sport-related eye injuries. Most patients were male (17/24, 70.8%), below 25 years old (18/24, 75%) and students (7/24, 29.2%) by occupation. The most common cause of injury was badminton (9/24, 37.5%) followed by ball games (6/24, 25%) and fishing (3/24, 12.5%). Most patients suffered from closed globe injuries (16/24, 66.7%). Anterior segment of the eye was mostly involved (16/24, 66.7%) with hyphema being the most common clinical presentation (11/24, 45.8%), followed by palpebrae edema (5/24, 20.8%). Patients were mostly admitted with moderate visual impairment (14/24, 58.3%). Most patients were managed by medical treatment (16/24, 66.7%) while those with more severe presentations underwent surgeries (7/24, 29.2%). Complications such as secondary glaucoma (1/24, 4.2%) and graft-rejection (1/24, 4.2%) were recorded. : The incidence of sports-related eye injuries increases every year. Badminton was responsible for the most cases of sports-related eye injuries. These injuries could result in severe complications. Protective eyewear could prevent these injuries.

Increased severity of ocular and oculofacial injuries in major league baseball after implementation of a pitch clock

Article

May 2025
Orbit

Augenverletzungen und Fehlsichtigkeit im Schul- und Vereinssport: Argumente für die DIN-geprüfte schulsporttaugliche Brille

Article

Feb 2025

Gernot Jendrusch

Visual deficits/ametropia are particularly significant obstacles in sports because the visual system controls/corrects all of an athlete’s movements. However, athletes are at increased risk for eye injuries caused by high-velocity objects e.g. balls or physical contact with opponents. This article presents the current (German) figures on eye injuries in club and school sports and evaluates the risk of eye injuries in various sports. 2392 eye injuries, selected from the 221273 club sports injuries recorded in the Ruhr University Bochum and ARAG Sports Insurance database for the period 1987–2017 were evaluated. The school sports eye injuries recorded by the German Social Accident Insurance for 2019 were also analyzed. Of all the club sports injuries recorded, 1.08% were eye injuries; of these, 19.7% had to be treated in hospital, 13.9% required surgery, and 56.9% prevented the injured athletes from working. Blunt trauma was the most common cause of injury, comprising more than 50% of cases. Eye injuries were strongly overrepresented in club sports injuries sustained during water polo, squash, badminton, and tennis (injury proportion ratio [IPR] = 5.1–8.8). In school sports, eye injuries comprised 1.83% of the reported cases. Eye injuries in sports are relatively rare, but often serious. Based on the increased IPR found for some sports, further studies must analyze the risk of eye injury in more detail. Eye protection in the form of sport-appropriate glasses should be used. In addition, the article addresses the problem of “defective vision in sport” and its adequate correction and shows the requirements for spectacles suitable for (school) sport using the example of DIN 58184 “Spectacles suitable for school sports – Requirements and test methods”.

Postoperative guidelines following pediatric cataract and glaucoma surgeries: a survey of preferred surgeon instructions

Article

Jan 2025
J AAPOS

Augenverletzungen und Fehlsichtigkeit im Schul- und Vereinssport: Argumente für die DIN-geprüfte schulsporttaugliche Brille

Article

Jan 2025
KLIN MONATSBL AUGENH

Gernot Jendrusch

Epidemiology of Consumer Product-Related Ocular Injuries in the Incarcerated Population

Article

Jan 2025
Semin Ophthalmol

Purpose: To characterize the epidemiology of consumer product-related ocular injury in the United States (US) incarcerated population, and identify preventable causes. Methods: The National Electronic Injury Surveillance System (NEISS) database was queried for cases of eye injury from 2014 to 2023. Incarcerated cases were identified using the keywords "prison", "jail", "inmate", and "incarcerate". Year of injury, diagnosis, product code, and demographic information were gathered and compared between the incarcerated and general US populations using SPSS version 29 (IBM Corp.). A narrative analysis categorized cases of ocular trauma in the incarcerated by common causes of injury. Results: Between 2014 and 2023, there were an estimated 1,644,841 cases of consumer-product related ocular injury the US, with 2683 cases occurring in the incarcerated. A higher percentage of ocular injury cases in the incarcerated involved African American individuals (43.42% vs. 17.18%), males (92.22% vs 68.54%), alcohol use (4.11% vs. 0.64%), drug use (3.91% vs. 0.82%), and hospitalization (4.96% vs. 1.39%). Contusions were less common in the incarcerated population (27.21% vs. 41.31%), while foreign body injuries were more common (24.38% vs. 18.75%). Penal labor, including cleaning (13.74%), welding (8.25%), yardwork (5.92%), and power grinding (5.72%), accounted for 36.36% of injuries. 26.50% of injuries were sports-related, with basketball involved in 16.82%. Conclusions: The epidemiology of ocular injury in the incarcerated differs from the general US population. Penal labor and sports-related ocular injury represent a majority of cases, underscoring the need for protective eyewear.

Surgical and Nonsurgical Trauma

Chapter

Jan 2025

Eye Conditions: Position Statement of the Association of Ringside Physicians

Article

Dec 2024

Orbital Trauma Epidemiologic Characteristics by Life Stage

Article

Aug 2024

Study Design Retrospective database review. Objective This study aims to characterize and compare the epidemiological factors of orbital trauma between life stages by utilizing the National Electronic Injury Surveillance System (NEISS), a nationally representative database. Methods The NEISS was queried for orbital injuries from 2013 to 2022. Demographic data, injury type, injury location, and product related to injury were compared across life stages defined as 0-5 years (young children), 6-17 years (adolescents), 18-64 years (working adults), and >65 years (elderly adults). Results 7846 orbital injuries were reported in the NEISS from 2013-2022. Incidence increased in all age groups over the study period but was highest in elderly adults. There was a bimodal distribution in the frequency of orbital trauma, with peaks occurring at age<20 and around age 80. Adolescents were most likely to be injured by sports-related products while young children and elderly adults were more likely to be injured by household products. Orbital fractures were the most common type of injury across all age groups (40.6%), with the highest rate observed in working adults. Elderly adults were more likely to be admitted to the hospital compared to working adults (RR 1.62 [1.49-1.77]). Conclusions The rate of orbital trauma is increasing over time, especially in elderly adults, highlighting the need for increased and improved preventative and education measures. The age-specific epidemiological factors identified in this study may help improve detection and management of injuries and guide public health initiatives.

Visual Performance and Sports: A Scoping Review

Article

May 2024

Vision is central to success in nearly all sports, and there is an emerging body of research investigating the links between visual abilities and athletic performance. This preregistered scoping review seeks to clarify the topics of study, methodologies used, populations under investigation, researchers, and disciplines driving this field. Systematic searches of English-language articles were conducted in PubMed and Web of Science, with additional literature identified through bibliographic searches. Six hundred sixty-seven articles published between 1976 and 2023 were identified with 547 empirical studies, 58 review articles, 20 commentaries, and 4 meta-analyses, among others. Among the empirical papers, 411 reported on visual assessments and 98 on vision training interventions. The most represented sports included baseball, soccer, basketball, and cricket, with over 150 articles reporting on professional, elite, or Olympic athletes. This scoping review describes the breadth of this emerging field, identifies its strengths and weaknesses, and provides recommendations for future improvement.

Implementation of anterior segment ophthalmic telemedicine

Article

May 2024
CURR OPIN OPHTHALMOL

Purpose of review The growing push to integrate telemedicine into ophthalmic practices requires physicians to have a thorough understanding of ophthalmic telemedicine's applications, limitations, and recent advances in order to provide well tolerated and appropriate clinical care. This review aims to provide an overview of recent advancements in the use of ophthalmic telemedicine for anterior segment eye examinations. Recent findings Virtual care for anterior segment evaluation relies on appropriate technology, novel workflows, and appropriate clinical case selection. Recent advances, particularly in the wake of the COVID-19 pandemic, have highlighted the utility of home-based assessments for visual acuity, external evaluation, tonometry, and refraction. Additionally, innovative workflows incorporating office-based testing into virtual care, termed ‘hybrid telemedicine’, enable high-quality ophthalmic testing to inform clinical decision-making. Summary Novel digital tools and workflows enable high-quality anterior segment evaluation and management for select ophthalmic concerns. This review highlights the clinical tools and workflows necessary to enable anterior segment telehealth.

Initial Assessment of the Injured Athlete

Chapter

Jan 2024

The athlete’s willingness and commitment to training hard to fight for achievements and wins and the psychological distress of training and competitions make sports prone to injuries. Therefore, sports medicine physicians should know about the particularities inherent to each sports modality to define the best strategy to work on the sports events, organizing the medical bag and supplies based on the commonly related injuries and environmental conditions that could predispose the athletes to injuries and clinical problems. This chapter explores the assessment and initial treatment of some specific indoor and outdoor sports injuries. It discusses some adverse athletes’ clinical conditions, such as syncope, heat exhaustion, and heat stroke, and injuries due to facial and head trauma, knockout events, upper and lower limb injuries, water events, and red flags.

Blunt Ocular Trauma in Sport

Article

Nov 2023
Curr Sports Med Rep

International Olympic Committee (IOC) consensus paper on sports-related ophthalmology issues in elite sports

Article

Full-text available

Jul 2023

Vision plays an important role in an athletes’ success. In sports, nearly 80% of perceptual input is visual, and eye health and sports medicine are closely intertwined fields of utmost importance to athletes. The physical nature of sports activities renders individuals more prone to various eye injuries than the general population. Ocular trauma can lead to lifelong sequelae, and impaired vision requires careful follow-up and management. Apart from injuries, athletes may also experience vision problems that can hamper their performance, including blurred vision, double vision, and light sensitivity. The interdisciplinary nature of sports medicine necessitates collaboration between sports medicine professionals and ophthalmologists. Through such collaborations, athletes can receive appropriate eye care, education on proper eye protection and guidance on adopting good eye health practices. If any inconspicuous symptoms are not detected and treated promptly, athletes may acquire systemic injuries because of defective vision, preventing them from achieving high level athletic performance in competitions. The protection of the elite athlete is the responsibility of all of us in sports medicine. To advance a more unified, evidence-informed approach to ophthalmic health assessment and management in athletes and as relevant for sports medicine physicians, the International Olympic Committee Consensus Group aims for a critical evaluation of the current state of the science and practice of ophthalmologic issues and illness in high-level sports, and present recommendations for a unified approach to this important issue.

