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Objective:
To describe the demographics and outcomes of sports-related ocular injuries in an Australian tertiary eye hospital setting.
Methods:
Retrospective descriptive study from the Royal Victorian Eye and Ear Hospital from 2015 to 2020. Patient demographics, diagnosis and injury causation were recorded from baseline and follow-up. Outcomes i...
Context in source publication
Context 1
... patient age was 28.67 AE 15.65 years (95% confidence interval 27.95-29.40). Age-specific rates of injury are shown in Figure 1. More than half of the patients (59.56%) were below the age of 30, with the most common age groups being 20-29 (27.11%), 10-19 (26.99%) and 30-39 (19.19%), respectively. ...
Citations
... Orbital fractures account for 5.0 to 33.5% of sports-related maxillofacial fractures [4][5][6][7][8][9]. Previous studies seldom document if these are blowout fractures, and if so, whether they are pure (rim-sparing) or impure (rim involvement). ...
... However, regularly played sports differ between countries, and international differences in culture and climate inevitably lead to varied preferences in sports [7]. For example, the primary sports that cause maxillofacial and ocular injuries are soccer in Australia and the Netherlands, Gaelic football in Ireland, ice hockey in Finland, and skiing in America [4][5][6][7]9]. Unique demographics and play styles exist within each sport, which may modify the characteristics of pure orbital blowout fractures obtained during play. ...
... Single-wall fractures were prominent in the overall study population (78.8%) and among groups (p = 0.035). Preceding studies have determined that sports-related maxillofacial and orbital injuries generally occur as a result of the following: falls during play, contact with other players, contact with equipment or projectiles (e.g., ball pitches, golf clubs), and collision with the environment (e.g., colliding with a tree) [4,5,7,9,[15][16][17][18]. The present study excluded falls; thus, only contact with players, equipment, and the environment was included. ...
The aim of this study was to present the demographic and clinical characteristics of sports-related pure (rim-sparing) orbital blowout fractures and to analyze these differences by type of sport. Ten years of sports-related orbital fracture data were accumulated. Patients were classified into similar sports (i.e., soccer and futsal) wherein orbital blowout fractures were obtained, producing 14 groups. This study included 377 sides from 374 patients. The majority of patients were male (83.4%), and the mean population age was 20.9 ± 10.8 years. The most common sports causing injuries were baseball/softball, rugby/football, and martial arts. Single-wall fractures were found in 78.8% of patients, but baseball/softball had a higher frequency of multiple-wall fractures (p = 0.035). Concomitant ocular and periocular injuries occurred in 18.6% of patients, which were frequently caused by baseball/softball (p < 0.001). The field of binocular single vision (BSV) included primary gaze in 84.2% of patients. Surgical management was conducted in 52.1% of patients. This study showed that baseball and softball had the highest rate of multi-wall fractures and concomitant ocular and periocular injuries. The field of BSV measured during the first examination was acceptable in most cases.
... No caso específico das lesões faciais e oculares, podem-se listar agressões, acidentes automobilísticos, quedas, lesões desportivas, ou seja, traumas que concentram grande potencial cinético. (1,2) Uma lesão facial bastante frequente é a chamada fratura de órbita, que pode ser subdividida em alguns tipo, como fratura de teto orbital, parede orbital e assoalho orbital, podendo se caracterizar por blow-out ou blow-in. (3)(4)(5)(6) Traumas orbitais, na maioria das vezes, vêm acompanhados de alterações funcionais significativas oculares e visuais, devido ao prejuízo de tecido ósseo, nervoso, vascular e até parenquimatoso cerebral na região do assoalho e nas paredes da cavidade orbital. ...
... Dentre as manifestações clínicas oftalmológicas mais importantes, estão: manifestação de enoftalmia, diplopia, hifema traumático, hemorragia retiniana, amaurose, quemose, neuropatia óptica traumática e hematoma retrobulbar. (1)(2)(3)(4)(5)(6)(7)(8) Um em cada quatro pacientes acometidos por trauma maxilofacial terá concomitantemente fraturas da órbita e lesão ocular. Por isso, uma avaliação oftalmológica minuciosa é recomendada para todos os pacientes que sofrem um trauma de face. ...
... Estes artigos foram analisados quanto a objetivo do estudo, população estudada e nível de evidência. Os oito estudos tiveram como objetivo analisar traumas orbitais com alterações funcionais significativas oculares e visuais pelo prejuízo aos tecidos ósseo, nervoso, vascular e até parenquimatoso cerebral na região do assoalho e das paredes de cavidades orbital (n=8) (1)(2)(3)(4)(5)(6)(7)(8) . A população estudada foi predominantemente pacientes acometidos por fraturas orbitárias (n=8), (1)(2)(3)(4)(5)(6)(7)(8) em consequência de acidente automobilístico (n=3), (4,6,7) agressão interpessoal (n=2), (6,7) quedas (n=2), (4,7) trauma penetrante por arma branca (n=3), (3,4,6) lesões desportivas (n=3) (2,5,8) e acidentes de trabalho (n=1). ...
