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Original Investigation
December 2016

Epidemiology of Sports-Related Eye Injuries in the United States

Author Affiliations
  • 1Center for Healthcare Quality and Patient Safety, University of Lugano, Lugano, Switzerland
  • 2Center for Surgery and Public Health, Harvard Medical School, Boston, Massachusetts
  • 3Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 4Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins School of Medicine, Baltimore, Maryland
  • 5Carver College of Medicine, University of Iowa, Iowa City
JAMA Ophthalmol. 2016;134(12):1382-1390. doi:10.1001/jamaophthalmol.2016.4253
Key Points

Question  What activities led to the highest number of sports-related eye injuries between 2010 and 2013 in the United States?

Findings  In a cross-sectional analysis of a nationally representative emergency department database, 120 847 individuals presented to emergency departments nationwide between 2010 and 2013 with a diagnosis of sports-related ocular injury, which was the primary diagnosis in 85 961 patients. Basketball, baseball, and air guns were the most common causes of injury, accounting for almost half of all primary sports-related eye injuries.

Meaning  These findings may help set priorities and develop strategies to try to reduce sports-related eye injuries among individuals presenting to emergency departments in the United States each year.


Importance  Ocular trauma can lead to lifelong sequelae, and sports-related ocular injuries have been shown to disproportionately affect the young. Studies quantifying and characterizing the incidence and type of injuries seen with sports-related ocular trauma may be useful for resource utilization, training, and prevention efforts.

Objective  To examine the emergency department (ED) burden of sports-related ocular trauma in the United States.

Design, Setting, and Participants  This retrospective, cross-sectional study examined the Nationwide Emergency Department Sample, containing data from approximately 30 million ED visits annually at more than 900 hospitals nationwide, from January 1, 2010, to December 31, 2013, to determine factors associated with sports-related ocular trauma.

Main Outcomes and Measures  Annual incidence of sports-related ocular trauma, broken down by age, sex, mechanism of injury, and related activity, as well as factors associated with short-term impaired vision.

Results  During the study period, 120 847 individuals (mean age, 22.3 years [95% CI, 21.9-22.7]; 96 872 males, 23 963 females, and 12 with missing data) presented with sports-related ocular trauma, which was the primary diagnosis in 85 961 patients. Injuries occurred most commonly among males (69 849 [81.3%]; 95% CI, 80.6%-81.9%) and occurred most frequently as a result of playing basketball (22.6%; 95% CI, 21.7%-23.6%), playing baseball or softball (14.3%; 95% CI, 13.7%-14.9%), and shooting an air gun (11.8%; 95% CI, 10.8%-12.8%). Odds of presentation to the ED with impaired vision were greatest for paintball and air gun injuries relative to football-related injuries (odds ratio, 4.75; 95% CI, 2.21-10.19 and 3.71; 95% CI, 2.34-5.88, respectively; P < .001).

Conclusions and Relevance  In our study, approximately 30 000 individuals presented annually to EDs in the United States with sports-related eye injuries; in more than 70% of these cases, eye injuries were the primary diagnosis. Activities involving projectiles pose the greatest risk for visual impairment in the short term, although long-term outcomes were unavailable.