Clinical report on the epidemiology of non-motorized pedal cycle-related ocular injuries in children ages 5 to 17

Article

Jul 2023
AM J EMERG MED

Guidance for Social/School Life and Future Directions

Chapter

Jun 2023

Visual impairment in the children with vitreoretinal disease can greatly impact both academic and social environments. Low vision in children can have ramifications on psychosocial, physical, and mental health that require tailored attention and guidance for each child. Families should be educated and advised on which activities are safest and most beneficial for their child. Affected children require early diagnosis, close monitoring, and prompt referral to visual rehabilitation centers to implement optical aids and low vision devices. These services can increase functional vision and lead to overall improved academic performance and quality of life. It is important for the ophthalmologist to recognize children’s individual needs and provide available resources in schools, communities, and local agencies to ensure well-being in both the child and the family.KeywordsLow visionAcademicsSocial developmentVisual rehabilitationOptical aids

Quantifying the efficacy of protective eyewear in pediatric soccer-induced retinal injury

Article

May 2023

Background: Ocular injury is common in children playing sports. Sports-related eye injuries, if severe enough, can lead to permanent vision impairment. Soccer, the most popular sport in the world, is a sport in which players rarely use protective eyewear. The purpose of this study was to determine how eye injuries are induced by a soccer ball impact and to evaluate whether eye protection influences the effects of impact. Methods: A finite element (FE) computer simulation was used to simulate soccer ball trauma on a model of the eye with and without eye protection. Protective eyewear of different materials (polycarbonate and acrylic) was modeled to investigate the optimal medium for eye protection. Stress and strain experienced by the eyeball was quantified by the FE computer simulation in each model. Results: Protective eyewear was found to be effective in lowering ocular stress and strain by absorbing and redirecting energy from the ball. Compared to the unprotected eye model, polycarbonate eyewear reduced the average stress the retina experienced by 61%, whereas the acrylic model reduced the average stress by 40%. Polycarbonate and acrylic eyewear also reduced the maximum strain experienced by the retina by 69% and 47%, respectively, reducing the severity of deformations of the eye on impact. Conclusions: These findings suggest that wearing protective eyewear, especially when made of polycarbonate, can be an effective means of reducing injury-inducing retinal stress. The use of eye protection is thus recommended for pediatric patients participating in soccer.

Padel an increasing cause of sport-related eye injuries in Sweden

Article

May 2023

Purpose: The objective of this study was to determine the current Swedish epidemiology of sport-related eye injuries and to analyse the effect of the increased popularity of the racquet sport padel. Methods: This was a retrospective, register-based, cohort study of medical records in the county of Jönköping, Sweden. All individuals with a sports-related eye injury needing healthcare between January 2017 and December 2021 were included. For these individuals, data about background, consequences and treatment of the injuries were obtained. Results: During the 5-year study period, 255 patients sought care for sports-related eye injuries at the ophthalmological clinics in Jönköping County. Floorball caused the largest proportion of eye injuries (39%) followed by padel (20%) and football (15%). However, the proportion of injuries caused by padel increased during the study period to be the dominating cause in 2021. Compared to floorball, patients with eye injuries from padel were older and had female gender to a higher extent. The ball caused almost all injuries from padel; the majority occurred in the right eye. Most the eye injuries from padel were mild or moderate but 4% had severe consequences with an imminent risk of long-term complications. Conclusions: In a short time period, padel has become the leading cause of sports-related eye injuries in Sweden. To reduce the number of eye injuries, protective eyewear could be recommended.

Incidence and clinical features of pediatric ocular trauma in a population-based cohort

Article

Feb 2023

Purpose: To report the incidence and clinical characteristics of pediatric ocular and adnexal injuries diagnosed over a 10-year period in Olmsted County, Minnesota. Methods: This multicenter retrospective, population-based cohort study included all patients <19 years of age in Olmsted County diagnosed with ocular or adnexal injuries from January 1, 2000, through December 31, 2009. Results: A total of 740 ocular or adnexal injuries occurred during the study period, yielding an incidence of 203 (95% CI, 189-218) per 100,000 children. Median age at diagnosis was 10.0 years, and 462 (62.4%) were males. Injuries presented to the emergency department or urgent care setting most frequently (69.6%) and often occurred while outdoors (31.6%) during summer months (29.7%). Common injury mechanisms included blunt force (21.5%), foreign bodies (13.8%), and sports activities (13.0%). Isolated anterior segment injuries occurred in 63.5% of injuries. Ninety-nine patients (13.8%) had visual acuity of 20/40 or worse at initial examination, and 55 patients (7.7%) had visual acuity of 20/40 or worse at final examination. Twenty-nine injuries (3.9%) required surgical intervention. Significant risk factors for reduced visual acuity and/or the development of long-term complications include male sex, age ≥12 years, outdoor injuries, sport and firearm/projectile injury mechanism, and hyphema or posterior segment injury (P < 0.05). Conclusions: Most pediatric eye injuries are minor anterior segment injuries with infrequent long-lasting effects on visual development.

Clinical Outcomes Following Ocular Trauma with Orbeez Gel Pellet Projectiles

Article

Jan 2023
OPHTHALMOLOGY

Wrist and Hand

Chapter

Jan 2022

Wrist and hand disorders are commonplace in musculoskeletal medicine, and for their prompt management, integration of clinical and ultrasonographic findings is paramount. In this chapter, we briefly describe the sonoanatomy of the wrist/hand, focusing on the spatial planning of the ultrasound-guided procedures. Taking into consideration several high-cost medications (e.g., orthobiologic agents) and/or possibility of various interventional procedures (e.g., hydrodissection) as regards regenerative medicine, ultrasonographic imaging and guidance would be of extra importance in comparison to blind injections. In this sense, patient and probe positionings along with particular technical tips for handling the needle are rendered for wrist/hand pathologies.KeywordsUltrasonographyExaminationWristHandIntervention

Evolution of Sports Ultrasound

Chapter

Aug 2022

Ultrasound (US) has played a role in MSK evaluation for over 50 years and has several advantages over other imaging modalities. Recent progress has expanded the scope of US in sports medicine to include other organ systems. US is an ideal imaging modality for injury evaluations at sporting events for its portability. Further, new programs enable physiologic and biological assessment of injured tissues to make return-to-play decisions. Its use in procedural guidance has improved the accuracy of existing office-based procedures while also opening the door for US-based micro-invasive surgical interventions. Ongoing research continues to expand the diagnostic and interventional capabilities of US, broadening the indications of US in the hands of skilled sports medicine physicians.KeywordsElastographyHerniaFASTEndofibrosisNerveNeuropathyExercise-induced laryngeal obstructionEILOESCAPEFracture

Trends in Sports-Related Ocular Trauma in United States Emergency Departments from 2010 to 2019: Multi-Center Cross-Sectional Study

Article

Aug 2022

Importance: Traumatic eye injury is one of the leading causes of visual impairment in the United States, but there is limited information available in the literature about ocular trauma related to sports. Objective: To evaluate the primary ocular diagnosis, type of sport, seasonal prevalence, and injury severity following ocular sports-related trauma. Design: Cross-sectional study. Setting: United States (US) hospital emergency departments (ED). Participants: Patients with sports-related ocular injuries in the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP) database from January 1, 2010 to December 31, 2019. Main outcome and measure: To identify and compare the type of sport, primary diagnosis of ocular injury, and injury severity. Results: For 4,671 sports-related ocular injuries identified, the mean age of injury was 19.4±15.2 years (median: 15.0 years, 79% male). The largest proportion of injuries occurred in the 12-17 years of age cohort (38.6%), occurring during summer months (P< .001). The most common sports associated with eye injury were basketball (37.8%), baseball (13.8%),, and football (12.3%). There were 3,214 injuries (68.8%) deemed 'minor' anterior segment injuries, 359 injuries (7.7%) deemed 'major' anterior segment injuries, 31 injuries (0.7%) deemed 'minor' posterior segment injuries, 77 injuries (1.7%) deemed 'major' posterior segment injuries, and 990 injuries (21.2%) of unknown severity. Basketball-related ocular trauma had a greater frequency of corneal/scleral abrasions than baseball (P < .001), soccer (P < .001), tennis (P = .03), softball (P = .001), and paintball (P = .02). Baseball-related ocular trauma had a greater frequency of contusions than basketball (P < .001), football (P < .001), soccer (P < .001), volleyball (P< .001). Paintball and soccer were more associated with 'major' anterior and posterior ocular injuries than basketball (P < .001, for both). Conclusion and relevance: Sports-related trauma remains a highly prevalent cause of eye-related visits to the emergency room, particularly in young male adolescents in the spring and summertime. While most diagnoses were deemed 'minor' injuries with basketball associated with corneal/scleral abrasions and baseball with contusions, paintball, and soccer were more significantly associated with 'major' anterior and posterior ocular injuries.

Sports ball projectile ocular trauma in dogs

Article

Apr 2022

Objective: To describe the clinical features, management, and outcome of dogs presenting with sports ball projectile ocular injuries. Animals studied: Eighteen dogs. Procedures: A retrospective study reviewing cases of ocular injury due to a sports ball projectile that presented to the Cornell University ophthalmology service between 2004 and 2021. Dog age, type of sports ball, initial ocular lesions, eye affected, clinical management, and visual outcome were recorded. Results: Sports ball projectile ocular injuries were identified in 18 eyes of 18 dogs. The median age of the dogs was 1.0 years old, ranging from 0.3- to 9-years- old. Nine dogs were male, and 9 were female. Ocular injuries were caused by small, dense balls (e.g., golf balls, baseballs) in 11 dogs; small, light balls (e.g., tennis balls, toy balls) in 5 dogs; and large, soft balls (e.g., soccer ball, football) in 2 dogs. Closed-globe injuries (12 of 18 eyes) presented with traumatic uveitis (91%), hyphema (45%), and subconjunctival hemorrhage (18%). All 12 closed-globe injury cases were medically managed, eight dogs remained visual. Open-globe injuries (6 of 18 dogs) presented with three corneal lacerations and three scleral ruptures. Five open-globe injuries required enucleation, and one was medically managed and maintained vision. Conclusion: Sports ball projectile ocular injuries in dogs can result in substantial ocular morbidity and in loss of vision. Small, dense balls were associated with injuries that carried the most guarded prognosis and required more aggressive management. Small and large lighter projectiles were associated with less serious ocular injuries and visual outcomes.

