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The mechanism and prevention of soccer eye injuries.

AIMS: To study the mechanism and the means of preventing soccer eye injuries. METHODS: Kicked soccer ball velocities were measured for a range of ages and experience. Soccer balls (sizes 3, 4, and 5), inflated to 3, 6, and 9 psi, were impacted onto an artificial orbit and the results analysed at 1000 frames per second. Protective eyewear was fitted to a headform then impacted and evaluated. RESULTS: The mean peak ball velocity was 20.4 (SD 6.2) m/s. Soccer balls at 18 m/s entered the orbit between 7.5 and 8.7 mm. There was no significant difference in orbital penetration as a result of ball size or pressure. The soccer ball stayed in the orbit approximately 10 ms and appeared to have a suction effect as it withdrew. Protective eyewear that complied with sports protective eyewear standard ASTM F803 prevented contact of the ball to the eye. CONCLUSIONS: The soccer ball causes eye injury by entering the orbit. Protectors that pass ASTM F803 would prevent orbital intrusion.

Adolescent↗

Violet and blue light blocking intraocular lenses: photoprotection versus photoreception.

AIM: To analyse how intraocular lens (IOL) chromophores affect retinal photoprotection and the sensitivity of scotopic vision, melanopsin photoreception, and melatonin suppression. METHODS: Transmittance spectra of IOLs, high pass spectral filters, human crystalline lenses, and sunglasses are used with spectral data for acute ultraviolet (UV)-blue photic retinopathy ("blue light hazard" phototoxicity), aphakic scotopic luminous efficiency, melanopsin sensitivity, and melatonin suppression to compute the effect of spectral filters on retinal photoprotection, scotopic sensitivity, and circadian photoentrainment. RESULTS: Retinal photoprotection increases and photoreception decreases as high pass filters progressively attenuate additional short wavelength light. Violet blocking IOLs reduce retinal exposure to UV (200-400 nm) radiation and violet (400-440 nm) light. Blue blocking IOLs attenuate blue (440-500 nm) and shorter wavelength optical radiation. Blue blocking IOLs theoretically provide better photoprotection but worse photoreception than conventional UV only blocking IOLs. Violet blocking IOLs offer similar UV-blue photoprotection but better scotopic and melanopsin photoreception than blue blocking IOLs. Sunglasses provide roughly 50% more UV-blue photoprotection than either violet or blue blocking IOLs. CONCLUSIONS: Action spectra for most retinal photosensitisers increase or peak in the violet part of the spectrum. Melanopsin, melatonin suppression, and rhodopsin sensitivities are all maximal in the blue part of the spectrum. Scotopic sensitivity and circadian photoentrainment decline with ageing. UV blocking IOLs provide older adults with the best possible rhodopsin and melanopsin sensitivity. Blue and violet blocking IOLs provide less photoprotection than middle aged crystalline lenses, which do not prevent age related macular degeneration (AMD). Thus, pseudophakes should wear sunglasses in bright environments if the unproved phototoxicity-AMD hypothesis is valid.

Aged↗

Sussex Eye Hospital sports injuries.

To assess the prevalence of sports eye injuries in our area a register was kept over the 18 months from October 1982 to March 1984. Squash, association football, badminton, and tennis were the main offenders. The severest injury was from a golf ball, involving a fractured zygoma. There was one retinal dialysis, and one lens dislocation requiring extraction. Spectacles were broken in six cases and a contact lens in one. Glass fragments needed operative removal in one case, but there were no penetrating injuries. The value of eye protection, not worn by any of our patients, is emphasised.

Adolescent↗

Sport associated eye injury: a casualty department survey.

A survey was performed of all patients attending the combined Glasgow Eye Infirmary and Western Infirmary Eye Casualty Department with sports injuries. During an 18-month period a total of 246 patients presented with such injuries. Football was responsible for 110 (44.7%), rugby for 24 (9.8%), squash for 19 (7.7%), badminton for 16 (6.5%), and skiing for 9 (3.7%), and 68 (27.6%) were caused by other sports. One hundred and sixty-two patients (65.8%) had superficial or surrounding soft tissue injuries, 54 (22%) had more severe anterior segment damage in the form of hyphaema or traumatic uveitis, 17 (6.9%) had retinal damage manifest as oedema or retinal tear with or without detachment, and two (0.8%) suffered severe disruption of the globe with subsequent loss of the eye in each case. Forty-six (18.7%) required inpatient care and 200 (81.3%) were treated as outpatients, of whom 104 required at least one follow-up appointment (42.3% of the total). I conclude that with increasing time available for leisure activities there has been a parallel increase in sport associated eye trauma.

