Sports-related injuries are a common cause of ocular damage and account for 40% of all eye injuries.
It is well known that eye injuries can occur in any kind of sport, although ball-related sports are the ones that most often cause eye injuries, such as basketball, football, tennis or volleyball.
In these sports, injury is usually caused by a blunt trauma due to the ball being a heavy object and travelling at high speeds. The site and force of the impact, as well as the size, shape and material the ball is made of, determine the severity and location of the injury.
For a long time it was believed that injuries caused by the football in the inner part of the eye were less frequent, as a larger ball would have to find an obstacle in the orbital bones, thus not being able to penetrate inside the eye.
However, several studies have confirmed that footballs deform significantly upon impact, even to the extent of directly hitting the eyeball. In such cases, the ball can cause major injuries, including the corneal abrasions, hyphema (i.e. bleeding in the anterior chamber of the eye), oedema. In addition, traumatic impact can also induce damage to the posterior segment of the eye, such as retinal rupture and retinal detachmentthe macular hole (a condition in which there is a hole in the centre of the macula, the central portion of the retina) and the choroidal haemorrhages.
Children and eye injuries in football
Several studies have described the retinal damage caused by football injuries in both children and adults. The sportsIndeed, it is the most common cause of serious eye injuries in children, although it could be assumed that younger children should suffer a milder injury due to the lower force with which the ball is hit.Â
In a recent Israeli study, published in theEuropean Journal of Ophthalmology research was conducted on the relationship between eye injuries and the game of football, one of the most popular sports in the country and one of the main causes of sports injuries. The study examined all paediatric cases of retinal injury and ocular trauma diagnosed in Israel over a ten-year period.
50% of the total cases were considered severe and 28% of the patients presented significant lesions, which required a immediate actiondue to retinal detachment. In two cases, even the total loss of sight in the eye affected by the trauma.
None of the children examined had a risk factor for retinal detachment prior to the trauma. Since the ball is usually kicked upwards, the injuries reported in the study occurred mainly in the upper quadrant of the retina. The upward trajectory of the ball also suggests greater velocity during impact, compared to a downward trajectory, which could play a role in the mechanism of the injury. Furthermore, the researchers hypothesised that the paediatric eye injuries are partly due to the morphology of the face of children, who have not yet developed pronounced orbital borders, which are present in adults and adolescents and allow better protection of the eye from trauma.Â
How to prevent eye injuries in children and how to intervene
The Israeli study found that, often, the lack of external signs, or visible lesions, in children's eyes does not exclude the presence of lesions of the posterior segment of the eye. In such cases, without a thorough examination of the bottom of the eye by the specialist, the intervention would not have been timely.
It is, therefore, necessary never to underestimate an ocular trauma. The progression of retinal complications (e.g. retinal detachment), in the cases considered in the study, was probably prevented precisely because of the early diagnosis and timely treatment by the ophthalmologist. A thorough ocular assessment with examination of the peripheral retina is, therefore, essential, regardless of whether there are external signs of injury, preferably without waiting too long after the injury.
The results of the study also strongly support the recommendations for the use of eye protection in children during football matches to reduce both the incidence and severity of possible eye damage. Even if they are not professional players, but young amateur footballers, the use of eye protection should be considered by all football players, regardless of age.
In conclusion, it is recommended that parents, teachers and other adults caring for 'budding athletes' take all possible precautions and never underestimate the risks related to football injuries and trauma in children.
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