R. S. Haring1,2,3,4, I. D. Sheffield5, J. K. Canner3, A. H. Haider1,2, E. B. Schneider1,2,3,4 1Harvard School Of Medicine,Brookline, MA, USA 2Brigham And Women’s Hospital,Center For Surgery And Public Health,Boston, MA, USA 3Johns Hopkins University School Of Medicine,Johns Hopkins Surgery Center For Outcomes Research,Baltimore, MD, USA 4Johns Hopkins Bloomberg School Of Public Health,Dept. Of Health Systems And Policy,Baltimore, MD, USA 5Brigham Young University,Provo, UT, USA
Introduction: Ocular injuries can have long-term sequelae and substantially impact quality of life. Currently available data on the incidence and overall burden of sports-related ocular trauma are limited or outdated. In 2015, the Centers for Disease Control and Prevention published a comprehensive model for the classification of sports and recreation-related injury. We applied this model to estimate and characterize the burden of sports and recreation-related (S/R) ocular injury in the United States.
Methods: Using the Nationwide Emergency Department Sample, we identified patients presenting with a diagnosis of ocular trauma from 2006-2012. We then examined ICD-9CM codes to identify individuals with S/R ocular injuries using the CDC’s comprehensive classification system. Age, sex, external mechanism of injury, type of S/R activity, and other factors were used to characterize and stratify injuries. Comparisons were made within and between injury strata across time. Data specific to individual team sports were not readily available until 2010; a subset was created to characterize those injuries from 2010-2012.
Results: A total of 287,718 ED visits associated with a diagnosis of S/R-related ocular injury occurred from 2006-2012. Males represented 78.8% of cases, and that proportion did not vary significantly across the 7-year period. The proportion of all ocular trauma cases that were S/R-related rose a relative 36.3%, from 3.8% of all injuries in 2006 to 5.2% in 2012. Overall, the leading single cause of S/R ocular injury was pedal cycling—an activity resulting in 34,965 (12.2%) S/R ocular injuries. The number of patients presenting cycling-related ocular injuries increased from 4,076 in 2006 to 5,623 in 2012. Among team sports, basketball resulted in the highest number of ocular injuries, with 17,018 patients presenting to the ED between 2010 and 2012. The next most common sport was baseball (12,734), followed by soccer (5,787), football (4,844), and watersports (2,063). During the study period, 291 patients were hospitalized with baseball-related ocular injury, 82 for basketball-related eye injury, 59 for soccer, and 45 for football-related injuries.
Conclusions: Despite an overall reduction in the number of all-cause ocular trauma cases reporting to the ED across the study period, the absolute number of S/R ocular trauma cases presenting for care increased significantly. The observed increase in S/R ocular trauma presentations appears to be driven in part by a 38.0% increase in the number of bicycle-related ocular injuries, which tend to be more severe (23.9% of cases resulting in hospitalization). Basketball remains the leading cause of S/R ocular injuries among the team sports, but hospitalization rates for baseball are 4.6 times higher than those for basketball (2.3% vs 0.5%). Efforts aimed at preventing serious vision-threatening injury may be most effectively focused on high energy S/R activities such as cycling and baseball.