Adolescent↗

Modern sports eye injuries.

AIMS: To determine the severity and long term sequelae of eye injuries caused by modern sports that could be responsible for significant ocular trauma in the future. METHODS: Prospective observational study of 24 (25 eyes) athletes with sports related ocular injuries from health clubs, war games, adventure, radical and new types of soccer, presenting to an eye emergency department between 1992 and 2002 (10 years). RESULTS: Modern sports were responsible for 8.3% of the 288 total sports eye injuries reported. Squash (29.2%) was the most common cause, followed by paintball (20.8%) and motocross (16.6%). The most common diagnosis during the follow up period was retinal breaks (20%). 18 (75%) patients sustained a severe injury. The final visual acuity remained <20/100 in two paintball players. CONCLUSIONS: Ocular injuries resulting from modern sports are often severe. Adequate instruction of the participants in the games, proper use of eye protectors, and a routine complete ophthalmological examination after an eye trauma should be mandatory.

Adolescent↗

Ocular injury in hurling.

OBJECTIVES: To describe the clinical characteristics of ocular injuries sustained in hurling in the south of Ireland and to investigate reasons for non-use of protective headgear and eye wear. METHODS: Retrospective review of the case notes of 310 patients who attended Cork University Hospital or Waterford Regional Hospital between 1 January 1994 and 31 December 2002 with ocular injuries sustained during a hurling match. A confidential questionnaire on reasons for non-use of protective headgear and eye wear was completed by 130 players. RESULTS: Hurling related eye injuries occurred most commonly in young men. Fifty two patients (17%) required hospital admission, with hyphaema accounting for 71% of admissions. Ten injuries required intraocular surgical INTERVENTION: retinal detachment repair (5); macular hole surgery (1); repair of partial thickness corneal laceration (1); repair of globe perforation (1); enucleation (1); trabeculectomy for post-traumatic glaucoma (1). Fourteen eyes (4.5%) had a final best corrected visual acuity (BCVA) of <6/12 and six (2%) had BCVA <3/60. In the survey, 63 players (48.5%) reported wearing no protective facemask while playing hurling. Impairment of vision was the most common reason cited for non-use. CONCLUSIONS: Hurling related injury is a significant, and preventable, cause of ocular morbidity in young men in Ireland. The routine use of appropriate protective headgear and faceguards would result in a dramatic reduction in the incidence and severity of these injuries, and should be mandatory.

Adolescent↗

An uncommonly serious case of an uncommon sport injury.

BACKGROUND: A 55 year old man sustained a severe ocular injury when hit by a cricket ball even though he was wearing a helmet. METHODS: A suprachoroidal haemorrhage was drained and dense intravitreal blood was removed. An inferior buckle was applied with the use of intraocular gas. A macular haemorrhage resolved slowly. RESULTS: Despite several surgical procedures over 1.5 years, the final visual acuity of the patient was only 6/60 because of a dense macular scar. CONCLUSIONS: Helmets worn as protection when playing cricket need to be designed better and be of better material. Eye protection should be worn at all levels of play.

Athletic Injuries↗

The effectiveness of a squash eyewear promotion strategy.

OBJECTIVE: To evaluate the protective eyewear promotion (PEP) project, which was a comprehensive educational strategy to increase the use of appropriate protective eyewear by squash players. METHODS: An ecological study design was used. Four squash venues in one playing association were randomly chosen to receive PEP and four in another association maintained usual practice and hence formed a control group. The primary evaluation measurements were surveys of cross sectional samples of players carried out before and after the intervention. The surveys investigated players' knowledge, behaviours, and attitudes associated with the use of protective eyewear. The survey carried out after the intervention also determined players' exposure to PEP. Univariate and multivariate analyses were undertaken to describe differences at PEP venues from pre- to post-intervention and to compare these with the control venues. RESULTS: The PEP players had 2.4 times the odds (95% confidence interval, 1.3 to 4.2) of wearing appropriate eyewear compared with control group players post-intervention, relative to the groups' pre-intervention baselines. Components of PEP, such as stickers and posters and the availability and prominent positioning of the project eyewear, were found to contribute to players adopting favourable eyewear behaviours. CONCLUSIONS: Components of the PEP intervention were shown to be effective. The true success will be the sustainability and dissemination of the project, favourable eyewear behaviours, and evidence of the prevention of eye injuries long into the future.

Adult↗