TOPLINE

An estimated 6466 patients with hockey-related eye injuries presented to US emergency departments over a period of 20 years. Protective eyewear was documented in only 1.9% of the patients studied, and nearly 1 in 8 diagnoses were serious enough to threaten vision and included cases of hyphema, corneal and scleral lacerations, retinal detachment, vitreous hemorrhage, and globe rupture.

METHODOLOGY

• Researchers queried the National Electronic Injury Surveillance System database for hockey-related ocular injuries from January 2004 to December 2023 to characterize epidemiologic trends and hockey-related ocular trauma in the US.
• A total of 215 cases (21.4% female patients; 69% pediatric) were identified, extrapolating to an estimated 6466 US cases nationwide over the 20-year study period.
• They analyzed patient demographic characteristics, the type of hockey played (ice, field, street, and roller), injury narratives, and the use of protective eyewear to determine how often these injuries occurred nationally, along with their type and severity.
• Injuries were categorized by location and severity as minor or major anterior segment injury, posterior segment injury, and periorbital injury, with acute vision-threatening injuries defined as those posing an immediate risk for major, potentially permanent vision loss.

TAKEAWAY

• Cases declined steadily from 2004 to 2018 but rose from 2018 to 2023.
• Most hockey-related eye injuries were caused by equipment, most often from being struck by a hockey stick (83%); injuries were approximately equally distributed across ice, field, and street hockey, and only 1.9% of injured players were reported wearing protective eyewear at the time of injury.
• Minor anterior segment injuries were the most common finding, occurring in 63% of patients.
• Of 259 total diagnoses, 32 (12.4%) were considered acute vision-threatening and included cases of hyphema (26), corneal and scleral lacerations (1 each), vitreous hemorrhage (2), globe rupture (1), and retinal detachment (1).
• Pediatric patients had more minor anterior segment injuries than adults (64% vs 46%; P = .02), whereas adult patients had more major posterior segment injuries (6% vs 0%; P = .009); male patients had more major anterior segment injuries than female patients (21% vs 2%; P = .002).

IN PRACTICE

“This study demonstrates that hockey was associated with considerable ocular injuries; while most injuries were minor, severe and vision-threatening injuries can occur. Considering the lack of proper protective eyewear mandates across all levels of play, our findings highlight the ongoing need for consistent use of protective eye equipment and targeted education to reduce preventable ocular morbidity potentially associated with this popular sport,” the researchers reported. 

SOURCE

The study was led by Leo L.T. Meller, MD, of the Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, at the University of California San Diego Shiley Eye Institute in La Jolla. It was published online on July 23 in JAMA Ophthalmology.

LIMITATIONS

The database only included patients who were seen in emergency rooms, so injuries treated in outpatient clinics or by primary care teams were not captured. As a result, milder injuries that did not require an emergency visit might have been underrepresented, while more serious cases could have been overrepresented. In addition, detailed eye examination findings (such as initial vision and intraocular pressure) and information on care after the visit were not recorded.

DISCLOSURES

Several authors disclosed having financial ties in the form of research funding, consulting fees, board memberships, patent licensing, and royalties to pharmaceutical and medical device companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.