Just a Black Eye or Something More Serious?

Sports that use a ball, puck, bat, stick or racquet such as baseball, hockey, lacrosse or basketball are considered high-risk sports that may require extra eye protection. When injury does occur, respond quickly for faster recovery and less eye trauma.

As a preventive measure, sports physicals should include a complete eye exam with close attention to any pre-existing ocular disorders such as myopia, surgical aphakia, retinal detachment, past eye surgery or infection, as these conditions increase the risk of serious eye injury. Special care should also be taken if the athlete’s family has a history of retinal detachment, retinal tears or diabetic retinopathy.

Blunt Injuries

These injuries occur when the eye is compressed by impact, as from a baseball. If there is only minor bleeding from the eyelid or a black eye, treat the eye with a cold compress to reduce swelling. If the athlete suffers from any of the following seek immediate care from an ophthalmologist:

  • Pupils that are not the same size or shape
  • Double vision when gazing at any angle
  • Blurred vision
  • Spots in the visual field (suggesting a retinal, optic nerve or nervous system injury)
  • Hyphema (bleeding beneath the cornea)

Don’t patch the eye, as it should be a physician’s decision whether or not to patch.

Penetration injuries

These injuries occur when an object punctures or embeds in the eye. Seek emergency medical attention immediately and take the following precautions:

  • Stabilize the injured eye by taping an eyecup over the eye (the bottom of a paper cup may also be used)
  • Never try to remove an embedded object
  • Never rub or apply pressure to an injured eye
  • If the eye is bleeding, avoid blood thinners such as aspirin or ibuprofen

Pink eye, or conjunctivitis, is a highly contagious viral or bacterial infection that should be isolated to prevent spread to the entire team. Viral pink eye, characterized by redness, swelling and a watery discharge, resolves without medication within 7 to 10 days. Athletes with viral pink eye shouldn’t return to play for 3 to 5 days. Bacterial pink eye may include redness, eye pain, swelling and a yellow or greenish discharge. Players can return to sport 24 hours after the introduction of an antibiotic. Advise team members to wash hands regularly.

Prevention

Although eye protection may not be required, coaches may recommend use in high-risk sports. The American Society for Testing and Materials (ASTM) has specified standards for eye protection in moderate- to high-risk sports, such as baseball, basketball, racquet sports, lacrosse and field hockey. A sturdy sports frame (ASTM F803-1) with 3-mm polycarbonate lenses is required for adequate protection. These lenses are impact-resistant, thin, light and offer 100 percent protection against UV radiation. Plain and prescription lenses are available. Contact lenses, sunglasses and traditional glasses are inadequate protection against eye injury.

Return to play is recommended once an injured player has been cleared by a physician and the injured eye is comfortable and vision has returned.