Article

Feb 2022

Background To analyze the incidence of baseball-related ocular injuries, mechanisms commonly associated with precipitating trauma, and secondary visual sequelae, and explore the age and sex-specific variations in the distributions of these variables. Methods Baseball-related ocular injuries presenting to the emergency department (ED) were identified using the National Electronic Injury Surveillance System for 2011 through 2020. Age, sex, diagnosis, mechanism of injury, visual sequela, and patient disposition were analyzed. Statistical comparisons were performed using the chi-square test and Fisher exact test. Results 558 ED presentations were captured, translating to an average national incidence of 1,492 events. The incidence of trauma declined notably. Most encounters involved pediatric (≤18) and male patients (82.6% and 87.6%, respectively). Patients commonly presented with contusions or abrasions (41.4%). Contact with the baseball was the most frequently mentioned mechanism of injury (87.6%). There was a significant age-related (P = 0.009) difference in the distributions of diagnoses. 7.3% of patients had a visual sequela. Conclusions There was a declining incidence of baseball-related ocular injuries presenting to the ED. However, the long-term complications of injuries could not be explored. Further efforts are required to understand the implications of ocular injuries to ensure patients receive appropriate protections.

PAs' skills in providing vision and ocular care

Article

Full-text available

Feb 2022

Objective: To evaluate characteristics, training, and self-reported skills and abilities in vision and ocular care among PAs not specializing in ophthalmology. Methods: A survey on PA practice was administered to 5,763 randomly selected US-based PAs, and 537 respondents who completed the survey were invited to complete a separate vision and ocular care survey. Of those respondents, 382 completed the vision and ocular care survey. Results: Among respondents, 23% of PAs were involved in eyecare by providing patient information, answering questions, and initiating discussions about vision care and ocular health more than once per month. More than 77% received vision and ocular care training in and/or outside PA training. PAs involved in eyecare had significantly greater odds of reporting higher desired and current skill and ability levels compared with PAs not involved in eyecare, in six of eight vision and ocular care domains. Conclusions: PAs who do not practice in ophthalmology provide vision and ocular care but have varying amounts of training and desire higher skill and ability levels. Ophthalmologists and PA institutions may develop vision and ocular care training for PA schools and continuing medical education.

Ocular Trauma

Chapter

Jan 2022

Occlusion de la veine rétinienne centrale secondaire à un traumatisme oculaire chez un patient jeune : Rapport de cas

Article

Full-text available

Feb 2021

Ailia Ahmed

Les occlusions de la veine rétinienne centrale (OVRC) d’étiologie trauma-tique ou chez les patients jeunes sont rares. Cet article décrit le cas d’un homme asiatique de 33 ans qui s’est présenté avec une plainte principale de vision périphérique floue et de photophobie dans l’œil gauche, une semaine après avoir subi un traumatisme oculaire contondant. Il a reçu un diagnostic d’OVRC traumatique fondé sur ses antécédents et les résultats de l’examen.

Evaluating Ciliary Body Damage Induced by Blunt Low Speed Impact Using Finite Element Simulation

Article

Aug 2021

Purpose: To evaluate the ciliary body mechanical load during low speed impact using finite element method to explain the mechanism of the cause of angle recession and cyclodialysis cleft. Methods: Optical coherence tomography images were obtained to assess the patient's ciliary body angle recession. A finite element eye model was established based on Virginia Tech eye model with the consideration of dynamic impact of a projectile striking an eye. The mechanical properties of the ocular tissues were obtained from literatures. The stress and strain were evaluated. Results: The stress distribution of the eye was calculated. The stress concentration at zonules was observed after 0.75 ms of the impact. The maximum stress at the cornea reached 3.8 MPa. The maximum stress at ciliary body was 57 KPa, which has high probability to cause ciliary body injury. The maximum stress at zonules was 0.98 MPa. The lateral expansion also reduces the forces transmitted along the sclera to the rear part of the eye. Conclusions: The eye under frontal impact will result in lateral expansion, which increase the stretch force of the lens, zonules and ciliary body. This mechanism can be seen as the protection for retina. The boundary of ciliary body is the most vulnerable position, where angle recession and cyclodialyses cleft will occur before retina damage occurrence. Translational relevance: The finite element model explains the blunt low speed impact induced ciliary body related injuries, which enables us to assess the ocular injury for low energy impact and better diagnosis and treatment in clinics.

A 5-Year Retrospective Assessment of Clinical Presentation Associated With Sports Injury in Young People Presenting to a Tertiary Eye Center

Article

Jun 2021
J PEDIAT OPHTH STRAB

Purpose: To examine the incidence and initial presentation of sports-related ocular injury in youth. Methods: This retrospective case series study was performed at Massachusetts Eye and Ear, Boston, Massachusetts. Inclusion criteria were visit dates between January 1, 2010 and December 31, 2015, age 5 to 25 years, an ocular injury International Classifcation of Disease code, and a sports-related mechanism of injury. Results: The final sample was 223 patients, representing approximately 20% of all youth eye injuries (mean age: 16.2 years (range: 6 to 24 years); 78.9% boys, 21.2% girls). The most common diagnosis was hyphema (72.2%). Most injuries occurred with soccer (23.3%), baseball (17.0%), and basketball (11.7%), with a mean visual acuity of 20/40, 20/50, and 20/50, respectively. The injuries with the lowest mean visual acuity resulted from paintball (20/500) and airsoft gun shooting (20/200). Thirty-three patients (14.7%) required surgical intervention. The average number of follow-up visits within 1 year was five. Conclusions: Approximately 20% of youth ocular injury visits were sports related, with male teenagers affected most. Hyphema was the most common type of sports-related eye injury posing a lifelong risk of ocular complications. Popular youth sports such as soccer, baseball, and basketball caused the most eye injuries. Shooting sports with paintball and airsoft guns were associated with the greatest loss of vision. Patients infrequently reported the use of protective eyewear at the time of injury. Protective eye equipment should be worn by youth participating in sports to prevent ocular trauma and the potential for surgical intervention. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Prevalence, Patterns, and Characteristics of Eye Injuries in Professional Mixed Martial Arts

Article

Full-text available

Jun 2021
Clin Ophthalmol

Purpose To describe the frequency and type of eye injuries in fighters in mixed martial arts (MMA) competition. Methods Fight result data were collected from the Nevada Athletic Commission database from 2001 to 2020. Any fighters in a professional mixed martial arts (MMA) contest with an eye injury were included. Main outcome measures included frequency and rate of eye injuries per fight and the types of eye injuries. Secondary outcome measures were gender, laterality, decision type, and length of no-contact recommended. Results Of the 256 MMA events in the database, 187 events (73.3%) had at least one eye injury. Of a total 2208 fights at these events, there were 363 fighters who sustained 369 eye injuries, with the yearly rate of eye injuries per 100 fighters ranging from 2.56 to 12.22. The most common injuries were eyebrow and eyelid lacerations (n=160, 43%), lacerations around the eye (n=98, 27%), and orbital fractures (n=62, 17%). Most eye injuries were right sided (n=197, 53.3%) and the majority of fighters with eye injuries lost their match (n=228, 62.8%). Fifty-seven fighters were recommended for further ophthalmology clearance after the match. The most common reasons for recommended ophthalmology follow-up was orbital fracture (n=25, 44%) and retinal injury (n=7, 12%). Forty-three fighters received no-contact requirements relating to their injury for an average of 8.9 weeks (range 1–24 weeks). Conclusion Ophthalmic injuries in professional MMA were prevalent, were most often lacerations surrounding the eye, and often accompanied the fighter losing their match.

Advances in Sports Medicine

Chapter

Apr 2021

Diagnosis and therapy are rapidly evolving in sports medicine. As resolution and portability have improved, ultrasound has become a popular option for evaluation of athletes in the office as well as on the sideline. While they remain investigational at this time, regenerative therapeutics, such as platelet-rich plasma, prolotherapy, and mesenchymal stem cells, have emerged as options to treat sports-related injuries. Finally, advances in motion capture technologies and use of wearable devices are increasingly utilized for athletes in an attempt to improve performance and prevent injury.

The Association of Visual Impairments of Elite Soccer Players with Concussion and Sports Injuries: A Prospective Cohort Study

Article

Full-text available

Mar 2021

Background: Visual skills play a pivotal role in athletic performance. However, in a professional setting, visual assessment is limited to a brief examination of visual acuity by the Snellen chart. This is while visual skills in sport comprise several other components. Objectives: This study aimed to evaluate the potential relationship between visual skills and sports injuries in professional soccer players. Methods: Through a prospective cohort study between September 2017 and October 2018, professional soccer league players were recruited for a complete eye examination including visual acuity, field of vision, and color discrimination as pre-competition examination. Any possible relationship between an abnormal eye finding and sports injury during the upcoming season was investigated. Results: A total of 386 male soccer players in 4 different playing positions were recruited from 16 league teams. Myopia, visual field defects, and green/blue/red color blindness were the most common visual impairments. Overall, there was no significant relationship between abnormal visual skills and the incidence of low back and upper extremity injuries among soccer players. However, a logistic regression model showed that the odds of quadriceps injury is 1.92 times higher (P-value: 0.005) for one diopter increase in both eyes' sum of refractive error. There is also an increased risk of concussion in players who have visual field defects (P-value < 0.005). Conclusions: Visual field defects can put soccer players at a higher risk for concussion. Moreover, uncorrected refractive eye errors will increase the incidence of lower limb injuries, mostly quadriceps injuries.

Ocular Related Sports Injuries

Article

Mar 2021

Ocular injuries occur frequently in sports, affecting the globe, surrounding soft tissues, and the orbital bony structure. This review provides the craniofacial surgeon a broad general overview of epidemiology, mechanism of disease, and prevention.

Management of Sport-Related Ocular Injuries and Concussion

Chapter

Jan 2022

Graham B Erickson

Participation in sports exposes athletes to the potential for eye injuries. This chapter presents the epidemiology and risks for sport-related eye injuries with discussion of sport-related ocular trauma management. For each type of injury, both sideline and clinical management considerations are presented. An overview of sport-related concussion is also presented with an emphasis on the management of visual symptoms.

