For Patients and Families

"Up to 90 percent of eye injuries can be prevented by protective eye equipment," says ophthalmologist Carolyn Wu, M.D. of Children's Hospital Boston. "Wearing eye protection while participating in sports significantly reduces the incidence and severity of eye injuries."

"If you are hit by an object smaller than the opening of the orbit (eye socket), pressure will be placed on the eye," says Dr. Wu. "This force and distortion causes injury to the ocular structures." If the object hitting the eye is larger than the orbital opening, pressure will also be placed on the bones surrounding the eye which could result in a fracture.

Orbital floor fractures can cause asymmetry in the appearance of the eyes. Additionally, the muscles responsible for moving the eye may become trapped in the fracture, which can cause a person to have difficulty when looking up or down, or double vision because the eyes are misaligned.

Other results of blunt trauma can range from a black eye to more severe damage to the structures in the eye such as internal bleeding, inflammation, cataract, retinal detachment, optic nerve damage or rupture of the eyeball.

Penetrating injuries are not as common as blunt injuries, but can be just as detrimental. They can be caused by a finger, eyeglass breakage or any sharp object poking the eye. Injuries can range from a scratch on the front of the eye (corneal abrasion) to lacerations of the eyelid or eyeball.

The treatment and visual outcome of the injury depends on which parts of the eye are injured. "Sometimes we are lucky. A child may get an injury that we can treat with medication or repair surgically and their vision will not be damaged," says Dr. Wu. "But in other cases, the injury may be more severe and neither medicine nor surgery can fully repair the damage. These children can be left with permanent visual loss and in some cases blindness."

The American Society for Testing and Materials (ASTM) has developed standards for protective eyewear to be worn in various sports. Each sport has a specific type of recommended protective eyewear, but all sports goggles should be made with polycarbonate lenses. Polycarbonate is a high-impact resistant plastic that offers ultraviolet protection and can be made in prescription or non-prescription lenses. These lenses are 10 times more impact resistant than other plastics. In comparison, regular eyeglasses have only 5 percent of the impact resistance of polycarbonate lenses. Your eye doctor can recommend the eyewear that is appropriate for your sport.

It can be difficult to convince athletes, especially teenagers, to wear the recommended protective eyewear. Children and teenagers have a high rate of sports-related eye injuries because of their involvement in a wide variety of athletics and their tendency to play aggressively. It is important for pediatricians, school officials, coaches, and parents to convey the importance of protective eyewear. "Unfortunately, we often see children after they've had an eye injury," says Dr. Wu. "They were hit in the eye with a baseball or soccer ball and weren't wearing eye protection. We educate them about protective eyewear. It is very important for children with a history of prior eye trauma or surgery to wear protection since they are at a higher risk of losing their vision if further injury occurs."

"Once someone has had an injury, they are much more willing to wear eye protection. Now they know the potential damage firsthand," she adds. "But ideally, everyone should wear protective eyewear before there is an injury to the eye."

Children's Hospital Boston�, 2005. This page may be reproduced for educational purposes. Reprint permission is required for all other uses.