Eye injury in sport

A Systematic Review on the Effectiveness of Eyewear in Reducing the Incidence and Severity of Eye Injuries in Racket Sports

PURPOSE

To assess what eyewear (if any) reduces eye injury incidence and severity in squash, racketball, tennis and badminton.

DESIGN

Systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and the 'implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science' (PERSiST) guidelines.

METHODS

PubMed, SportDiscus and Web of Science were searched on 22nd February 2023. All study types except reviews were eligible. Studies had to report the type of eyewear worn (if any) with a form of eye injury incidence and severity.

RESULTS

364 papers were initially retrieved and after the screening process 29 remained. A subgroup analysis was carried out on studies that had a sample size of five or above, were not only looking at a particular type of eye injury and that had sufficient data to allow the percentage of eye injuries that occurred when no eyewear was worn to be calculated. From this analysis, the median percentage of eye injuries that occurred when no eyewear was worn was found to be 93%. Some of these injuries were serious and required complex treatment. Prescription lenses, contact lenses and industrial eyewear made some injuries more severe. In squash and racketball, lensless eye guards were ineffective as the ball could deform on impact, still making contact with the eye. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries and so provided adequate protection in all four sports.

CONCLUSIONS

Although this systematic review only summarizes evidence on injuries requiring hospital treatment, it is recommended that national governing bodies and key decision makers within squash, racketball, tennis and badminton examine the evidence presented and consider extending existing rules or implementing new recommendations and policies on protective eyewear use to reduce eye injury incidence and severity in their sport.

A COMBINATION OF EXPERIMENTAL AND NUMERICAL ANALYSES TO MEASURE THE COMPRESSIVE MECHANICAL PROPERTIES OF TENNIS BALL

Tennis is almost a newly born sport (1859) that can be played individually against a single opponent (singles) or between two teams of two players each, namely doubles. Materially, tennis balls were made of cloth strips stitched together from thread. They have also been made of hollow rubber with a felt coating appearing in different colors from traditionally white to yellow in the recent years to permit their visibility. Although the most common injuries associated with tennis have been reported to be related to rotator cuff, elbow, wrist, anterior knee pain, and ankle, the injury that a tennis ball can cause, for example, for eye is still not clear. However, as the tennis ball can reach to a speed of 260 km/h, it seems vital to understand its mechanical properties to have a deep insight into the injury that can happen during playing. Therefore, this study aimed to perform an experimental study to evaluate the linear elastic and nonlinear hyperelastic mechanical properties of the tennis ball under compressive loading. To do this, 40 numbers of approved tennis balls by international tennis federation (ITF) were prepared and subjected to a series of compressive loadings. The strain of the balls was measured via a pair of CCD cameras using digital image correlation (DIC) technique. The results revealed the mean elastic modulus, maximum stress, and strain of 336.69 kPa, 410.15 kPa, and 66%, for the tennis balls, respectively. The nonlinear mechanical behavior of the tennis balls were also computationally investigated through a hyperelastic material model, namely Ogden. Finally, a finite element (FE) model was executed to verify the hyperelastic data with that of experimental and, interestingly, the numerical data were in good agreement with experimental ones. The findings of this study may have implications not only for understanding the compressive mechanical properties of the tennis ball, but also for investigating the injury that can occur in the human body by tennis ball, especially the eye.

Sports injuries: an ounce of prevention and a pound of cure

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.

Field hockey injuries

Field hockey is a popular sport that is played throughout the world. Most of the literature on the sport has focused on describing injury patterns. This research reveals that most injuries are minor and that the most common injury is an ankle sprain. Studies also suggest that men have a higher rate of injury and that they experience severe injuries more often than women. These severe injuries include trauma to the head, face, and upper limb and usually are the result of contact with the stick or ball. Consequently, many authors suggest that all players wear face and hand protection. Current International Field Hockey Federation rules recommend minimal protective equipment (e.g., mouthguard, shin, and ankle guards), and surveys indicate that many players do not wear mouthguards regularly. Looking into the future, research should focus on developing and evaluating effective strategies for injury prevention.