The Cost of Blindness in the Republic of Ireland 2010–2020

Article

Full-text available

Jan 2016

Aims. To estimate the prevalence of blindness in the Republic of Ireland and the associated financial and total economic cost between 2010 and 2020. Methods. Estimates for the prevalence of blindness in the Republic of Ireland were based on blindness registration data from the National Council for the Blind of Ireland. Estimates for the financial and total economic cost of blindness were based on the sum of direct and indirect healthcare and nonhealthcare costs. Results. We estimate that there were 12,995 blind individuals in Ireland in 2010 and in 2020 there will be 17,997. We estimate that the financial and total economic costs of blindness in the Republic of Ireland in 2010 were €276.6 million and €809 million, respectively, and will increase in 2020 to €367 million and €1.1 billion, respectively. Conclusions. Here, ninety-eight percent of the cost of blindness is borne by the Departments of Social Protection and Finance and not by the Department of Health as might initially be expected. Cost of illness studies should play a role in public policy making as they help to quantify the indirect or “hidden” costs of disability and so help to reveal the true cost of illness.

Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths.

Article

Full-text available

Apr 2010

Changes in Quality of Life Associated with Complications of Diabetes: Results from the ADVANCE Study

Article

Full-text available

Dec 2015

Objective: To measure the impact of complications on summary measures of health-related quality of life among people with type 2 diabetes. Methods: Patients participating in the Action in Diabetes and Vascular Disease:Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial were administered a health-related quality-of-life questionnaire, the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L), on four occasions over a 5-year period. We used two-way fixed-effects longitudinal regression models to investigate the impact of incident diabetes complications (stroke, heart failure, myocardial infarction, ischemic heart disease, renal failure, blindness, and amputation) on EQ-5D-3L utility score (where 1 = perfect health), while controlling for characteristics of individuals that do not vary over time. Results: The effect of having any one of the seven complications was to reduce the EQ-5D-3L utility score by 0.054 (95% confidence interval 0.044-0.064), and this was not significantly affected by baseline age, sex, economic region, or the value set used to derive utilities. The complication with the largest disutility was amputation (0.122), followed by stroke (0.099), blindness (0.083), renal failure (0.049), heart failure (0.045), and myocardial infarction (0.026). Ischemic heart disease did not significantly reduce the utility score. Quality of life also declined with elapsed time-by an average of 0.006 per year, in addition to the effect of complications. Conclusions: Common complications significantly reduce health-related quality of life. Utility scores derived from the EQ-5D-3L provide a potential measure that can be used to summarize patient-reported outcomes and inform health economic models. Prevention of complications is critical to reduce the progressive burden of declining quality of life for people with diabetes. © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

Eye Protection and Risk of Eye Injuries in High School Field Hockey

Article

Full-text available

Aug 2015
Pediatrics

To determine if injury rates among female field hockey players differ before and after implementation of a national mandate for protective eyewear (MPE). We analyzed girls' field hockey exposure and injury data collected from national (High School Reporting Information Online [RIO]) and regional (Fairfax County Public Schools) high school sports injury databases in 2 seasons before (2009/10 and 2010/11) and 2 seasons after (2011/12 and 2012/13) a national MPE. The incidence of eye/orbital injuries was significantly higher in states without MPE (0.080 injuries per 1000 athletic exposures [AEs]) than in states with MPE (before the 2011/12 mandate) and the postmandate group (0.025 injuries per 1000 AEs) (odds ratio 3.20, 95% confidence interval 1.47-6.99, P = .003). There was no significant difference in concussion rates for the 2 groups (odds ratio 0.77, 95% confidence interval 0.58-1.02, P = .068). After the 2011/12 MPE, severe eye/orbital injuries (time loss >21 days) were reduced by 67%, and severe/medical disqualification head/face injuries were reduced by 70%. Concussion rates for field hockey (0.335 per 1000 AEs) rank third among girls' sports included in the High School RIO surveillance program. Among female high school field hockey players, MPE is associated with a reduced incidence of eye/orbital injuries and fewer severe eye/orbital and head/face injuries. Concussion rates did not change as a result of the national MPE. Concussion remains the most common injury involving the head and face among female field hockey players, prompting further inquiry into potential effects of adopting protective headgear/helmets. Copyright © 2015 by the American Academy of Pediatrics.

Trends in incidence and severity of sports-related traumatic brain injury (TBI) in the emergency department, 2006–2011

Article

Full-text available

May 2015
BRAIN INJURY

To characterize and identify trends in sports-related traumatic brain injury (TBI) emergency department (ED) visits from 2006-2011. This study reviewed data on sports-related TBI among individuals under age 65 from the Nationwide Emergency Department Sample from 2006-2011. Visits were stratified by age, sex, injury severity, payer status and other criteria. Variations in incidence and severity were examined both between groups and over time. Odds of inpatient admission were calculated using regression modelling. Over the period examined, 489 572 sports-related TBI ED visits were reported. The majority (62.2%) of these visits occurred among males under the age of 18. The average head Abbreviated Injury Severity score among these individuals was 1.93 (95% CI = 1.93-1.94) and tended to be lowest among those in middle school and high school age groups; these were also less likely to be admitted. The absolute annual number of visits grew 65.9% from 2006 until 2011, with the majority of this growth occurring among children under age 15. Hospitalization rates dropped 35.6% over the same period. Changes in year-over-year presentation rates vs. hospitalization rates among young athletes suggest that players, coaches and parents may be more aware of sports-related TBI and have developed lower thresholds for seeking medical attention.

Article

Full-text available

Apr 2014
Arq Bras Oftalmologia

Purpose: To measure and investigate visual functioning and health-related quality of life (QOL) in patients after ocular penetrating injuries (OPI). Methods: Fifty-four adult patients with OPI and 26 healthy control subjects were enrolled in the study. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) and the 36-Item Short Form Health Survey (SF 36) were administered. Sociodemographic and clinical data also were collected. The primary outcome measures were comparisons and multivariate analysis among groups for the NEI VFQ-25 and SF 36 subscale scores. Results: All NEI VFQ-25 scores, except general health, were significantly lower in the OPI group than those in the control group. All SF 36 scores were significantly lower in the OPI group than in the control group. The NEI VFQ-25 subscale item scores showed no significant differences with respect to age, educational level, or visual acuity in the injured eye. The SF 36 subscale item scores revealed no significant differences according to gender or educational level. Conclusions: Patients with OPI have increased psychological symptoms and lower levels of QOL than healthy control subjects have. Deteriorations in QOL should be kept in mind when managing patients with OPI.

Visual and anatomic outcomes of golf ball-related ocular injuries

Article

Full-text available

Jan 2014

AimsTo investigate the characteristics and prognoses of golf ball-related ocular injuries (GROIs) using standardized terminology, classification, and scoring systems.Methods Twenty-two GROI patients were assessed using the Birmingham Eye Trauma Terminology, Ocular Trauma Classification Group (OTCG) classification, and Ocular Trauma Score. Globe preservation and final visual acuity (FVA) were assessed according to the injury severity categorical designation.ResultsFourteen patients were injured on golf courses and eight on driving ranges. Nine patients (40.9%) had open-globe injuries (five ruptures (22.7%), four penetrating injuries (18.2%)). All rupture cases required enucleation, whereas penetrating injury cases did not (the FVA ranged from 20/100 to no light perception). In open-globe injuries, wearing glasses protected against rupture (P=0.008). Thirteen patients sustained closed-globe injuries that were accompanied by lens subluxation (38.5%), choroidal rupture (30.8%), macular commotio retinae (38.5%), and traumatic optic neuropathy (7.7%). Twelve (54.5%) patients had orbital wall fractures. The mean number of related surgeries required was 1.5±1.7 across all patients.Conclusion Eyes with GROIs had devastating FVA and globe preservation status, especially those with open-globe injuries. Observing golf rules and improving driving-range facilities are essential for preventing GROIs. Protective eyewear may reduce ocular damage from GROIs, especially globe rupture.Eye advance online publication, 3 January 2014; doi:10.1038/eye.2013.283.

Effectiveness of Protective Eyewear in Reducing Eye Injuries Among High School Field Hockey Players

Article

Full-text available

Nov 2012
Pediatrics

Objective: To determine if injury rates differ among high school field hockey players in states that mandated protective eyewear (MPE) versus states with no protective eyewear mandate (no MPE). Methods: We analyzed field hockey exposure and injury data collected over the 2009-2010 and 2010-2011 scholastic seasons from national and regional databases. Results: Incidence of all head and face injuries (including eye injuries, concussion) was significantly higher in no-MPE states compared with MPE states, 0.69 vs 0.47 injuries per 1000 athletic exposures (incidence rate ratio [IRR] 1.47; 95% confidence interval [CI]: 1.04-2.15, P = .048). Players in the no-MPE group had a 5.33-fold higher risk of eye injury than players in the MPE group (IRR 5.33; 95% CI: 0.71-39.25, P = .104). There was no significant difference in concussion rates for the 2 groups (IRR 1.04; 95% CI: 0.63-1.75, P = .857). A larger percentage of injuries sustained by athletes in the no-MPE group required >10 days to return to activity (32%) compared with athletes in the MPE group (17%), but this difference did not reach statistical significance (P = .060). Conclusions: Among high school field hockey players, playing in a no-MPE state results in a statistically significant higher incidence of head and face injuries versus playing in an MPE state. Concussion rates among players in MPE and no-MPE states were similar, indicating that addition of protective eyewear did not result in more player-player contact injuries, challenging a perception in contact/collision sports that increased protective equipment yields increased injury rates.

What the comprehensive economics of blindness and visual impairment can help us understand

Article

Full-text available

Sep 2012
Indian J Ophthalmol

Kevin D Frick

Since the year 2000, the amount written about the economics of blindness and visual impairment has increased substantially. In some cases, the studies listed under this heading are calculations of the costs related to vision impairment and blindness at a national or global level; in other cases the studies examine the cost-effectiveness of strategies to prevent or modify visual impairment or blindness that are intended to be applied as a guide to treatment recommendations and coverage decisions. In each case the references are just examples of many that could be cited. These important studies have helped advocates, policy makers, practitioners, educators, and others interested in eye and vision health to understand the magnitude of the impact that visual impairment and blindness have on the world, regions, nations, and individuals and the tradeoffs that need to be made to limit the impact. However, these studies only begin to tap into the insights that economic logic might offer to those interested in this field. This paper presents multiple case studies that demonstrate that the economics of blindness and visual impairment encompasses much more than simply measures of the burden of the condition. Case studies demonstrating the usefulness of economic insight include analysis of the prevention of conditions that lead to impairment, decisions about refractive error and presbyopia, decisions about disease and injury treatment, decisions about behavior among those with uncorrectable impairment, and decisions about how to regulate the market all have important economic inputs.

