Most Pediatric Eye Injuries Are Sports-Related

Houston (May 16, 2002) – With the onset of summer vacation triggering a rise in the number of active hours school-aged children are spending, so too rises the number of sports-related eye injuries seen by Kelsey-Seybold Ophthalmologist Melinda Rainey, M.D – usually caused by a baseball or elbow hitting the eye. The overall incidence of eye trauma from sports and recreational activities in patients under the age of 25 is 100,000 per year, with 90 percent of these injuries preventable with proper eye protection.

The good news is that these types of blunt injuries generally do not cause too much damage to the eyeball itself. If the eyeball itself has not been punctured, there is usually a lot of swelling around the eye, resulting in black eye, and the possibility of a fracture in the bones surrounding the eye. However, it’s a very different situation when the eye is hit with a smaller ball, such as a golf ball or racquetball, or with a sharp object, such as a BB. In those situations, the eyeball can be perforated, leading to serious eye problems, such as hemorrhage, retinal detachment or even blindness.

“It can be like that scene in ‘A Christmas Story,’” says Dr. Rainey. “Kids really can shoot their eye out, or at least cause a lot of damage with a BB gun.”

Dr. Rainey, a board certified pediatric ophthalmologist at Kelsey-Seybold Clinic, offers these words of advice to the parents of children who have sustained an eye injury: Do a visual inspection, stay alert and be suspicious.

"The first thing to do is to look at the eye. If you don’t have a little pin light, use natural light or a flashlight. Take a look at the surface. It should have a smooth, lustrous appearance,” she said. “Make sure there are no puncture wounds or cuts and that nothing is embedded in the eye. If a blow to the eye or a cut to the eyelid occurred, be sure to check for injuries to the eyeball itself,” she adds.

The second thing to do is to check vision. “You don’t need an eye chart,” she explained. “If the child is old enough to read, ask them to read from a book while you cover one eye, then the other. Check their distance vision, too. If they’re younger, have them identify a picture of a favorite animal. If your child’s vision is blurred or lost, or your child reports double vision, call your doctor immediately,” Dr. Rainey said.

Dr. Rainey offers one tip that parents might overlook: Your kids might not be telling you the truth. “Kids can tolerate much more pain than punishment,” she notes. “If you haven’t witnessed the eye injury and they tell you, ‘Oh, I just ran into the counter,’ be suspicious,” the doctor noted. “I’ve treated many patients who didn’t want to tell their parents they were playing with fireworks or BB guns or that a sibling or friend stuck them in the eye with a sharp object.”

One potentially serious problem that can result from an eye injury is a condition known as “iritis” – generally characterized by red, dilated vessels that continue to get redder and redder and are very sensitive to light. “It’s not just one spot on the eye; it’s the entire eye,” says Dr. Rainey. “While ‘baseball eye’ or ‘elbow eye’ will generally heal itself within two weeks, this condition can result in a loss of vision if it is untreated.” A combination of medical supervision and topical steroids will generally correct the problem.

Other potentially serious injuries involve burns to the eye, which can be caused by fireworks, chemicals, or hot air or steam. Many of these substances won’t cause damage if flushed out right away, but acids and alkali substances can damage the eye and may lead to an eye infection. “It’s important to call your doctor and see a specialist right away,” says Dr. Rainey.

The least damaging eye injury is usually the most painful – a scratch or mild cut to the eyeball (cornea). These superficial injuries can be treated by antibiotic drops and will generally heal with no after effects.

While most pediatric eye injuries are minor, parents should stay vigilant. Examine the eye. Check the child’s vision. “If there are any vision problems, if you can see an object embedded in your child’s eye, if your child has sustained a burn or there is bleeding, call your doctor immediately,” urges Dr. Rainey. “And if pain, redness, or photo sensitivity persist for more than 24-48 hours, see an ophthalmologist to rule out “iritis” or another serious problem that could result in vision loss.”

Dr. Rainey offers one final tip: Follow your doctor’s instructions. “Kids hate eye drops and medication,” she notes. “As soon as they start feeling a little better, they’ll stop taking their medication and tell you they’re fine. Make sure they follow the recommended treatment.”