Eye Injuries in Singapore – Don’t Risk It. Do More. A Prospective Study

Introduction: The purpose of this study was to characterise and describe the epidemiology of all eye injuries presenting to the National University Hospital (NUH). Materials and Methods: A prospective study was conducted over a 7-week period (11/4/2005 to 29/5/2005) on all ophthalmic trauma patients seen by the Department of Ophthalmology in NUH. Data on patient presentation, source of injury and intervention were collected via a standardised interview and examination, and documented using a validated datasheet. Results: A total of 133 patients, and 139 eyes, were included in the study. The average age was 33.5 years, with a range of 5 years to 88 years, and 84.2% (n = 112) were men. Close to half (46.6%, n = 62) of the patients studied were non-Singaporeans. 56.4% (n = 75) of all eye injuries were work-related and only 5% (n = 7) of eyes were open-globe injuries. Common sources of eye trauma included: Use of high-powered tools in activities such as grinding, welding and hammering (38.3%, n = 51), human-inflicted injuries (12.0%, n =16) and road traffic accidents (8.3%, n = 11). Of the work-related eye injuries, 29.3% (n = 22) reported to having used personal protective equipment (PPE) at the time of injury, 38.7% (n = 29) had been issued PPE but had not used them, while 32% (n = 24) reported that PPE had not been issued. An initial visual acuity of 6/12 or better was found in 63.0% (n = 88) of patients and a reading of 6/60 or worse was found in 10.0% (n =14). Superficial foreign bodies (22.4%, n = 55) were the most common clinical finding, followed by periorbital bruise (12.2%, n = 30), lid ecchymoses (6.9%, n = 17), orbital fractures (6.5%, n = 16), lid laceration (6.1%, n = 15) and corneal abrasions (5.7%, n = 14). Conclusion: There is a broad spectrum of causes, mechanisms and severity of ophthalmic injuries seen in the hospital, of which work-related trauma makes up a significant proportion. The patients who suffer occupational injuries are a well-defined group: Young, non-Singaporean males, working with power tools in the construction industry are at particular risk. Although preventive strategies are in place for this high-risk group, the lack of awareness and compliance limit their effectiveness. The adequacy and functionality of PPE should be emphasised. In addition, preventive efforts are equally important in domestic, recreational, sports and transport settings. Eye trauma research and prevention can be further aided by a collaborative registry of eye injuries. A long-term islandwide database of all ophthalmic injuries is recommended. Key words: Accident prevention, Blindness, Epidemiology, Eye injuries, Ocular trauma

Identifying and treating corneal abrasions

Athletic activities cause up to 10% of all eye injuries in children(1) and account for 25% of severe eye injuries.(2) The sports most commonly associated with eye injury are baseball, basketball, tennis, and ice hockey,(1) but eye injury can occur in any sport.

What do adult squash players think about protective eyewear?

OBJECTIVE

To determine the attitudes of adult squash players towards protective eyewear.

METHODS

A survey of 197 competition and social squash players from seven squash centres in the outer eastern suburbs of Melbourne, Australia was conducted in September to October 1995. Information about participation in squash, previous injuries, use of protective eyewear, barriers towards eyewear use, and attitudes towards protective eyewear was obtained by a self report questionnaire.

RESULTS

Squash is a popular sport in Australia. Of the players surveyed, 6% played in junior competitions, 67% in senior competitions, and 27% were social players. Most had been playing for more than ten years. Some 15% of players had previously suffered an eye injury, most commonly caused by a racquet. Less than 10% of players reported that they wore protective eyewear when they played squash, and 35% of these wore prescriptive lenses which they considered to be protective. The major reason for not wearing protective eyewear was the perception that it was unnecessary. Poor vision and a lack of comfort were also stated as reasons by a significant number of players. More than half (57%) of the respondents agreed that more players should wear protective eyewear, yet only 16% thought it should be compulsory for all players. There was considerable support for protective eyewear use by junior players, however.

CONCLUSIONS

The rate of protective eyewear use is low among competition and social squash players in Melbourne. The major areas that need to be addressed are the ignorance of the need for protective eyewear among social and experienced players and the mistaken belief that prescription lenses provide adequate protection on a squash court.

Eye injuries in athletics and recreation

Sports-related eye injuries represent a significant eye health hazard worldwide. In the USA, it is estimated that eye injuries from sports account for more than 100,000 physician visits per year at the cost of greater than $175 million. The sports responsible for the greatest number of injuries are baseball, ice hockey, and racquet sports. In the USA there are over 189 million participants in these sports with a disproportionate number (one-third) of injuries involving the pediatric population. The most common injuries are abrasions and contusions, followed by more serious injuries, including hyphema. Substantial reduction in the incidence of eye injuries through prevention has been demonstrated in the sport of hockey which can serve as a model for other sports. Specific criteria for protective eyewear must be developed. Polycarbonate plastic lenses and frames which are sturdy and impact resistant provide optimal protection. Lensless goggles, street wear and spectacle correction glasses do not provide adequate eye protection. The ophthalmologist's role in preventing sports-related eye injuries includes addressing particular sports participants needs, identifying one-eyed athletes, and informing patients of the need for protective eyewear.

Sports-Related Eye Trauma

In brief Encounters with balls, fingers, elbows are common mechanisms of eye injury in patients who participate in sports. A careful history and a systematic approach to the eye examination are important steps when diagnosing and treating eye injuries on the playing field or in the office. Seemingly minor injuries require close scrutiny because severe underlying injury may not be obvious. Patients should be encouraged to protect their eyes during high-risk activities, as this can reduce the number and severity of eye injuries.

Visual fields with protective eyewear

Sports-related eye injuries are quite common, yet the number of athletes who utilize protective eyewear is extremely low. The purpose of this study was to determine if there is a significant visual field loss associated with wearing eye protection. One of the authors was subjected to standard kinetic visual field testing with and without eye goggles. No significant difference was revealed. Physicians, physical therapists, and trainers should promote the use of protective eyewear and reassure athletes that they will not lose visual field.