Pediatric Eye Injuries Treated in US Emergency Departments, 1990-2009

Article

Full-text available

Dec 2011
Clin Pediatr

This study investigates activity– and consumer product–related eye injuries treated in US hospital emergency departments among children <18 years old using National Electronic Injury Surveillance System data from 1990 through 2009. An estimated 1 406 200 (95% confidence interval = 1 223 409-1 588 992) activity– and consumer product–related pediatric eye injuries occurred during the study period, averaging 70 310 annually. The annual number of injuries declined significantly by 17%. Patients ≤4 years of age accounted for 32% of all injuries and had the highest mean annual eye injury rate (11.31 per 10 000 population). Eye injuries associated with sports and recreation (24%) and chemicals (17%) occurred most frequently. The majority (69%) of eye injuries occurred at home. Opportunities exist to further decrease these injuries. Pediatricians should educate child caregivers and children about risks for eye injuries in the home and about use of appropriate protective eyewear during sports.

Effectiveness of the Women's Lacrosse Protective Eyewear Mandate in the Reduction of Eye Injuries

Article

Full-text available

Dec 2011

In an effort to minimize the risk of catastrophic eye injury, US Lacrosse initiated mandatory use of protective eyewear in women's lacrosse in the 2004-2005 season. The authors compared eye injury rates in girls' scholastic lacrosse before and after implementation of protective eyewear. They also compared head/face injury rates, concussion rates, and overall injury rates before and after the rule change to assess possible unintended consequences of the change. Cohort study; Level of evidence, 3. The study group included female scholastic lacrosse players in the 25 public high schools in Fairfax County, Virginia, during the 2004-2009 spring seasons. Injury rates were compared with those from the same data source for the 2000-2003 seasons. Premandate versus postmandate injury rates were adjusted for athlete exposures, or total opportunities for injury throughout the season. The rate of eye injuries was reduced from 0.10 injuries per 1000 athlete exposures (AEs) in 2000 through 2003 before the use of protective eyewear to 0.016 injuries per 1000 AEs in 2004 through 2009 (incident rate ratio [IRR], 0.16; 95% confidence interval [CI], 0.06-0.42). The rate ratio of head/face injuries excluding concussion also decreased (IRR, 0.44; 95% CI, 0.26-0.76). There was no change in the rate ratio of total injuries involving all body parts (IRR, 0.93; 95% CI, 0.82-1.1) after introduction of protective eyewear. However, the rate ratio of concussion increased (IRR, 1.6; 95% CI, 1.1-2.3). The use of protective eyewear in women's lacrosse was associated with a reduction in the number of eye injuries. The number of head/face injuries decreased in this study group after introduction of protective eyewear, and there was no change in overall injury rates. The reason for the increase in concussion rate cannot be determined conclusively based on this study, but the authors speculate that this increase resulted largely from increased recognition and diagnosis because overall injury rates do not indicate rougher play with introduction of protective equipment.

Eye Injury in Sport

Article

Full-text available

Apr 1989

Nicholas P Jones

Eye injury sustained during sport is increasing in incidence worldwide, reflecting the rise in popularity of sport as recreation. It can account for up to 25% of severe eye injuries. This paper considers the historical context and demography of sports injuries, and the physical mechanisms and results of various types of ocular trauma in relation to sport. It reviews the specific problems associated with the sports considered to be most important in the epidemiology of eye injuries today. Certain sports, such as boxing, have an intrinsic risk of injury so high that some consider the sport should be banned. The risk of injury in many sports can be mitigated by changes in rules, such as the prevention of high sticking in ice hockey. Other sports with high risk of trauma could be made far safer with the widespread introduction of eye protection, and this applies especially to squash and badminton. The various types of eye protection are discussed. There is an urgent need to increase awareness of the risk of eye injury, to teach safe techniques, and to encourage the use of appropriate ocular protective wear in those at high risk of injury, especially the one-eyed.

One year of severe eye injuries in sport

Article

Full-text available

Feb 1988

Nicholas P Jones

A one year prospective study was undertaken to assess all sports injuries requiring inpatient treatment at Manchester Royal Eye Hospital. (1 January to 31 December 1987.) Fifty two patients were admitted (25.1% of all admissions due to trauma). Racquet sports accounted for 51.9% of these cases. Eight patients required 12 surgical procedures and there were 3 perforating injuries. Sport is becoming an increasingly important cause of severe eye injury and the encouragement of adequate ocular protection is now a matter of urgency.

Sport associated eye injury: A casualty department survey

Article

Full-text available

Oct 1987

Caroline Macewen

A survey was performed of all patients attending the combined Glasgow Eye Infirmary and Western Infirmary Eye Casualty Department with sports injuries. During an 18-month period a total of 246 patients presented with such injuries. Football was responsible for 110 (44.7%), rugby for 24 (9.8%), squash for 19 (7.7%), badminton for 16 (6.5%), and skiing for 9 (3.7%), and 68 (27.6%) were caused by other sports. One hundred and sixty-two patients (65.8%) had superficial or surrounding soft tissue injuries, 54 (22%) had more severe anterior segment damage in the form of hyphaema or traumatic uveitis, 17 (6.9%) had retinal damage manifest as oedema or retinal tear with or without detachment, and two (0.8%) suffered severe disruption of the globe with subsequent loss of the eye in each case. Forty-six (18.7%) required inpatient care and 200 (81.3%) were treated as outpatients, of whom 104 required at least one follow-up appointment (42.3% of the total). I conclude that with increasing time available for leisure activities there has been a parallel increase in sport associated eye trauma.

Visual impairment and hip fracture

Article

Full-text available

Nov 2000
AM J EPIDEMIOL

As part of a case-control study, the Auckland Hip Fracture Study (1991-1994), the authors examined associations between impaired vision and risk of hip fracture. Subjects (911 cases and 910 controls aged 60 years or older) completed a questionnaire and had vision measurements taken, including measurements of visual acuity and stereopsis (depth perception). Binocular visual acuity worse than 20/60 was statistically significantly associated with increased risk of hip fracture after adjustment for age, sex, proxy response, hours of activity per week, and height (odds ratio (OR) = 1.5; 95% confidence interval (CI): 1.1, 2.0), as was having poor vision (less than 20/100) in both eyes (OR = 2.4; 95% CI: 1.0, 6.1). Having no depth perception was associated with increased risk (OR = 6.0 95% CI: 3.2, 11.1), as were categories of decreasing stereopsis (trend p = 0.0001), self-reported poor vision (OR = 1.4; 95% CI: 1.0, 1.9), not wearing glasses at the time of the fall (OR = 1.2; 95% CI: 1.0, 1.6), and increasing time since the last eye examination (trend p = 0.03). The population attributable risk of hip fracture due to poor visual acuity or stereopsis was 40%. Visual factors are important fall-related factors which influence risk of hip fracture. Risk of hip fracture may be decreased by correcting refractive error, improving stereopsis, and administering regular eye examinations.

Visual Acuity Impairment and Mortality in US Adults

Article

Full-text available

Dec 2002
ARCH OPHTHALMOL-CHIC

To examine the associations between reported visual impairment (VI) and mortality in a nationally representative sample of US adults. The National Health Interview Survey is a multistage probability survey of the US civilian population. Adults within households were administered questions about VI and selected eye diseases (n = 116 796). Mortality linkage data with more than 96% of the 1986-1994 survey participants were available through December 31, 1997. Statistical analyses included Cox proportional hazards regression analysis. All-cause, cardiovascular disease-related, and cancer-related mortality. A total of 327 participants (0.3%) had severe bilateral VI; an additional 4754 (4%) had some VI and/or severe VI in at least one eye. Mortality linkage identified 8949 deaths. After controlling for survey design, age, race, marital status, educational level, reported health status, glaucoma, cataract, and retinopathy, women, but not men, with reported severe bilateral VI were at a significantly increased risk of death relative to their counterparts without VI (hazard ratio [95% confidence interval], 2.21 [1.61-3.02] and 1.33 [0.96-1.84], respectively); risk of mortality was also slightly but significantly elevated in women and men with some reported VI compared with those reporting no VI. Similar patterns of associations were found for cardiovascular disease-related mortality. Risk of cancer-related mortality was not associated with VI. Reported severe bilateral VI and, to a smaller extent, less severe VI are associated with an increased risk of all-cause mortality and cardiovascular disease-related mortality in US women; there is weaker evidence for an association between VI and mortality in US men.

Epidemiology of Blinding Trauma in the United States Eye Injury Registry

Article

Full-text available

Jun 2006

To analyze the epidemiology and clinical characteristics of serious eye injuries leading to legal blindness. Analysis of information on 11,320 eyes in the United States Eye Injury Registry (USEIR) database. Legal blindness in this study was defined as visual acuity of worse than 20/200. No less than 27% of eyes with serious injury had < 20/200 final vision, although the rate varied greatly with injury type. Several risk factors were found to statistically significantly increase the chance of eye trauma resulting in blindness: age over 60 years, injury by assault, sustained on street/highway, or occurring during fall or by gunshot. Trauma to the left eye carried a statistically significantly poor prognosis as did two injury types, rupture and perforating. Involvement of the posterior segment was another factor indicating poor outcome; in particular, vitreous hemorrhage, retinal detachment, choroidal rupture, and endophthalmitis were found to increase the risk of blindness. Conversely, young age, contusion and intraocular foreign body injuries, among others, signaled a better than average chance of good outcome. Overall, 60.5% of injured eyes showed visual improvement after treatment. This large study identified multiple risk factors whose presence significantly increases the chance of the injured eye becoming "legally blind." Continued efforts to improve treatment and develop/implement prevention measures based on risk analysis should reduce the incidence of blinding trauma.

