Doctors of optometry can help prevent eye-related injuries from sports and recreation

A new study underscores the role doctors of optometry can play in preventing eye injuries to children who participate in sports and recreational activities.

The study , published in the January 2018 issue of Pediatrics, found that an estimated 441,800 children were treated in this country's emergency rooms for eye injuries from 1990 to 2012. The study was based on 23 years of data on children 17 and younger from the National Electronic Injury Surveillance System.The top eye "injuries" associated with sports and recreational activities were corneal abrasion (27.1%), conjunctivitis (10%) and foreign body in the eye (8.5%).

And the top activities associated with the injuries: basketball (15.9%), baseball and softball (15.2%) and non-powder guns (10.6%). It's worth noting that overall injury rates stayed the same (football) or even dropped (basketball and baseball/softball), but jumped significantly for non-powder guns such as BB, pellet and paintball guns (nearly 170%) and swimming (142.3%).

"Pediatric sports—and recreation-related eye injuries remain common," concluded the study's researchers. "Increased prevention efforts are needed, including child, parent and coach education, along with adoption of rules that mandate the use of eye-protective equipment to decrease sports—and recreation—related eye injuries among children.

"The severity and increasing rate of eye injuries associated with non-powder guns underscores the need for special preventive efforts toward this source of pediatric eye injury," they said.

Researchers were affiliated with the Center for Injury Research and Policy at Nationwide Children's Hospital, Columbus, Ohio; The Ohio State University; Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana; and the Child Injury Prevention Alliance, Columbus, Ohio.

What doctors of optometry can do

Keith Smithson, O.D., is chair of the AOA Sports & Performance Vision Committee and team doctor of optometry for several Washington, D.C.-area professional sports teams. Doctors of optometry can advise parents and young athletes on sports eye protection, Dr. Smithson says.

"This should encourage all parents to seek a comprehensive vision exam before their child starts any new involvement in a sports activity," Dr. Smithson says. "We provide a much more comprehensive assessment than a pediatrician screening and this study, as well as concussion studies, describe the ocular impact of injuries and the potential concussion risks when playing sport without maximized visual skills.

"Many kids, my son included, are very engaged with play with the newest high-velocity NERF guns," he adds. "I require my son and all his friends to use eye protection, which I provide when they are playing with these toys at our home."

Fraser Horn, O.D., also serves on the AOA Sports & Performance Vision Committee and is associate dean of academic programs at Pacific University College of Optometry in Forest Grove, Oregon. Dr. Horn also is doctor of optometry for Pacific University athletes and consults with amateur and professional sports teams.

"This study, along with other studies, should ring loud in our ears as a public health concern and an opportunity for doctors of optometry to talk with our patients," says Dr. Horn, noting that the study's figures don't reflect the number of patients who seek out care after sustaining eye injuries from their doctors of optometry or primary care physicians.

Dr. Horn agrees.

"Doctors of optometry need to make sure that we are asking about what activities our children, and adults, are performing and then making appropriate recommendations/requirements for protective eyewear that meets the relevant ASTM standards," he says. "With that said, this only helps locally and does not transition to someone wearing protective eyewear often enough."

Doing more

Doctors of optometry can do even more, Dr. Horn says.

"The key is truly for AOA and state affiliates to work with leagues to change rules/regulations so that way everyone who plays a sport/activity is required to wear eye protection," he adds. "It was done with a women's lacrosse league and they found a decrease in eye and face injuries. The other option is to do something similar to what is done with concussion—have leagues send out information sheets to parents so they understand that there is a risk of eye injury, and we recommend standardized eye protection. This way at least they are making an informed decision."

Doctors of optometry are in a unique position to make a difference by preventing injury before it happens, says Doug Melzer, O.D., who practices in the Portland, Oregon area and participates in a number of outdoor recreational activities himself.

"The advantage of good counseling of our patients in relation to eye protection and safe participation in sporting activities is that they ultimately become advocates for their peer group to use protection even without knowing it," Dr. Melzer says. "An example of something similar is the routine use of helmets for skiing and snowboarding. Twenty years ago, you would look out of place with a helmet on, and yet, today it is a standard accessory worn by a high percentage of active participants."

See these AOA Sports & Vision Performance Vision Committee resources to learn about caring for the vision needs of people who participate and compete in sports.