One in four patients affected by maxillofacial trauma will have concomitant orbital fractures and ocular injuries; therefore, an ophthalmological evaluation is recommended for all patients who have been affected by facial trauma. Some ophthalmological exams soon after the trauma can be decisive for the preservation of visual acuity. Patients with physical examination findings of poor visual acuity, afferent pupillary defect, radiographic images with high depth of orbital fracture, are at greater risk of vision loss and specific concern for evaluation of ocular injury. The objective of this study was to gather the prevalent ophthalmologic clinical manifestations in patients affected by orbital fractures, to achieve a better perspective and understanding about the consequences that the pathology brings to the individual regarding ophthalmology and the most appropriate treatments. This is an integrative review study, using the Pubmed®/Medline®, SciELO, Virtual Health Library and Lilacs databases, with a controlled vocabulary according to the search strategy in each of the bibliographic databases, using the terms “ophthalmologic complications”, “prevalence”, “orbital fracture”, in studies published from 2013 to 2023. The quality of the articles was assessed using the Study Quality Assessment Tool from the Department of Health and Human Services. A total of 46 references were found, 20 in Pubmed®/Medline®, 17 in SciELO, 9 in the Virtual Health Library and none in Lilacs. After excluding duplicate references, 44 references were selected for eligibility assessment. After reading the titles and abstracts (n=44), 36 studies were excluded for the following reasons: articles that did not answer our scientific question (n=11) and publication over 10 years (n=25). In the eight selected articles, the objective of the study, the population studied, and the level of evidence were identified. The eight studies aimed to analyze orbital trauma with significant ocular and visual functional changes due to damage to bone, nerve, vascular, and even brain parenchymal tissue in the region of the floor and walls of orbital cavities. Among the most important ophthalmologic clinical manifestations, there are enophthalmos, diplopia, traumatic hyphema, retinal hemorrhage, amaurosis, chemosis, traumatic optic neuropathy and retrobulbar hematoma. Considering the eight studies analyzed, there was a unanimous presence of ophthalmological clinical manifestations in all affected patients, with low visual acuity and hyphema being predominant. Regarding the findings of lower prevalence, when equating them to the most common ophthalmologic clinical manifestations, they have as main factor the transient state, which can be concluded that, even with all the severity of the orbital fracture, its tendency is not to leave permanent sequelae in most cases, although the relationship established by the absence of permanent sequelae is not clear, speculating that this absence is due to the identification of the condition and the appropriate intervention in a timely manner.
Orbital fractures; Eye injuries; Facial injuries; Visual acuity; Prevalence
... Sports-related eye injuries mainly affect young people in their 20s (14)(15)(16)(17)(18)(19), which is similar to the age distribution in this study. In other rare instances, the incidence has been observed to be higher in teenagers (3,20), late vicenarians (21) or quadragenarians (11,22) for particular groups or sports. ...
... The primary causes of sports injury vary among different countries (3,8,10,(14)(15)(16)(20)(21)(22)(23)(24)(25), such as prominence of basketball in America (38.6%) (14,19), badminton in Malaysia (66.6%) (23), floorball in Finland (32%) (26), hockey in Canada (44.19%) (24), cycling in western Australian (22%) (20), and baseball in Korea (30.5%) (21). Soccer, the most popular sport in the world, is the primary (18.2-32.5%) ...
... Soccer, the most popular sport in the world, is the primary (18.2-32.5%) (15,16,22,25) or important (3,14,20,21) (10), which supports our findings. ...
Objective
To investigate the epidemiological and clinical characteristics of sports-related eye injuries in China, as well as how they differ depending on the sport or other specific factor that caused them.
Methods
Consecutive medical records from 2015 to 2019 of sports-related eye injuries from a standardized database in nine tertiary referral hospitals in China were retrospectively reviewed and analyzed.
Results
A total of 377 eyes in 376 inpatients (mean age, 22.5 ± 7.3 years; men:women 15.4:1) were included. Soccer (46.8%), basketball (27.1%), and badminton (16.8%) were the top three sports that caused injury. Ball strikes (74.7%), physical collision (13.8%), and racket/equipment beating (9.0%) were the common specific causes of injury. Blunt force injuries (95.8%) and close globe injuries (95.1%) accounted for the majority of injuries. Open globe injuries occurred more in basketball (8.3%) than in other sports, mainly due to physical collision (12.8%) and racket/equipment beating (11.8%). Basketball (13.4%) or physical collision (21.3%) caused Zone I injuries more frequently than other sports. Soccer (60.5%) and basketball (54.6%) caused more injuries to the posterior segment of the eyeball than other sports, mainly due to ball strikes (96.6%). Badminton (69.8%) and racket beating (61.8%) caused more Zone II globe injuries than other sports. In badminton, the percentage of hyphema (85.7%), the most typical symptom of eye damage, and ultimate visual acuity (VA) ≥20/40 (88.9%) was the greatest. A final low vision score of (≤4/200) was observed in 10.6% of all participants, including three participants who had an eye removed due to rupturing. The final VA was positively correlated with the presenting VA (r = 0.421).