Sports‐related eye injuries

Article

Jun 1994

Lye Pheng Fong

Objective To: (i) determine the magnitude and describe the spectrum of sports‐related eye injuries; (ii) compare the sporting profile variations within Australia and overseas; and (iii) provide recommendations to help decrease the frequency and severity of eye injuries in sports. Design and setting Descriptive study of sports‐related eye injuries identified from a cross‐sectional survey of ocular trauma treated in an eye hospital during a two‐year period from November 1989 to October 1991. Results Although sports injuries comprised only 5% of all eye trauma, they accounted for a disproportionately high ocular morbidity, representing 22% of hospital admissions. Most patients were admitted for hyphaema (81%), but there were eight ruptured globes and 20 other cases required surgical repair. For those hospitalised for serious injuries, 19% were legally blind (visual acuity < 6/60) and 10% had visual acuity between 6/18 and 6/36 initially, with 29% of patients recording a visual loss in excess of 50% incapacity (<6/18) at three months after injury. Conclusion Eye injuries were most frequently caused by squash, badminton, Australian Rules football and cricket, a sports profile distinctly different from those of the United States and United Kingdom. That none of the players in my study had worn correct eye protection offers a wide scope for preventing injuries in what should be safe recreational pastimes.

Article

Feb 2016
SCAND J MED SCI SPOR

Several previous studies have shown that floorball belongs to a high-risk group of sports in terms of eye injuries. Protective eyewear is available, but the extent of its use and impact on eye injuries are unknown. The purpose of this study was to investigate the current incidence of eye injuries caused by floorball and to compare it with the present use of protective eyewear. Medical records were used to identify all eye injuries suffered while playing floorball in Jönköping County from 2008 to 2011 (N = 167). All these patients were sent a questionnaire that included inquiries about the use of protective eyewear. The study shows that floorball caused more eye injuries than all other sports combined (56%). Prolonged decreased visual acuity was very unusual (0.5%), but moderate eye injuries with some risk of future problems were seen in 62% of the sample. More than one fifth of the injured patients reported some kind of vision-related problem 2-7 years after the original injury. Only one player had been using protective eyewear at the time of injury. Our results underline the importance of protective eyewear to prevent floorball-related injuries.

Epidemiology of Eye-Related Emergency Department Visits

Article

Jan 2016

Importance Determining the epidemiology of eye-related emergency department (ED) visits on a national level can assist policymakers in appropriate allocation of resources.Objective To study ED visits related to ocular conditions for all age groups across the United States.Design, Setting, and Participants Nationally representative data from the US Nationwide Emergency Department Sample (NEDS) were used to analyze ED visits from January 1, 2006, to December 31, 2011 (6 years). All patients with eye problems presenting to EDs across the United States were eligible for inclusion. A weighted count of 11 929 955 ED visits were categorized as possibly emergent (emergent), unlikely to be emergent (nonemergent), or could not be determined. Data were analyzed from March 1 to May 30, 2015.Main Outcomes and Measures Population-based incidence rates of eye-related ED visits, incidence rates of eye injuries, relative proportions of emergent vs nonemergent eye-related ED visits among different age groups, and independent factors associated with emergent vs nonemergent visits.Results From 2006 to 2011, 11 929 955 ED visits (male patients, 54.2%; mean [SD] age, 31 [22] years) for ocular problems across the United States were categorized as emergent (41.2%), nonemergent (44.3%), or could not determine (14.5%). Corneal abrasions (13.7%) and foreign body in the external eye (7.5%) were the leading diagnoses in the emergent category. More than 4 million visits were for conjunctivitis (28.0%), subconjunctival hemorrhages (3.0%), and styes (3.8%). Emergent visits were significantly more likely to occur among males (odds ratio [OR], 2.00; 95% CI, 2.00-2.01), patients in the highest income quartile (OR, 1.47; 95% CI, 1.46-1.49), older patients (OR, 2.38; 95% CI, 2.38-2.44), and patients with private insurance (OR, 1.29; 95% CI, 1.28-1.30). Mean annual inflation-adjusted charges for all eye-related ED visits totaled $2.0 billion.Conclusions and Relevance Across the United States, nonemergent conditions accounted for almost half of all eye-related ED visits. Interventions to facilitate management of these cases outside the ED could make ED resources more available for truly emergent ophthalmic and medical issues.

Article

Dec 2015

Purpose: To identify the causes of sports-related eye and adnexal injuries in children in Perth, Western Australia, to determine which sporting activities pose the highest risk of eye and adnexal injury to children. Methods: We performed a 12-year retrospective review of children admitted to hospital from 2002 to 2013 with sports-related ocular and adnexal eye injuries. The main outcome measures were the cause and type of ocular and adnexal injuries, age and gender risk factors. Results: A total of 93 cases of sports-related ocular and adnexal injury were identified in the 12-year time period. A peak in injuries occurred for 12- to 14-year-olds with a second peak in 6- to 8-year-olds; the median age was 8.82 years (range = 1.59-16.47). Cycling, football (including soccer and Australian Rules Football), tennis, trampolining, fishing and swimming were the sports responsible for the greatest number of injuries, a total of 63%. More than one-third (35%) of injuries resulted from being struck by a blunt object, and more than a quarter (26%) were as a result of contact with a blunt projectile. Conclusion: Serious ocular and adnexal injuries have occurred in children as a result of participating in sports, with cycling and football being the largest contributors in the 12-year period we assessed. As we continue to encourage children to spend more time participating in sports and recreational activities, identifying associated risk factors will help us develop injury prevention strategies to promote eye safety for children.

Depression and Vision and Hearing Impairments in Later Life

Article

Mar 2003
Generations

Amy Horowitz

Combative Sports Injuries: An Edmonton Retrospective

Article

Jul 2015

Mixed martial arts (MMA) is an increasingly popular combative sport involving aggressive techniques that present substantial injury risk. We examined the incidence and types of injuries sustained in MMA fights and compared this with injuries sustained in boxing matches. Consecutive Case Series. We used data from post-fight medical examinations on all bouts in Edmonton, Canada, between 2000 and 2013. The participants were 1181 MMA competitors and 550 boxers. The attending physician conducted a mandatory post-fight examination of all fighters and documented the nature of injuries sustained. Boxers were significantly more likely not to experience injury (49.8% vs 59.4%, P < 0.001), whereas MMA fighters were significantly more likely to experience 1 injury (typically contusion/bruising, P < 0.001). Boxers were more likely to experience loss of consciousness (7.1% vs 4.2%, P = 0.01) and serious eye injury (1.1% vs 0.3%, P = 0.02). The overall injury incidence in MMA competitors appears slightly higher than for boxers, but MMA fighters experience more minor contusion/bruising injuries. Boxers are more likely to experience serious injury such as concussion/head trauma involving loss of consciousness or eye injury such as retinal detachment.

Ocular injury in the United States: Emergency Department visits from 2006-2011

Article

Jul 2015

Head, Face, and Eye Injuries in Collegiate Women's Field Hockey

Article

Jun 2015

Elizabeth Gardner

While there is concern regarding head, face, and eye injuries in field hockey, prompting some to recommend the use of protective equipment such as goggles and helmets, little has been written about their incidence and mechanism of injury in the modern game of field hockey. The elucidation of this information will better inform the development of maximally effective injury prevention schemes to protect the athlete while maintaining the integrity of the game. To determine the incidence and epidemiology of head, face, and eye injuries in United States collegiate women's field hockey players from 2004-2005 to 2008-2009. Descriptive epidemiological study. All head, face, and eye injuries reported to the National Collegiate Athletic Association Injury Surveillance System for collegiate women's field hockey athletes from the 2004-2005 through 2008-2009 seasons were analyzed. Data regarding the event type, injury mechanism, body part injured, type of injury, outcome, and time lost were reviewed. The weighted injury incidence per 1000 athlete-exposures (AEs) was calculated using the exposure data set for the same years; 95% CIs were calculated based on a normal approximation to the Poisson distribution. There were 150 reported traumatic injuries during this time period, with a weighted occurrence of 1587.3 injuries. The overall incidence of head, face, and eye injuries in collegiate women's field hockey was 0.94 per 1000 AEs (95% CI, 0.86-1.19). Injuries to the head or face, other than the mouth, nose, and eye, accounted for 75.3% of these injuries. The incidence of eye injuries was 0.07 per 1000 AEs (95% CI, 0.03-0.12); nose injuries occurred at a rate of 0.10 per 1000 AEs (95% CI, 0.05-0.15). The rate of traumatic dental injuries was 0.06 per 1000 AEs (95% CI, 0.04-0.14). Contact with an apparatus caused 72.9% of all injuries; specifically, contact with an elevated ball accounted for 47.9% of all injuries, and contact with an elevated stick caused 21.7% of all injuries. While the majority of players suffering a head, face, or eye injury were able to return to sport that season (90.0%), the remaining athletes suffered season-ending injuries (10%). Concussions accounted for 42.8% of all head, face, and eye injuries reported (0.40 per 1000 AEs; 95% CI, 0.32-0.53). Head, face, and eye injuries occur regularly in women's field hockey. This description of the injury profile and mechanisms of injury may be used to design appropriate injury prevention schemes for the sport. © 2015 The Author(s).

Clinical and Economic Burden of Visual Impairment in an Aging Society of South Korea

Article

Jun 2015
ASIA-PAC J PUBLIC HE

Whereas the incidence of visual impairment and blindness (VI&B) is decreasing, the total number of VI&B is increasing due to the growth of elderly population. To compare the clinical and economic outcomes of patients with and without VI&B (ie, cases and controls) in Korea, a case-control study was performed using the Health Insurance Review and Assessment Service-National Patients Sample data. Cases had higher prevalence for all of the Charlson Comorbidity Index components, depression, fracture, and injury as well as eye diseases compared to age- and sex-matched controls. In regression after adjustment of concomitant diseases, cases had 2.7 times (95% confidence interval = 2.3-3.2) higher medical expenditure than controls. The results of this study confirm that patients with VI&B have significantly higher direct medical expenditures and concomitant diseases than those without VI&B and highlight the need for a public health strategy to reduce potentially avoidable costs attributed to VI&B. © 2015 APJPH.

