Complete Story
08/08/2024
August Kids Corner – Sports Eye Safety in Children
Sports Eye Safety in Children
There are two most important points about sport eye safety:
- Sports related ocular injuries are not uncommon, especially in children.
- The incidence of sports related ocular injuries can be GREATLY reduced by the use of protective eyewear.
We all know that ocular injuries can result in significant morbidity and permanent vision loss that may impact the quality of life for our patients. Ocular injuries in youth are disproportionately sports related. Most studies looking into the incidence of sports related eye injuries only include ocular injuries that are reported through emergency departments, so although this is very useful data, we know it greatly underrepresents the true number of injuries as many patients will instead go to their eye doctor or primary care provider directly.
R Sterling Hering et al reported in JAMA Ophthalmology (Nov 2016) that approximately 30,000 individuals presented annually to emergency departments in the US with sports related ocular injuries. Of these, in 70% of the cases, ocular injuries were the main presenting condition. This was a retrospective study looking at data from over a three year period. Further analysis revealed that 81.3% of these patients were male and the average age of patients with sports related eye injury was 20.1 years olds for males (peak at 17 years old) and 19 years old for females (peak at 15 years old). More than half of the patients were less than 18 years old.
When looking into specific sports incidence, for males the sports with the highest incidence of ocular injuries were basketball (26% of all injuries), baseball (13%) and air guns (13%). For females, the sports of highest incidence were softball (19%), cycling (11%) and soccer (10%).
A study by Iller et al published in Pediatrics in February 2018 analyzed data over a twelve year period and revealed similar age and gender distribution of patients with sports related eye injuries that presented to EDs. In this study the most common ocular injuries reported were corneal abrasions (27.1%) conjunctivitis (10%) and foreign body (8.5%). This study also reported that 4.7% of patients required hospitalization for their injury, and of these, 49% of those hospitalized had ocular injuries caused by non-powder gun-related injuries.
Of importance, as corneal abrasions are the most common ocular injury that presents to the ED, optometrists should be very aware that based on recent publications in Annals of Emergency Medicine in March 2021 and in the Journal of Anesthesiology and Pain Therapy 2021 that some emergency room doctors are prescribing short term use of topical anesthetics (tetracaine and proparacaine) to these patients. This of course of course is contrary to most of our practice and also contraindicated based on a publication by Zhang et al [J Ocul Pharmacol Ther. 2022 Apr;38(3)] that showed that topical proparacaine use did impede corneal healing both in vitro and in vivo.
Moving on to point #2 above will be short and to the point. In an article by Harrison and Telander (Pediatric Annals , 2002; 31(1) they state that OVER 90% OF SPORTS RELATED EYE INJURIES IN CHILDREN CAN BE PREVENTED WITH THE APPOROPRIATE USE OF PROTECTIVE EYEWEAR.
As primary eyecare professionals, we have an obligation to inform all of our patients that participate in sports of the high morbidity of sport related ocular injuries and also of the tremendous effectiveness of wearing approved eyewear and/or visors as appropriate. This is of course even more important in our amblyopic and monocular patients. Also remember that ASTM F803 approved shatterproof sports eyewear with 3mm thick polycarbonate lenses are 20 times stronger than dress eyewear.
If cost is a barrier, please direct your patients to the Play Hard Don’t Blink program run by the Ohio Ophthalmological Society and funded by the Save our Sight (SOS) funds through the Ohio Department of Health. They have three programs that supply FREE protective eyewear for 1) Sports teams; 2) Kids in technical school programs with higher incidence of ocular injury, and, 3) individual children from families that meet the financial need criterion. Information on these programs can be found at https://superspecs.org/
Also, the National Eye Institute has a PowerPoint and speakers’ guide that you can use as a starting point for a presentation that you can make to schools or athletic organizations in your area. This is found at https://www.nei.nih.gov/sites/default/files/nehep-pdfs/SpeakersGuide.pdf
