Sports-related ocular injuries. A three-year follow-up study.

Purpose

The authors performed a sports-related ocular injuries evaluation with periodic patient observation and follow-up, to outline the severity and long-term sequelae of eye injuries in sports.

Methods

A prospective study was conducted of 84 consecutive patients (85 injured eyes) with sports-related eye injuries examined at the Eye Emergency Department of Porto S. João Hospital, between April 1992 and March 1995. The ophthalmologic examination was recorded using the United States Eye Injury Registry report forms, and the follow-up ranged from 3 months to 3 years.

Results

Injuries occurred predominantly in young males (mean age, 24.8 +/- 9.6 years). The type of sport and the mechanism most frequently responsible for injuries were, respectively, outdoor and indoor soccer (72.6%) and ball trauma (64.3%). Of 45 patients presenting with hyphema, 24 (53.3%) had vitreous and/or retina (V/R) lesions (95% confidence interval [CI], 35.8-67.5) compared with 13 of 39 (33.3%) patients with no hyphema (95% CI, 20.0-49.1). Angle recession was significantly more common in the presence of hyphema (55.6%; 95% CI, 41.0-69.5 vs. 10.3%; 95% CI, 3.3-22.9; P < 0.00005), and retinal tears were more common in the presence of vitreous hemorrhage (P = 0.004). Nineteen of 58 (32.8%) patients with "normal" visual acuity (> or = 20/40) presented with V/R lesions. Hyphemas were significantly more frequent in soccer players (38/61 vs. 7/23, P = 0.018).

Conclusion

These results highlighted the serious nature of outdoor and indoor soccer injuries. The severity of the anterior segment injury was not a good predictor of posterior segment damage. Ophthalmologists can help prevent delayed consequences by including regular gonioscopy and peripheral retinal examination in all cases of blunt trauma. The United States Eye Injury Registry report forms adapted to sports proved to be a useful tool for collecting detailed information and sharing a common database.