Ocular Injuries in Sport and the Effectiveness of Eye Protection: A Narrative Review of Epidemiology by Discipline, Injury Mechanisms, Types of Eye Protectors and Current Preventive Recommendations

Abstract

Background. Sports-related ocular trauma is a substantial yet largely preventable cause of visual morbidity, accounting for about 10–20% of all eye injuries and representing a leading cause of monocular blindness in young, predominantly male participants; in the United States alone some 600,000 sports eye injuries occur annually, about 13,500 causing permanent sight loss.

Aim. To synthesise and critically compare current evidence on the epidemiology of sports eye injuries by discipline (racket, team and combat sports), their biomechanical mechanisms, the types and standards of ocular protectors, and current preventive recommendations.

Material and methods. Narrative review of peer-reviewed epidemiological studies, hospital and registry series, clinical case series, finite-element analyses, a scoping review and international consensus guidance.

Results. Risk concentrates in fast-projectile racket sports (squash, badminton, tennis, pickleball), popular team ball sports (soccer, basketball, baseball, handball, floorball, field hockey, cricket) and full-contact combat sports (boxing, mixed martial arts). Blunt closed-globe injury dominates, producing hyphema, angle recession, secondary glaucoma, commotio retinae, retinal dialysis and detachment, orbital blow-out fracture and, less often, globe rupture; finite-element models explain the anterior- and posterior-segment stress distribution involved. About 90% of injuries are preventable, and polycarbonate eyewear meeting recognised standards, visors and face masks markedly reduce incidence and severity, whereas ordinary spectacles and contact lenses give no protection.

Conclusions. Effective prevention requires mandatory, standardised eye protection in high-risk disciplines, rule modification, pre-participation and periodic ophthalmic screening (especially for functionally one-eyed, highly myopic and post-surgical athletes), and coordinated education of athletes, coaches and parents.