Trends in Sports- and Recreation-Related Traumatic Brain Injuries Treated in US Emergency Departments: The National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) 2001-2012

Article

May 2015

Sports- and recreation-related traumatic brain injuries (SRR-TBIs) are a growing public health problem affecting persons of all ages in the United States. To describe the trends of SRR-TBIs treated in US emergency departments (EDs) from 2001 to 2012 and to identify which sports and recreational activities and demographic groups are at higher risk for these injuries. Data on initial ED visits for an SRR-TBI from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) for 2001-2012 were analyzed. NEISS-AIP data are drawn from a nationally representative sample of hospital-based EDs. Cases of TBI were identified from approximately 500 000 annual initial visits for all causes and types of injuries treated in EDs captured by NEISS-AIP. Numbers and rates by age group, sex, and year were estimated. Aggregated numbers and percentages by discharge disposition were produced. Approximately 3.42 million ED visits for an SRR-TBI occurred during 2001-2012. During this period, the rates of SRR-TBIs treated in US EDs significantly increased in both males and females regardless of age (all Ps < .001). For males, significant increases ranged from a low of 45.8% (ages 5-9) to a high of 139.8 % (ages 10-14), and for females, from 25.1% (ages 0-4) to 211.5% (ages 15-19) (all Ps < .001). Every year males had about twice the rates of SRR-TBIs than females. Approximately 70% of all SRR-TBIs were reported among persons aged 0 to 19 years. The largest number of SRR-TBIs among males occurred during bicycling, football, and basketball. Among females, the largest number of SRR-TBIs occurred during bicycling, playground activities, and horseback riding. Approximately 89% of males and 91% of females with an SRR-TBI were treated and released from EDs. The rates of ED-treated SRR-TBIs increased during 2001-2012, affecting mainly persons aged 0 to 19 years and males in all age groups. Increases began to appear in 2004 for females and 2006 for males. Activities associated with the largest number of TBIs varied by sex and age. Reasons for the reported increases in ED visits are unknown but may be associated with increased awareness of TBI through increased media exposure and from campaigns, such as the Centers for Disease Control and Prevention's Heads Up. Prevention efforts should be targeted by sports and recreational activity, age, and sex.

Comparability of National Estimates for Traumatic Brain Injury-Related Medical Encounters

Article

May 2015

To describe similarities and differences in the number of civilian traumatic brain injury (TBI)-related hospitalizations and emergency department visits between national databases that capture US hospital data. TBI-related hospitalizations included in the National Hospital Discharge Survey (NHDS) and Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) and emergency department visits in the National Hospital Ambulatory Medical Care Survey (NHAMCS) and HCUP Nationwide Emergency Department Sample (HCUP-NEDS) for 2006-2010. Cross-sectional design. Nationwide counts of TBI-related medical encounters. Overall, the frequency of TBI is comparable when comparing NHDS with HCUP-NIS and NHAMCS with HCUP-NEDS. However, annual counts in both NHDS and NHAMCS are consistently unstable when examined in smaller subgroups, such as by age group and injury mechanism. Injury mechanism is consistently missing from many more records in NHDS compared with HCUP-NIS. Given the large sample size of HCUP-NIS and HCUP-NEDS, these data can offer a valuable resource for examining TBI-related hospitalization and emergency department visits, especially by subgroup. These data hold promise for future examinations of annual TBI counts, but ongoing comparisons with national probability samples will be necessary to ensure that HCUP continues to track with estimates from these data.

Sports and health: Equivalence or contrariety

Article

Dec 2014
ACTA CLIN CROAT

Playing sports is a widely known method of health promotion. Balanced exercise and diet are keys to healthy life. However, sports activities can cause different injuries, from joint to head injuries. Although head injuries cause a variety of acute and chronic disorders, they are often undertreated. There are 1.6 million injured people examined at emergency departments throughout Europe every year. In sports like boxing, football, soccer, hockey, handball, basketball and bicycling, head injuries occur at a frequency of 4% to 22%. Particularly significant are chronic difficulties that occur after recurrent head injuries, i.e. cognitive deficits and changes in electroencephalogram. Qualifications of professional personnel are insufficient for professional evaluation and treatment of head injuries. The best way for sports to become an important link in health and disease prevention is to go back to sports basics while using acquired scientific knowledge.

Insights into inpatients with poor vision: A high value proposition: Inpatients With Poor Vision

Article

Mar 2015
J HOSP MED

Vision impairment is an under-recognized risk factor for adverse events among hospitalized patients, yet vision is neither routinely tested nor documented for inpatients. Low-cost ($8 and up) nonprescription "readers" may be a simple, high-value intervention to improve inpatients' vision. We aimed to study initial feasibility and efficacy of screening and correcting inpatients' vision. From June 2012 through January 2014 we began testing whether participants' vision corrected with nonprescription lenses for eligible participants failing a vision screen (Snellen chart) performed by research assistants (RAs). Descriptive statistics and tests of comparison, including t tests and χ(2) tests, were used when appropriate. All analyses were performed using Stata version 12 (StataCorp, College Station, TX). Over 800 participants' vision was screened (n = 853). Older (≥65 years; 56%) participants were more likely to have insufficient vision than younger (<65 years; 28%; P < 0.001). Nonprescription readers corrected the majority of eligible participants' vision (82%, 95/116). Among an easily identified subgroup of inpatients with poor vision, low-cost readers successfully corrected most participants' vision. Hospitalists and other clinicians working in the inpatient setting can play an important role in identifying opportunities to provide high-value care related to patients' vision. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine. © 2015 Society of Hospital Medicine.

Article

Jan 2015

PurposeThis study aims to represent the epidemiologies, findings, treatments, use of resources, outcomes and protective-eyewear-use recommendations in sports-related eye injuries by sport type.Methods The study population is comprised of all new eye injury patients in 1 year in Helsinki University Eye Hospital. Data were collected from patient questionnaires and hospital records. The follow-up period was 3 months.Results149/1151 (12.9%) of eye injuries were sports-related. Thirty two percent were related to floorball (type of hockey played on a mat with a stick and a ball); football, tennis and ice hockey were the next most common eye-injury-causing sports. Relatively, the most dangerous sports were rink bandy, (bandy played on ice hockey rink with a stick and a ball) (0.50 injuries in 12 months/1000 participants, CI 0.10–1.46), floorball (0.47, CI 0.34–0.62) and tennis (0.47, CI 0.26–0.77). Contusion was the primary diagnosis in 77% of cases; 41% of contusion patients had severe, mainly retinal findings. The number of outpatient visits was 459; inpatient days 25 and major surgeries 31. One hundred and eight patients were estimated to need life-long follow-up. Seventeen patients had a permanent functional impairment, 4 in ice hockey, 3 in floorball, 2 each in tennis and badminton.Conclusion Compared to a previous study, ice hockey eye injuries are increasing and relatively severe, and a third of these injuries occurred despite visor use. Floorball eye injury incidence has significantly declined, mainly due to recently enforced mandatory protective eyewear for younger age groups. Based on these findings, we recommend, in floorball, that protective eyewear should be mandatory in all age groups. Universally in ice hockey, the proper use of a visor should be emphasised.

Article

Sep 2014
AM J PHYS MED REHAB

The baseball and medical communities have recognized injuries of the upper extremity associated with the overhead throwing motion and have examined manners in which to reduce risk. The authors examine special features of the adolescent pitcher as compared with skeletally mature pitchers and characteristics of pitch mechanics, type, velocity, fatigue, and overuse. A summary is presented on previously identified risk factors as they relate to pitching injuries. Development, use, and compliance with the most current pitching guidelines in youth baseball, based on the available evidence, will be presented and examined. In an increasingly competitive environment, identifying known risk factors and potential signs of pathology as well as implementing the current best evidence in a consistent manner are important steps in decreasing injury risk of youth baseball pitchers. More research is needed to evaluate the effectiveness of pitching guidelines in the short and long term and to focus on manners in which to increase compliance with best practice procedures throughout youth baseball organizations.

Sport-related eye trauma

Article

Jun 2014

Sport-related eye injuries are a common cause of acute ocular injury. This article provides a basic clinical overview of the diagnosis and immediate medical management of sport-related eye injuries, and is relevant to all Armed Forces primary care and emergency medicine practitioners.

Impact of visors on eye and orbital injuries in the National Hockey League

Article

Jun 2014

Objective: Eye and orbital injuries are a significant risk to professional hockey league players and have resulted in career-ending injuries. The goal of this study was to determine the incidence, value lost, mechanism, and effect of visors on eye and orbital injuries over the last 10 National Hockey League (NHL) seasons: 2002-2003 to 2012-2013. Design: Retrospective case-control study. Participants: Participants were 8741 NHL players who had played at least 1 game during the last 10 seasons. Methods: Using The Sports Network (TSN), ProSportsTransactions, and the Sporting News Hockey Register, NHL players were searched to identify eye and orbital injuries. The mechanism of injury was obtained from media reports and direct observation from online videos. The number of players wearing visors each year was obtained from The Hockey News annual visor survey. Results: A total of 149 eye or orbital injuries over the last 10 seasons resulted in an overall incidence of 2.48 per 10 000 athlete exposures. A total of 1120 missed games led to a lost financial value of more than $33 million. Visor use among players grew from 32% in 2002-2003 to 73% in 2012-2013, and there was a significantly increased risk for having an eye or orbital injury when a visor was not worn (OR 4.23, 95% CI 2.84-6.30). Most injuries were a result of being hit by a deflected or direct puck (37%) followed by being struck by a high stick (28%). Players who did not wear a visor were found to be involved in more fights, hits, and penalty minutes (p < 0.001). Conclusions: Eye and orbital injuries are mostly accidental in nature and represent a significant risk and cost to the NHL and its players. Eye and orbital injuries are significantly more likely in players who do not wear visors.

Age and consumer product-related eye injuries in the United States

Article

Jan 2014
Rh I Med J

Purpose: The purpose of this study was to describe the epidemiology of consumer product (CP) related eye injuries presenting to US emergency departments (EDs) stratified by age. Methods: The Consumer Product Safety Commission's National Electronic Injury Surveillance System (CPSC-NEISS) database was used to derive national, weighted estimates of nonfatal Emergency Department visits for eye injuries by patients' age, gender, diagnosis, injured body part, locale of incidence, and related CP. Results: The CPs causing the highest proportion of injury visits varied among the different age groups: chemicals in the very young (0-4 yr), household items in 5-9 year olds, sports products in 10-24 year olds, cutting and construction tools in 25-64 year olds, and chemicals in the elderly (65+). Patients aged 0-4 also represented the age interval with the highest rate of injury visits (92 visits per 10,000). Conclusion: This study identified the CPs responsible for the most eye injury visits by age groups. Further research is needed on how to effectively change the behavior of individuals and their environment so that we can minimize preventable eye injuries from consumer products.

