America's Favorite Sports Pose a Risk for Orbital Fractures
Adolescents and men in the US faced a notable burden of orbital fractures and associated ocular injuries from sports such as baseball, softball, and bicycling, underscoring the need for protective glasses and clear safety rules — as well as the strict enforcement — of these regulations to prevent loss of sight during athletic activities.
METHODOLOGY:
Researchers analyzed data from the National Electronic Injury Surveillance System from 2014 to 2023 to understand how often individuals suffered from orbital fractures while playing sports in the US.
They looked up the database for cases of facial fractures linked to sports, excluding those involving motor vehicles, and reviewed trauma narratives specific to orbital fractures; records of individuals younger than 5 years were not analyzed.
The national estimates of orbital fractures were calculated, and details such as the age of the patients, the type of sport played, the location of the fracture, and the frequency of associated ocular injuries were evaluated.
TAKEAWAY:
This study identified 1468 cases of orbital fractures stemming from sports, corresponding to an estimated 49,765 cases (95% CI, 47,219-52,311) nationwide; the incidence of these injuries remained largely stable throughout the study period.
The study population had a mean age of 27.1 years, with men comprising 79% of cases, and the highest frequency of sports-related orbital fractures observed among those aged 10-19 years.
Baseball (28.6%), bicycling (23.1%), and softball (6.7%) were the most frequently implicated sports in orbital fractures; most cases of orbital fractures (56.9%) were linked to activities in which participants were required to come into bodily contact with one another.
An analysis of narratives specific to orbital fractures revealed that the orbital floor was the most commonly fractured site, accounting for 59.8% of cases; about 14% of patients sustained injuries to the eye or surrounding areas, most often cuts to the eyelid, scratches or cuts to the cornea, cuts to the eyebrow, and bleeding beneath the conjunctival membrane.
IN PRACTICE:
'The sustained rates of orbital fractures highlight a critical gap in sporting protective equipment and emphasize the importance of adopting protective equipment specifically designed for orbital injury prevention, including face shields and protective eyewear,' the researchers reported.
'The findings presented here, coupled with evidence that properly fitted protective eyewear or face shields can reduce the risk of ocular injuries by 90%, emphasize the crucial role of eye protection in sports,' they added.
SOURCE:
This study was led by Niloufar Bineshfar, MD, of the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine in Miami. It was published online on June 21, 2025, in Ophthalmology.
LIMITATIONS:
Some injuries may not have been reported or may have been labeled incorrectly, causing inaccuracy in the incidence rates for orbital fractures and related eye injuries. No details were available on the severity of the injuries, how people healed over time, or what care they received. Since injuries to other parts of the body were noted only from 2019 onward, some damage to the eye before that date may have been missed.
DISCLOSURES:
This study was funded by the Bascom Palmer Eye Institute and a Research to Prevent Blindness Unrestricted Grant. The authors reported having no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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