Take steps to protect vision

August is Children’s Eye Health and Safety Month, and September is Sports Eye Safety Awareness Month. While sports provide valuable benefits for children, such as physical fitness and teamwork skills, they also carry risks, especially to the eyes. Every year, nearly 30,000 sports-related eye injuries are treated in U.S. emergency rooms. The encouraging news is that most of these serious injuries can be avoided by wearing proper protective eyewear. Parents, coaches and young athletes should all prioritize eye safety to keep sports both fun and safe.

Common Eye Injuries

Corneal Abrasions: These occur when the eye’s surface is scratched, often by fingers, equipment or debris. Symptoms include redness, pain, tearing and light sensitivity. Depending on the size and severity, these typically heal on their own, but antibiotic drops or ointment may be prescribed to prevent infection.

Intraocular Injury: A direct impact to the eye, often caused by a small, fast-moving object, can result in damage to the delicate internal structures of the eye. This can lead to conditions such as hyphema (bleeding inside the eye) or more severe injuries like retinal detachment. Any changes in vision following such an injury require prompt evaluation by an ophthalmologist, along with careful monitoring for potential complications. Regular follow-up is crucial to check eye pressure and perform dilated eye exams to assess for any retinal tears or other internal damage.

Eyelid or Facial Lacerations: These injuries often result from blunt force trauma, such as being struck by a ball or an elbow, which can lead to bruising (commonly known as a black eye) and cause the skin to split, resulting in a laceration. Treatment typically includes applying ice packs to reduce swelling, using pain medication for discomfort and seeking medical evaluation. In cases where the lacerations are significant, surgical closure with stitches may be necessary to ensure proper healing.

Orbital or Facial Fractures: When blunt force trauma is more severe, such as a direct hit from a hard object like a baseball or puck, or from falls and collisions in sports like boxing or martial arts, the impact can fracture the facial bones, including the orbital bones surrounding the eyes. Such injuries require urgent evaluation by a specialist trained in orbital trauma, such as an oculoplastic surgeon. An oculoplastic surgeon will also ensure there is no damage to the eye itself or the muscles that control eye movement. This evaluation typically includes CT scan imaging to assess the extent of the fractures and identify the bones affected. Minor, stable fractures that are not displaced may only need observation and follow-up visits to monitor healing. However, more severe fractures, particularly those that are displaced, may require surgical intervention to realign and stabilize the bones using plates, screws or wires.

Penetrating Injuries: Rare, but severe, and perhaps can be the most devastating to vison. These occur when a sharp object pierces and/or ruptures the eyeball. This type of injury is an emergency and requires immediate medical attention with an ophthalmologist and will usually require emergency surgery. Follow-up care is essential to monitor healing and prevent complications.

How to Prevent Sports Eye Injuries

Use Protective Eyewear: Regular eyeglasses do not provide proper eye protection and can even worsen injuries if they shatter. The American Academy of Ophthalmology (AAO) recommends children wear polycarbonate lenses, which are 10 times more impact-resistant. For high-risk sports like ice hockey, lacrosse and combat sports, polycarbonate face masks or wire shields are essential. If you have reduced vision in one eye, consider the risks before participating in such activities.

Regular Eye Check-Ups: Ensure your child has regular eye exams, including dilated exams and checks for their glasses prescription, as these can change as they grow. These exams help detect vision problems that might increase the risk of injury during sports. It’s also important to discuss with your ophthalmologist any specific risks associated with the sport your child participates in, so you can take the necessary precautions to protect their vision.

When to Seek Medical Care

If you have high myopia (nearsightedness) or a history of eye surgery, you’re at higher risk for severe complications from eye injuries. After an eye injury, parents and coaches should watch for any changes in vision (blurry, double vision or loss of vision), light sensitivity, persistent pain, bleeding, bruising or noticeable damage to the eye or eyelid, it is essential to see an ophthalmologist immediately. Prompt medical attention is crucial, as some injuries can lead to permanent vision loss or even blindness.

Consult with a Specialist

Eye safety in sports is often overlooked but essential. By understanding the common injuries, preventive measures, and knowing when to seek medical care, parents and coaches can help protect young athletes. In complex cases, consulting an oculoplastic surgeon, who has specialized training in reconstructive surgery of the eyes and surrounding structures, can be crucial. Oculoplastic surgeons are ophthalmologists with additional training who handle eyelid abnormalities, tear duct obstructions, orbital fractures and more, offering both functional and cosmetic restoration to help patients recover from traumatic eye injuries.

Cynthia M. Noguera, MD is an assistant clinical professor in the Department of Ophthalmology at LSU Health Shreveport. Dr. Noguera specializes in oculofacial plastic and reconstructive surgery.