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2. Sports-Related Eye injuries Dr.Broomand Golestan University

3. Epidemiology • Sports cause more than 40,000 eye injuries each year. More than 90 percent of these injuries can be prevented. • Overall, basketball and baseball cause the most eye injuries, followed by water sports and racquet sports.

4. How are sports classified? • When it comes to eye injuries, sports can be classified as: • low risk, high risk, and very high risk. • Low-risk sports do not use a ball, puck, stick, bat, or racquet, and have no body contact. Some low-risk sports are track and field, swimming, gymnastics, and cycling.

5. High-risk sports use a ball, puck, bat, stick, racquet, or body contact. Some high-risk sports are baseball, basketball, hockey, football, tennis and other racquet sports, fencing, and water polo. • Very-high-risk sports do not use eye protectors. Some very-high-risk sports are boxing, wrestling, and contact martial arts.

6. What should we consider before playing sports? • family doctor should examine persons before play sports. • Tell doctor if they have any eye problems or if they have a family history of retinal problems.

7. What are the most common types of injuries? • Common types of eye injuries are : • blunt trauma. • penetrating injuries. • radiation injury from sunlight.

8. Blunt Trauma • Blunt trauma occurs when something hits you in the eye. • Blunt trauma causes most sports-related eye injuries. Some serious examples : • 1-orbital blowout fracture (a broken bone under the eyeball) • 2- ruptured globe (broken eyeball) • 3- detached retina. • 4-Hyphema • 5-Vit Hemorrhage • Bruising of the eye and eyelid (“black eye”) looks bad but usually is a less serious injury

9. injuries Penetrating • Penetrating injuries occur when something cuts into your eye. • These injuries are not very common. • Broken eyeglasses • Fish hook injury • Finger injury to medial canthus (Canalicular injury)

10. Radiation injuries • Radiation injuries are caused by exposure to ultraviolet light from the sun. • These injuries are most common in sports such as: • snow skiing . • water skiing and other water sports. • Climbing.

11. How can I protect myself from eye injuries? • eye doctor can tell how to protect our eyes. • Wearing eye protection can reduce the number and severity of eye injuries. • Only 3-mm polycarbonate lenses should be used in protective sports eyewear. These lenses are available in plain and prescription forms. • Never wear protective devices without lenses. • Contact lenses and sunglasses will not protect our eyes from blunt or penetrating injuries. • Wearing a helmet or faceguard cannot protect our eyes.

12. What is a one-eyed athlete? • A “one-eyed athlete” has less than 20/40 vision in one eye. • If such an athlete loses vision in the good eye because of injury, he or she could become legally or totally blind. • Before playing a given sport, the athlete must know • the risks of that sport • , how well protective devices work • if a typical eye injury can be treated successfully.

13. During games and practices for all sports with the risk of eye injury • one-eyed athletes must wear eye protectors . • In sports that require a face mask, such as hockey, football, and lacrosse, the athlete must wear eye protectors under the face mask. • One-eyed athletes should never participate in very-high-risk sports such as boxing, wrestling, and contact martial arts, because eye protection is not worn in those sports. • The one-eyed athlete should be checked by an eye doctor before playing in any sport.

14. When can an injured athlete return to play? • serious eye injury : • should be examined by an ophthalmologist and return to play only if the doctor says it is safe.Theathlete should wear eye protectors. • For a less serious injury: • the team physician can decide if the athlete can return to play based on the type of injury and how the athlete feels. Athletes should never use topical anesthetics so they can keep playing.

15. Lid Echymosis

16. Lid Laceration

17. Ocular Trauma Ocular Trauma

18. Black ball Hyphema

19. Iridodialysis

20. Lens Injury

21. Vitreous hemorrhage • Direct ophthalmoscope • Red reflex • Difficult to appreciate the red reflex • Cornea, anterior chamber, and lens look clear • Refer to ophthalmology

22. Acute retinal tear

23. Retinal Hemorrhage

24. Prevention of Eye injury • Protective eyewear should be worn by athletes and patients that are one-eyed • Criteria is visual acuity less than 20/40 in the poorer eye--loss of the good eye would render patient unable to drive legally • Recommended eyewear is frames or goggles with polycarbonate lenses • Need plano lenses if contacts are worn

25. Blow-out fracture • Enophthalmos • epiocular ecchymoses and swelling • infraorbital nerve anesthesia • Ophthalmoplegia - • - in upgaze and downgaze • Doplopia

29. Summary • A complete eye examination should be part of any sports physical. • With each athlete, physicians should obtain an ocular history, paying special attention to prior conditions such as a high degree of myopia, surgical aphakia, retinal detachment, eye surgery, and injury or infection. Athletes with such risk factors should be evaluated by an eye care professional before engaging in any high-risk or very-high-risk sport.

30. Criteria for return to play following severe Eye Injury • Requires ophthalmology exam . • Eye must be pain free with return of Visual Acuity . • Eye Protection required . • No ocular anesthetics may be used to return to play .

37. Ninety percent of sports-related eye injuries may be prevented with protective eyewear. • Prevention is the best and most effective treatment. • Regular eye exams are the first step.