Soccer (football) ocular injuries: An important eye health problem

T he ideal scenario for a sports (or any other) eye injury is for it never to have happened. According to the US Centers for Disease Control and Prevention, ‘‘injury is probably the most unrecognized major health problem facing the nation today, and the study of injury presents unparalleled opportunities for reducing morbidity and mortality and for realizing significant savings in both financial and human terms—all in return for a relatively modest investment.’’ The social cost of eye trauma, the most common ophthalmic indication for hospitalisation, is enormous. National projections estimate annual US hospital charges of $175 million to $200 million for 227 000 eye trauma hospital days. Tan, in a recent BJO editorial, commented on prevention of blindness programmes, and stated that ‘‘let us then remind ourselves of prevention of blindness programmes which have the potential to do the greatest good for the most people.’’ By carefully evaluating the underlying mechanisms, patterns, and rates of injury in a given sport, it is possible to design and implement extremely effective preventive programmes. Soccer ocular injury is an important eye health problem in Europe and probably worldwide. In these series, contrary to previous ophthalmology teaching that eye injuries are rarely caused by balls larger than 4 inches in diameter, the large diameter soccer ball was responsible for most soccer injuries. In 1994, Vinger focused on some pertinent questions related to soccer eye injuries. ‘‘How is sufficient energy transmitted from the large ball to the eye to result in severe lesions in many injured players? Are the eye injuries caused by ball deformation? Does underinflation result in more eye injuries than properly inflated balls? Are sports eye protectors currently in use for racket sports sufficient to prevent injury?’’ In the same chapter he proposed the future method of investigation, and stated that ‘‘impact testing of balls at varying speeds and pressures, with and without various eye protectors in place, using high-speed photography, should, in combination with prospective injury studies, answer these questions over the next several years.’’ In fact, several years elapsed to the publication, in this issue of the BJO (p 167), of a paper about the mechanism of soccer eye injuries, where the authors tried to address some of above mentioned questions and to lead off its prevention.