Incidence of sport-related traumatic brain injury and risk factors of severity: A population-based epidemiologic study

Article

Sep 2013

Few studies of sport-related traumatic brain injury (TBI) are population-based or rely on directly observed data on cause, demographic characteristics, and severity. This study addresses the epidemiology of sport-related TBI in a large population. Data on all South Carolina hospital and emergency department encounters for TBI, 1998-2011, were analyzed. Annual incidence rate of sport-related TBI was calculated, and rates were compared across demographic groups. Sport-related TBI severity was modeled as a function of demographic and TBI characteristics using logistic regression. A total of 16,642 individuals with sport-related TBI yielded an average annual incidence rate of 31.5/100,000 population with a steady increase from 19.7 in 1998 to 45.6 in 2011. The most common mechanisms of sport-related TBI were kicked in football (38.1%), followed by fall injuries in sports (20.3%). Incidence rate was greatest in adolescents ages 12-18 (120.6/100,000/persons). Severe sport-related TBI was strongly associated with off-road vehicular sport (odds ratio [OR], 4.73; 95% confidence interval [95% CI], 2.92-7.67); repeated head trauma (OR, 4.36; 95% CI, 3.69-5.15); equestrian sport (OR, 2.73; 95% CI, 1.64-4.51); and falls during sport activities (OR, 2.72; 95% CI, 1.67-4.46). The high incidence of sport-related TBI in youth, potential for repetitive mild TBI, and its long-term consequences on learning warrants coordinated surveillance activities and population-based outcome studies.

Double Jeopardy: The Effects of Comorbid Conditions among Older People with Vision Loss

Article

Jan 2006
J VISUAL IMPAIR BLIN

John Crews

This retrospective study used national survey data to examine multiple effects of nine comorbid conditions--breathing problems, depression risk, diabetes, heart problems, hearing impairment, hypertension, joint problems, low back pain, and stroke--on physical functioning, participation, and health status among older adults with visual impairments. Bivariate and multivariate procedures were used to compare older adults who had neither visual impairment nor these conditions with adults of similar age who had one of the nine conditions only, visual impairment only, or both visual impairment and the condition. Findings indicate that older adults with visual impairment frequently experience comorbid conditions, and that these conditions are associated with difficulties in walking and climbing steps, shopping, and socializing, and with significantly more self-reports of declining health. Results suggest that interventions by health care and mental health providers, as well as enhanced rehabilitation services, have the potential to reduce or prevent the deleterious effects of comorbid conditions. [ABSTRACT FROM AUTHOR] Copyright of Journal of Visual Impairment & Blindness is the property of American Foundation for the Blind and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A survey of ocular sports trauma and the role of eye protection

Article

Aug 2012

Purpose: The incidence of sports associated ocular injuries presenting to emergency departments is rising. Despite this, eye protection is not widely used in the general population. This survey was conducted to determine the spectrum of ocular sports injuries that presented to the emergency department of an ophthalmic hospital, which serves a large sector of inner city London. The role of eye protection in preventing ocular sports injuries was also investigated. Methods: All patients who attended the emergency department with sports associated ocular injuries between May and July 2008 were identified. Medical records of these patients were examined. Results: There were a total of 16999 ophthalmic emergency attendances. 48 (0.28%) patients presented with sports related ocular injuries. The outcomes of the consultations were: 13 (27.1%) patients discharged from the emergency department, 17 (35.4%) had reviews arranged in the emergency department, 18 (37.5%) referred to subspecialties. The mean presenting LogMAR visual acuities of patients that were discharged, reviewed in the emergency department, and referred to subspecialties were 0.01 (±0.33), 0.48 (±0.75), and 0.31 (±0.61) respectively. Visual acuities were better by 0.39 (95% CI 0.01-0.77, p=0.042) in patients who were discharged compared to patients who were reviewed in the emergency department or referred to subspecialties. Evaluation of records revealed that no patients wore eye protection and none were given advice regarding prevention of future injuries. Conclusion: Results from this survey show that ocular sports injuries account for a proportion of ophthalmic emergency attendances with a potential impact on service provision. It is essential that ophthalmologists, optometrists and other healthcare professionals are aware of the potential ocular morbidity from sports trauma and the importance of providing advice on the prevention of such injuries.

Limitations of Administrative Databases

Article

Jun 2012
J Am Med Assoc

To the Editor: Clinical research relying on readily available, inexpensive data originally collected for administrative or billing purposes or both has increased exponentially. Yet the inherent limitations of these administrative databases are frequently ignored. Drs Vaughan Sarrazin and Rosenthal1 provided a summary of these important limitations, including some potential pitfalls in examining diagnostic procedures. A major and often overlooked pitfall is surveillance bias—the phenomenon of “the more you look, the more you find.”2

Sports Injuries: An Ounce of Prevention and a Pound of Cure

Article

Apr 2011

Objectives: To evaluate and review the literature regarding sports-related eye injuries and prevention through appropriate protective eyewear. Methods: The literature was reviewed regarding sports-related eye injuries and prevention of these injuries. Results: The review of the literature suggests that ocular sports injuries can occur with all sports and affects all ages. These injuries may affect professional athletes and amateur athletes around the world. There are between 40,000 and 600,000 documented sports-related ocular injuries in the United States every year. More than 90% of these ocular injuries from sports are preventable. Conclusions: Most of sports-related eye injuries are preventable. Increased recognition of the risks of eye injury playing sports may lead to improved protection and a decreased morbidity from eye injuries. To help prevent sports-related eye injuries, education of athletes, parents, coaches, trainers, referees, and health care practitioners is critical.

Incidence of sports-related eye injuries in the United States: 2001-2009

Article

Nov 2010
GRAEF ARCH CLIN EXP

Article

Feb 1995

The study investigated the workload offered by sport-related trauma to a busy casualty clinic and was carried out in two parts. The first part concerned compiling information about sport-related injuries presenting in 1 year to the outpatient eye clinic at Bradford Royal Infirmary. The second part attempted to investigate the awareness and the use of eye-protectors for squash by the student community of Bradford University, using a questionnaire. The sport-related injuries presenting to the casualty department were classified according to the sport involved. Analysis of the data shows that racquet sports, namely tennis, badminton and squash, jointly formed the highest percentage of presentations. In the case of squash and tennis injuries, follow-up treatment and/or admission to hospital was required in 100% of cases. These injuries could be reduced by wearing adequate eye-protectors. The questionnaire survey showed that only 9% of the squash players wore eye protection whilst playing, of whom 3.37% of the total had suffered lacerating injuries previously. Comparison with previous studies indicates that the pattern of eye injuries presenting to casualty departments, and the awareness of the general public concerning the use of eye-protectors, has not altered in recent years. Unless steps are taken, in terms either of mandatory use of eye-protectors and/or of educating the general public on the possible devastating effects of injury, these preventable injuries will continue to burden already overworked hospital casualty departments, draining both resources and expertise.

Article

Nov 2007

The objectives of this study were to determine the distribution of different sports-related eye injuries and to identify injury types to enable recommendations to be made about the use of protective eyewear. The study population comprises all 565 eye trauma patients examined at the Ophthalmology Emergency Clinic of the Helsinki University Central Hospital over a 6-month period. Data were collected from patient histories and questionnaires. In addition, three severe floorball eye injury cases are presented. Of the 565 eye traumas, 94 (17%) were sports related. Of these, 42 (45%) were associated with floorball. Countrywide, in Finland, estimated over 300 (+95% CI 228-415) floorball eye injuries occur annually. The mean age of floorball patients was 22 years. The most common finding (55%) in sports injury patients was hyphema. Clinically severe eye injuries during this period accounted for one-fourth of all cases. During the study period, no eye injury was found in an organized junior ice hockey, where facial protection is mandatory. Floorball is estimated to belong to the highest risk group in sports, and thus, the use of protective eyewear is strongly recommended. We conclude that national floorball federations should make protective eyewear mandatory.

Healthcare Cost and Utilization Project. Overview of the Nationwide Emergency Department Sample (NEDS). https://www.hcup-us .ahrq.gov/nedsoverview Comparability of national estimates for traumatic brain injury-related medical encounters

Nov 2009
150-159

Ca Taylor
Ai Greenspan
L Xu
Mj Kresnow

Mid America Clinical Laboratories. Client alert: 2010 changes to ICD-9-CM codes effective October 1, 2009. http://www.maclonline.com/ICD-9_Alert _2010.htm. Accessed May 11, 2016. 40. Healthcare Cost and Utilization Project. Overview of the Nationwide Emergency Department Sample (NEDS). https://www.hcup-us .ahrq.gov/nedsoverview.jsp. Updated January 4, 2016. Accessed July 8, 2016. 41. Taylor CA, Greenspan AI, Xu L, Kresnow MJ. Comparability of national estimates for traumatic brain injury-related medical encounters. J Head Trauma Rehabil. 2015;30(3):150-159.

Traumatic brain injury in the United States: emergency department visits, hospitalizations and deaths 2002-2006. https://www.cdc.gov /traumaticbraininjury/pdf/blue_book.pdf. Published Changes in quality of life associated with complications of diabetes: results from the ADVANCE Study

Apr 2010
36-41

M Faul
L Xu
Mm Wald
Vg Coronado
H Arima
M Woodward

Faul M, Xu L, Wald MM, Coronado VG. Traumatic brain injury in the United States: emergency department visits, hospitalizations and deaths 2002-2006. https://www.cdc.gov /traumaticbraininjury/pdf/blue_book.pdf. Published March 2010. Accessed April 26, 2016. 43. Hayes A, Arima H, Woodward M, et al. Changes in quality of life associated with complications of diabetes: results from the ADVANCE Study. Value Health. 2016;19(1):36-41.

to 49 years in US emergency departments from

Jan 2000
366-370

to 49 years in US emergency departments from 2000 to 2012. Sports Health. 2015;7(4):366-370.

The cost of blindness in the Republic of

Jan 2010

D Green
G Ducorroy
E Mcelnea

Green D, Ducorroy G, McElnea E, et al. The cost of blindness in the Republic of Ireland 2010-2020.

Soccer-related injuries in children and adults aged 5

Ao Esquivel
A Bruder
K Ratkowiak
Se Lemos

Esquivel AO, Bruder A, Ratkowiak K, Lemos SE. Soccer-related injuries in children and adults aged 5

a (continued) Characteristic No. (%) [95% CI

Jan 2010
560-566

Table 2. Sports-Related Ocular Injuries, by Vision Impairment Status, From January 1, 2010, to December 31, 2013 a (continued) Characteristic No. (%) [95% CI] Vis Sci. 2016;93(6):560-566.

Epidemiology of Sports-Related Eye Injuries in the United States

Abstract

No full-text available

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