Doctor assessing man hit in the eye with a ball

You’ve Just Been Hit in the Eye with a Ball – Now What?

It’s estimated that 100,000 people suffer a sports-related eye injury each year with 30,000 of them being treated in emergency rooms.

When it comes to contact sports and sports involving projectiles (such as baseballs), eyes can often end up taking the hit. In fact, baseball is one of the top causes of eye injuries amongst children 14 years and under. Even among professional athletes, baseball is right up there on the list of causing serious eye injuries in sport. Other infamous sports for eye injuries are hockey and basketball.

First Aid After a Ball to the Eye

If you’ve just been hit in the eye socket by a baseball, tennis ball, basketball, soccer ball, golf ball or football, dodge ball, or any ball, get a cold compress or an ice pack. However, make sure to apply the cold pack very gently – avoid putting any pressure on your poor eye. The purpose of the compress is to help reduce the swelling that naturally happens after blunt trauma to the soft tissue of your eyelids and surrounding anatomy. The ice pack can also help to manage pain. If you need to, taking over-the-counter painkillers such as acetaminophen or ibuprofen can help with the pain and discomfort, too.

You can expect to have an impressive black eye for the following week or two. After the first 24 hours, switch your cold compress to a warm compress instead. This can help resolve the bruising more quickly.

When to See the Eye Doctor

It never hurts to see the eye doctor after any incident involving a ball and your eye. It’s especially important to seek urgent medical attention if:

  • You have any sort of visual disturbances. This can include blurry vision, the sensation of a dark shadow or curtain across part or all of your sight, distorted vision (straight lines appear wavy or curved), double vision, seeing floating lines or spots, or seeing flashing lights.
  • You feel you can’t turn your eye properly, such as when trying to look to the side or up or down. This will often result in double vision and/or considerable pain when you do try to turn your eyes.

A baseball, tennis ball, or puck hitting your eye at high speeds can be devastating. In the worst-case scenario, you may permanently lose part or all of your sight from that eye. Blunt trauma to the eye can cause:

A retinal detachment.

The retina is the sensory tissue lining the inside of the eyeball; it contains all the light-sensing cells that allow you to see. A retinal detachment is exactly as it sounds – the retina detaches and separates from the rest of the eyeball. This results in loss of sight in that area of the detachment. Surprisingly, you may not immediately be aware that you’re experiencing a retinal detachment, particularly if it starts off as just a small area. The hit to your eye doesn’t need to be a big one to cause a retinal detachment, especially if you have preexisting risk factors such as high short-sightedness (myopia) or a family history of retinal detachments. The symptoms of a retinal detachment include:

  • A black shadow coming across your vision
  • Flashing lights, often in the periphery of your vision
  • A sudden shower of floaters, or increase in the number of specks and lines you see floating across your sight

Retinal detachments are not painful (though a baseball to the eye is). However, they are an ocular emergency, so they should be attended to at the hospital immediately. Depending on the location and extent of the detachment, it may be treated with surgery or a laser procedure to fix the retina back in place.

An orbital fracture.

The orbit refers to your eye socket, the little bony house in which your eyeball sits. Unsurprisingly, a ball traveling at high enough speed has the potential to crack a few bones. The most common type of orbital fracture after a baseball injury tends to be a blowout fracture. This refers to a break in the bones that make up the floor or nose-side wall of the orbit. Symptoms of an orbital fracture can include:

  • Double vision, as the eye muscles become pinched or trapped in the bone fractures
  • Pain when attempting eye movements
  • An eyeball that appears to be either bulging or sunken
  • Facial numbness on the side of the fracture

In some situations, orbital fractures may heal on their own. The potential for this can be determined through imaging, such as x-rays or CT scans. If it’s a significant fracture, such as one that has trapped the eye muscles, you may need surgery to reposition the eye and cover over the break in the bone.

Complications leading to glaucoma.

Glaucoma is an eye disease resulting in damage to the optic nerve. Untreated glaucoma leads to irreversible vision loss, typically starting in the periphery of your field of view. While most instances of glaucoma are a result of genetics and an aging body, blunt trauma can induce glaucoma, too.

Having a ball to the eye can physically damage the drainage structure of the eye. This drainage structure is important for helping manage the pressure inside the eye, known as intraocular pressure. If fluid is unable to flow out from the eyeball at a rate matched to the production of fluid, the increase in intraocular pressure can cause glaucoma.

Blunt trauma can cause bleeding inside the front half of the eyeball. This is called a hyphema. It appears as an accumulation of blood pooling between the transparent cornea and colored iris. This collection of blood can obstruct the drainage channels, resulting in an increase of intraocular pressure and subsequent glaucoma.

Traumatic glaucoma can rear its head even years after the original accident. There are typically no symptoms of glaucoma, so it’s important to keep in touch with your eye doctor long-term if you’ve suffered any type of ball hit to the eye, so that he or she can keep a watch on your intraocular pressures. Treatment for glaucoma is aimed at lowering the pressure in your eye to protect the optic nerve. This can be done through medicated eyedrops, a laser procedure, or surgery.

A cataract.

Cataracts are often a normal part of aging; however, like glaucoma, they can also be caused by blunt trauma. The cataract won’t pop up immediately after a baseball, basketball, or tennis ball hits your eye, but traumatic cataracts tend to develop relatively quickly (over months rather than years, as in age-related cataracts). A cataract is a clouding or opacity of the lens inside your eye.

Out of all the ball-to-the-eye trauma-related complications, a cataract is probably the least urgent to deal with. You’ll figure you’re developing a cataract if you start to experience:

  • Vision that slowly becomes hazy, cloudy, or foggy
  • An increase to your sensitivity to bright lights (glare sensitivity)
  • Increasing difficulty in reading fine print or discerning low contrast details against a background
  • An alteration to your color vision

Cataract surgery is the most commonly performed eye operation in the Western world, mainly due to the prevalence of age-related cataracts. It’s typically a straightforward, safe procedure, but operating on a traumatic cataract can be a little more delicate due to potential damage to the surrounding eye structures from the accident.

If ever in doubt of whether you should see an eye doctor urgently after a baseball, tennis ball, basketball, soccer ball, golf ball, or football to the eye socket, it’s best to play it safe and take yourself straight to hospital anyway. Don’t forget that gentle cold compress on the drive there and next time, perhaps consider some protective eyewear before you step up to the plate again.