Conclusion
Sports can lead to high proportions of ocular contusion injury and low vision. VA prognosis is closely related to initial VA following ocular sports trauma, which is directly determined by the causative sports and/or the specific causes. Effective eye protection is imperative to avoid or reduce visual impairments of sports participants.
... These will require follow-up and management. 5 We must distinguish between penetrating and perforating injuries. Penetrating injuries occur when there is a single laceration to the eye, causing an open globe. ...
Vision plays an important role in an athletes’ success. In sports, nearly 80% of perceptual input is visual, and eye health and sports medicine are closely intertwined fields of utmost importance to athletes. The physical nature of sports activities renders individuals more prone to various eye injuries than the general population. Ocular trauma can lead to lifelong sequelae, and impaired vision requires careful follow-up and management. Apart from injuries, athletes may also experience vision problems that can hamper their performance, including blurred vision, double vision, and light sensitivity.
The interdisciplinary nature of sports medicine necessitates collaboration between sports medicine professionals and ophthalmologists. Through such collaborations, athletes can receive appropriate eye care, education on proper eye protection and guidance on adopting good eye health practices. If any inconspicuous symptoms are not detected and treated promptly, athletes may acquire systemic injuries because of defective vision, preventing them from achieving high level athletic performance in competitions.
The protection of the elite athlete is the responsibility of all of us in sports medicine. To advance a more unified, evidence-informed approach to ophthalmic health assessment and management in athletes and as relevant for sports medicine physicians, the International Olympic Committee Consensus Group aims for a critical evaluation of the current state of the science and practice of ophthalmologic issues and illness in high-level sports, and present recommendations for a unified approach to this important issue.
... 4 CGI represents a prevalent cause for hospital presentations due to its association with work or sporting activities. 5,6 The blunt impact force in CGI can lead to coup and contrecoup injuries with resulting posterior segment sequelae associated with poor visual outcomes. [7][8][9][10] Adnexal and associated injuries, such as retrobulbar haemorrhage, orbital fracture, and eyelid laceration with canalicular involvement, frequently occur concomitantly with CGI and these warrant study given the potential for complications necessitating emergent or surgical management. ...
... 14 Cricket, badminton, and soccer were the most common ocular sport injuries in our cohort, in contrast to previous studies that have shown Australian rules football, rugby, and horseback riding to be frequent. 3,5 Critically, eye protection was not worn in almost all work-and sport-related injuries (10.9% and 2%, respectively). This is an extremely concerning finding and is consistent with global studies that call for strengthening of guidelines and public policy to reduce preventable blindness. ...
... Several factors in a trauma setting like the clinical urgency, fear of exacerbating an injury, time constraints, multiple competing tasks, familiarity with the examination, or availability of equipment may have posed barriers to complete documentation. 5,6 Furthermore, relatively minor cases may have been managed without formal ophthalmic review, while severe adnexal or systemic injuries generally required admission under the plastics, maxillofacial or trauma surgical teams. This is a pertinent finding as a high frequency of adnexal and associated injuries were observed (71.5%), and the literature has reported that up T A B L E 3 Best-corrected visual acuity of patients with closedglobe injuries at presentation and final follow-up (n = 395). ...
Background:
To examine the epidemiology, visual outcomes, surgical interventions, and socioeconomic costs of closed globe (CGI) and adnexal injuries.
Methods:
A retrospective 11-year tertiary-trauma centre study of 529 consecutive CGI was conducted using the Revised Globe and Adnexal Trauma Terminology classification in individuals aged ≥16 years. Outcome measures included best-corrected visual acuity (BCVA), operating theatre visits, and socioeconomic costs.
Results:
CGI disproportionately impacted young males during work (89.1%) and sports (92.2%), with eye protection only worn in 11.9% and 2.0%, respectively. Home was the most prevalent location (32.5%) due to falls (52.3%) in older females (57.9%). Concomitant adnexal injuries occurred frequently (71.5%), particularly in assaults (88.1%), and included eyelid lacerations (20.8%), orbital injuries (12.5%), and facial fractures (10.2%). Final median BCVA improved to 0.2 logMAR [6/9] (IQR 0-0.2) from 0.5 logMAR [6/18] (IQR 0-0.5) (p < 0.001). Surgery was required in 89 CGI (16.8%) in 123 theatre visits. In multivariable logistical regression modelling, presenting BCVA was predictive of final BCVA (odds ratio [OR] 8.4, 95% confidence interval [95%CI] 2.6-27.8, p < 0.001), while involvement of the lids (OR 2.6, 95%CI 1.3-5.3, p = 0.006), nasolacrimal apparatus (OR 74.9, 95%CI 7.9-707.4, p < 0.001), orbit (OR 5.0, 95%CI 2.2-11.2, p < 0.001), and lens (OR 8.4, 95%CI 2.4-29.7, p < 0.001) predicted for operating theatre visits. Economic costs totalled AUD20.8-32.1 million (USD16.2-25.0 million) and were estimated at AUD44.5-77.0 million (USD34.7-60.1 million) annually for Australia.
Conclusions:
CGI is a prevalent and preventable burden on patients and the economy. To mitigate this burden, cost-effective public health strategies should target at-risk populations.
