Ocular trauma is any type of injury that occurs to the eye or the tissues around it. It can be as simple as a black eye or as serious a fracture of bones surrounding the eye, said Dr. R. Sterling Haring, lead author of the study, published in JAMA Ophthalmology. Eye injuries can lead to long-term vision impairment and can affect learning, work, relationships and a person's ability to drive.
"There's not an aspect of your life that this wouldn't touch," said Haring, a researcher with Johns Hopkins Bloomberg School of Public Health and the University of Lugano.
The study examined visits to emergency departments in 900 hospitals nationwide. From 2010 to 2013, about 30,000 patients visited emergency rooms every year with sports-related eye injuries. The numbers would be higher if visits for urgent care facilities, ophthalmologists or other physicians were taken into account, said Haring.
Among those with sport-related eye injuries, 60% of the males and 67% of the females were 18 or younger.
The sports most linked to eye injuries among males were basketball (26%), baseball or softball (13%), and air guns (13%). For females, the top sports were baseball or softball (19%), followed by cycling (11%) and soccer (10%).
"In basketball, people are jumping, and it could be a lot of elbows or fingers, whereas in baseball, it's going to be a baseball," Haring said.
Though the likelihood of a visual impairment is relatively low, it has been linked to activities like paintball and air guns. The activities are similar, but paintball is often played at facilities with safety requirements, while people tend to use air guns in their backyards. The number of injuries tied to air guns is drastically higher.
Haring said sport-related eye injuries should be addressed on a school level, as well as on a policy level.
"Sports enthusiasts, parents, school officials, sports officials, health officials, government representatives and industry representatives need to be at the table to discuss the next step, what needs to be done and how we can do it," he said.
"It would be great to have rules and regulations to mandate protective eyewear in sports where we know children can have their eyes hurt," said Dr. William V. Good, pediatric ophthalmologist and senior scientist at Smith-Kettlewell Eye Research Institute in San Francisco, who was not involved in the research.
Hockey once led to many serious eye injuries among children, he noted, until rules requiring eye protection were put in place.
But requiring protective eyewear might not work for every sport or player, said Dr. Jennifer Shu, a pediatrician in Atlanta.
"Awareness is a good thing, and recommendation should be based on research," Shu said.
She argued that sometimes, the eyewear receiving the shock might end up bruising a person's face. More research is needed to identify which equipment is protective and what sports it will be needed for. She pointed out that the costs and logistics of protective eyewear should be taken into consideration, as well.
"We can't have a blanket recommendation," she said. "We have to consider the risks and benefits."