By M. Bowes Hamill, MD

Americans love their sports as well as other indoor and outdoor activities. These pastimes provide wonderful opportunities for healthy exercise and great memories. But for some, especially for children, preventable eye injuries can spoil such reminiscences.

Approximately 42,000 sports-related eye injuries occur every year in the United States. More than one-third of the victims are children. In fact, sports represent the number one cause of eye injuries in children under the age of sixteen. Injuries range from abrasions of the cornea and bruised eyelids to internal eye damage, such as retinal detachments and internal bleeding. Many of these injuries lead to vision loss and permanent blindness.

The sports with the highest risk -- for which eye protection is available -- include basketball, baseball, hockey, football, lacrosse, fencing, paintball, water polo, racquetball, soccer and downhill skiing. In baseball, for example, most eye injuries result from the ball hitting the eye. Batters are the most common victims, though pitchers and outfielders can also be hurt. In basketball, most eye injuries result from the eyes being poked by fingers and elbows.

Wearing Protective Eyewear

Athletes participating in high-risk sports -- especially young athletes -- should wear appropriate sport-specific protective eyewear as recommended and properly fitted by an ophthalmologist or other eye care professional. The good news is that athletes today can choose from various types of lightweight and sturdy protective eyewear that look and fit better than those used in the past.

Eyewear that is properly fitted and consistently worn does not hinder performance in any way, and can prevent 90 percent of sports eye injuries. Many famous athletes, including NBA All-Star Kareem Abdul-Jabbar, NFL Hall of Fame Eric Dickerson and MLB Hall of Fame Johnny Bench, have excelled in their respective sports while wearing protective eyewear. In Canada, eye injuries decreased by 90 percent after certified full-face protectors attached to headgear were made mandatory in organized amateur hockey.

The lenses of the different types of protective eyewear should be made of polycarbonate, which is 20 times stronger than the lenses of typical eyewear. Polycarbonate can withstand a ball or other projectile traveling at 90 miles per hour. Contact lenses offer no protection, and street wear glasses are inadequate to protect against any type of eye injury.

Special consideration needs to be given to athletes with good vision in only one eye, or with a history of eye injury. Functionally one-eyed athletes (those whose best-corrected visual acuity is less than 20/40 in the poorer-seeing eye), or those who have had previous eye injury or surgery, should never participate in boxing or full-contact martial arts, for which no adequate eye protection is available. For sports in which a facemask or helmet with eye protectors is required, functionally one-eyed athletes should also wear sports goggles with polycarbonate lenses to ensure adequate protection. The helmet should fit properly and have a chinstrap.

Parents' Role in Sports Eye Safety

Because many children's sports leagues, schools and teams don't require children to wear eye protection, parents must insist that children wear eye protection every time they play. In addition, they should set a good example by wearing eye protection themselves whenever they play sports.

Parents can get involved at the local level and help pass ordinances that require children under the age of 16 to wear batting helmets with protective face shields when playing baseball, as the City of Baltimore did recently. Also, they can work to mandate the use of softer baseballs, which are available (and would cause fewer head injuries), but are generally not used.

Similar requirements could be applied to other sports as well. The key is to take active, preventive steps to ensure that we all protect our most valuable sense -- sight.

M. Bowes Hamill, MD, is the Associate Professor of Ophthalmology at the Baylor College of Medicine and Spokesperson for the American Academy of Ophthalmology and Eye MD Association. Dr. Hamill is also the Chairman of the Eye Health and Public Information Task Force at the Academy of Ophthalmology.

Source: Lighthouse International's EnVision newsletter (Spring 2004 issue)



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