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Protective eyewear during sports activities to prevent retinal detachment.

January 8, 2011

Harpreet S Walia, MDa and Sandeep S Walia, BBS, MBAb



Wearing glasses when you do not need them to see better is sometimes done for fashion, but mainly considered unnecessary. Wearing glasses when playing sports when you do not need them to see better seems not only unnecessary but almost a nuisance. However, even when glasses do not improve vision during athletic endeavors, there is a huge benefit to wearing them: protecting your eyes! In fact, several popular athletes, like NBA Star Amar'e Stoudemire and WBNA Star Cappy Poindexter, have started doing so after suffering retinal detachments.

Retinal detachments are a common cause of sudden, acute visual loss. The retina is the tissue lining the back surface of the eyeball and is responsible for transmitting signals to the brain. It is a key contributor to central vision as well as peripheral vision, color vision, night vision, shape recognition, and many more visual functions. A retinal detachment is when the retina separates from its underlying source of blood supply, the choroid. There are three major types of retinal detachments which represent a potential cause of permanent blindness, depending on the underlying reason and precise location of the detachment. When a tear in the retina causes the retina to detach, it is considered a rhegmatogenous retinal detachment.

Roughly 1 in 10,000 people in the US each year will have a retinal detachment. Symptoms of retinal detachment include seeing flashing lights, a new number of floaters, or noticing a curtain or shadow in the periphery of your vision. There are several risk factors for having a retinal detachment. Some risk factors cannot be modified. For instance, risk is greater with age, high myopia (being really near-sighted), and having a family history of retinal detachment. There are a few eye conditions, like lattice degeneration and posterior vitreous detachment, which cannot be modified and are usually only diagnosed after a thorough eye exam. Some risk factors, like diabetes, can be modified. There is one big risk factor which can be modified and prevented to a certain extent-TRAUMA! Trauma to the eye can be considered any blunt or penetrating injury to the eye and is a risk factor for rhegmatogenous retinal detachments.

Rhegmatogenous retinal detachments occur most commonly in people around 60-70 years of age followed by people aged 20-30 years old. It is presumed that this younger population is because of trauma. Likewise, men have a higher rate than women, also presumed to be due to trauma. There are usually more in summer than winter. Again, because of trauma! In fact, in children under 18 trauma is the overwhelming majority cause of rhegmatogenous retinal detachments. Studies from the UK show trauma to be the underlying cause in roughly half of children with retinal detachment. Protective eyewear can reduce these traumatic rhegmatogenous retinal detachments by as much as 90%!

Ophthalmologists and Retina Surgeons have several ways to treat rhegmatogenous retinal detachments. These methods include laser therapy, cryotherapy (freezing -probe therapy), pneumatic therapy (injection of gas into the eye), surgery with placement of a sclera buckle around the eye, surgery with a vitrectomy. Again, the final outcome depends on many factors and is individualized on a case-by-case basis. Trauma can make the repair and recovery difficult. In fact studies have shown that that recovery was worse in patients with retinal detachments from squash playing accidents and soccer-ball accidents. So, protective eyewear during athletic activities in any age group may not improve vision but can certainly be useful in the prevention of many high-risk activities. With or without protective eyewear, if you suffer any trauma to your eyes or experience the symptoms of retinal detachment, promptly seek medical care from an ophthalmologist to potentially save your sight!

References

Friedman NJ, Kaiser PK, Trattler WB. Review of Ophthalmology, First Edition. Philadelphia, PA: Elsevier Saunders, 2005.

Horn EP, McDonald HR, Johnson RN, et al. Soccer ball-related retinal injuries: a report of 13 cases. Retina. 2000; 20(6):604-9.

Knorr HL, Jonas JB. Retinal detachments by squash ball accidents. Am J Ophthalmol. 1996; 122(2):260-1. Lee RWJ, Mayer EJ, Markham RH. The aetiology of paediatric rhegmatogenous retinal detachment: 15 years experience Eye 2008 (22): 636-640

Mitry D, Charteris DG , Fleck BW, et al . The epidemiology of rhegmatogenous retinal associations detachment: geographical variation and clinical Br J Ophthalmol 2010 (94): 678-684

Rumelt S, Sarrazin L, Averbukh E, M Halpert M , et al. Paediatric vs adult retinal detachment. Eye 2007 (21): 1473-1478

Steel D, Fraser S. Retinal Detachment. Clin Evidence. 2008: 710.

Author Affiliations

a Emory Eye Center, Atlanta, Georgia
b Texas Tech University School of Medicine, Lubbock, Texas
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