Research & Publications

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.

Cup of coffee being poured

Managing Myopia with a Cup of Coffee

Depending on where you live, the coffee culture can be a big part of life. Whether you source and grind your own beans or delight in a Starbucks grande apple crisp oatmilk macchiato, once you’re hooked, that caffeinated zing is hard to pass over. In addition to helping humans wake up in the mornings for centuries, caffeine has been used for:

  • Treating migraines and headaches
  • Improving memory and mental alertness
  • Help with weight loss and obesity
  • Treating acute pain
  • Treating bronchopulmonary dysplasia in newborns
  • Lowering risk of type 2 diabetes

Researchers are now looking at how another use of caffeine can be added to the list – managing myopia.

What is Myopia?

Myopia is a type of refractive error of the eye, also often called near- or short-sightedness. People with myopia find that their far distance vision is unclear, while objects up close are easier to see. The higher your degree of myopia, the more quickly things become blurry as they move further away.

Myopia results when there is a mismatch between the length of your eyeball and its refractive power. This means that as light enters the eye, it is bent, or refracted, to a degree that is too strong. This results in the focal point of incoming light falling on a place in front of the retina. In order to see clearly, we want light to come to a sharp focus right on the retina. Eye doctors often put this another way – the length of the eye is too long for its power.

We treat myopia with minus-powered lenses, whether spectacles or contacts. People with myopia may also be suitable for surgical vision correction, such as LASIK or PRK. However, in relatively recent years, eyecare professionals and researchers have been asking another question – could we prevent or slow the development of myopia in the first place?

 

The Concept of Myopia Management

Having myopia isn’t just an inconvenience. It’s not just about not being able to see the board at school or the ball off in the distance. It is also a factor that increases your risk of several other eye diseases, some of which can have devastating consequences for your vision. These can include:

  • Myopic macular degeneration
  • Retinal tears and detachments
  • Cataracts
  • Glaucoma

The impact of myopia as a risk factor for these conditions increases as the degree of myopia increases. For example, having short-sightedness between -1 and -3D increases your risk three-fold compared to someone who has perfect vision and no prescription (known as emmetropia). However, someone with a myopic prescription between -6 to -9D is at a 21-times greater risk than someone with emmetropia. That, in case you weren’t sure, is a lot.

So, in light of this, eyecare practitioners (predominantly optometrists), set out on the ever-evolving adventure that is myopia control, or myopia management. The aim of myopia management is to slow the development of short-sightedness in children so that when their prescription naturally stops changing with age, they will end at a lower degree compared to if they hadn’t been offered myopia management. Several myopia control strategies have been clinically demonstrated to reduce the rate of myopia progression in children, though the efficacy varies. These include:

  • Orthokeratology
  • Atropine eye drops
  • Multifocal spectacle lenses
  • Specifically-designed myopia control contact lenses
  • Specifically-designed myopia control spectacle lenses

All these treatments work by reducing the progressive elongation of the eyeball, which, as we discussed earlier, is what induces myopia. Research into how best to use these strategies is still ongoing. However, we know enough at this point for many optometrists around the world to have thrown themselves into myopia management with gusto.

 

But Wait, I Thought Children Aren’t Meant to Have Caffeine?

If you don’t want your kids bouncing off the walls til 3am (or later), then no, we don’t want to be serving up cups of Americano to our under-agers. However, in a study published last year, researchers found that topical eye drops of caffeine were able to protect against myopic eyeball elongation in the eyes of monkeys that had been given treatments to deliberately induce myopia. Some monkeys were also given treatment to deliberately induce long-sightedness (hyperopia). However, when the caffeine eye drops were administered to this group, it was found to have no effect, meaning the caffeine had a selective action on eyeball elongation (this is a good thing).

The study also noted that blood levels of caffeine in these monkeys was no greater than that after one cup of coffee in a human adult. Researchers were also careful to report that the monkeys treated with the caffeine showed no change to their behaviors (that is, there were no monkeys bouncing off the walls).

At the moment, a whole lot more research is needed before we can start dripping coffee into our children’s eyes. We don’t yet know the most effective dose for human children, the ideal dosing schedule, or the full risk profile of side effects.

 

What to Do in the Meantime

While we wait to find out whether single origin beans or Folgers instant coffee works better, keep an eye on your children’s eye health. If your child already has short-sightedness, be sure to keep up with regular visits to your eyecare professional to ensure his or her script is up to date and there are no other eye disorders developing. If your child is emmetropic and still has perfect vision, there is some evidence that spending increased time outdoors can be protective against developing myopia. For more tailored guidance on how to look after your child’s eyes and reduce their risk of short-sightedness and all the related complications, talk to your eyecare professional.

 

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Research & Publications

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 …

Cup of coffee being poured

Managing Myopia with a Cup of Coffee

Depending on where you live, the coffee culture can be a big part of life. Whether you source and grind your own beans or …

Fruits and vegetables that can prevent the development of glaucoma

How Your Lifestyle Can Impact the Development of Glaucoma

It’s no secret that a lot of diseases are influenced by lifestyle factors. For example, your risk of cardiovascular disease …