The popular sport of pickleball across the United States is causing an unexpected public health problem - a sharp increase in the number of serious eye injuries. New research shows a significant increase in cases of pickleball-related eye injuries, and experts are calling for mandatory eye protection standards to ensure the safety of athletes.
Pickleball is a sport that combines elements of tennis, badminton and table tennis. The field is 20×44 feet (approximately 6.1×13 meters) and is played using plastic balls with holes. Although the movement has a long history since 1965, it has only entered an explosive period in recent years. Three doctors from Rutgers New Jersey Medical School, Rutgers Robert Wood Johnson Medical School and the New Jersey Veterans Affairs Medical Center jointly conducted a cross-sectional study to analyze the incidence, types and causes of pickleball-related eye injuries in the United States from 2005 to 2024, with special attention to the surge in cases from 2021 to 2024. The data comes from the National Electronic Injury Surveillance System (NEISS) database in which about 100 hospitals in the United States participate, and the overall situation in the United States is estimated through statistical weighting.
Data shows that no pickleball-related eye injuries were recorded before 2014. From 2021 to 2024, there will be approximately 405 new cases every year, and the estimated number of cases in 2024 has reached 1,262. Nearly 90% (88%) occurred between 2022 and 2024, coinciding with the outbreak of the sports craze. The average age of the injured was 54 years old (median 58 years old), and 70% of them were 50 years old and above. The proportion of men and women was similar (56% men, 44% women), and there was no significant gender difference.
Causes of injury include:
The ball directly hit the eye 43% of the time
28% of falls occurred during competition
Racket hit damage accounts for 12%
“Unspecified” reasons accounted for 17%
Injury types include:
Periocular lacerations (35%)
Corneal abrasions (16%)
Iris inflammation (8%)
Contusion (5%)
"Serious injury" category (13%): includes retinal detachment, orbital fracture, eyeball rupture and hyphema, etc., with risk of permanent blindness.
The researchers pointed out that the sample only involved 73 cases in 100 hospitals and failed to cover more than 5,000 hospitals in the United States. It is estimated that many minor injuries were underreported. In addition, the database does not record visual recovery outcomes or financial burden, and much important information was not included in the analysis. Nonetheless, the increase in the number of injuries is directly related to the explosive growth in the number of participants in the program - approximately 20 million participants in the United States in 2024, a 311% increase from 2020. New players lack experience and the risk of accidents increases significantly.
Currently, eye protection is not mandatory in both amateur and professional Pickleball competitions. The United States National Pickleball Governing Body (USA Pickleball) vetoed mandatory eye protection rules in 2024 because of the difficulty of management. The American Academy of Ophthalmology (AAO) recommends the use of eye protection equipment that meets ASTM F3164 standards, but the popularity of pickleball is very low.
To this end, the research team calls for:
Develop unified eye care guidelines
Strengthen public safety propaganda
Promote further research on protective measures and long-term treatment effects
Relevant results have been published in the journal "JAMA Ophthalmology".