Pickleball-related eye injuries on the rise

A new study published in Eye analyzed 10 years of U.S. emergency department (ED) surveillance data to compare ocular trauma linked to pickleball, dodgeball, and kickball.

The findings demonstrated a significant increase in pickleball-related eye injuries over the last decade, with investigators noting many of these injuries could be preventable with better awareness and wider use of protective eyewear.

Interesting … explain why sports-related eye injuries are still a public health issue.

Sports-related ocular trauma remains a meaningful source of emergency care in the U.S. As investigators have noted, athletics account for nearly 30,000 ED visits annually for eye injuries nationwide, while ocular trauma overall can lead to long-term visual impairment, emotional distress, and reduced quality of life.

However: Many conversations around sports injuries focus on knees, shoulders, concussions, or fractures, with eye trauma often overlooked—even though damage may be sudden and sometimes vision-threatening.

• Ball sports are especially relevant due to direct high-speed impacts, close player spacing, and unpredictable rebounds.

And how does this relate to pickleball?

That matters for pickleball because the sport combines rapid exchanges at the kitchen line, short reaction windows, and a hard perforated ball.

In fact: As pickleball has gone from a niche pastime to one of America’s fastest-growing sports in recent years, eye safety has not kept pace. What looks like a low-impact activity can still involve a hard plastic ball traveling at high speed in close quarters, creating real injury risk.

• And on the subject of research: Prior reports have mostly been limited to case studies and smaller injury analyses, leaving a gap in national-level data on who is getting hurt and how often.

Which brings us to this national injury study.

Precisely. Researchers sought to characterize national patterns of ocular trauma tied to pickleball, dodgeball, and kickball in the United States.

• Their focus: Incidence trends, demographics, injury mechanisms, diagnoses, and where injuries happened.

And where did they collect this data?

The team used data from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS), which samples about 100 hospitals and generates national estimates from ED visits.

Cases from 2014 through 2023 were reviewed, and physician investigators manually screened injury narratives to confirm that each case truly involved one of the three sports plus an ocular or orbital injury.

Take note: That manual review step is important, as it reduced miscoding and improved confidence that the injuries analyzed were genuinely sport-related eye trauma rather than unrelated incidents.

Noted. So who was included in the study?

The investigators initially identified 2,199 ball-sport trauma cases in the database.

After applying inclusion criteria and manually confirming eligible eye or orbital injuries, the sample was narrowed to 120 confirmed cases.

Those 120 cases translated to a weighted national estimate of 7,974 injuries.

By sport, the weighted estimates were:

• 3,874 injuries linked to dodgeball
• 2,573 linked to pickleball
• 1,527 linked to kickball

What did the researchers find about pickleball-related eye injuries?

Although pickleball had fewer raw cases than dodgeball, its injury trend rose significantly over time (unlike the other two sports). The clearest headline: growth.

Case in point: Pickleball-related ocular trauma increased significantly from 2014 to 2023, with statistical modeling identifying a meaningful upward trend in both national injury estimates and population-adjusted incidence.

Between 2021 and 2023 alone, the study reported:

• An 1,810% increase in weighted national injury estimates
• A 1,791% increase in incidence per million people

In short: More people are playing pickleball, but injury rates may also be increasing beyond simple participation growth.

How did pickleball compare with dodgeball and kickball?

Pickleball looked very different from the youth-centered injury pattern seen in dodgeball and kickball. Those sports mainly affected children and teenagers, while pickleball injuries were concentrated in adults and older adults.

Mean ages were:

• 13.32 years for dodgeball
• 14.88 years for kickball
• 58.27 years for pickleball

Location patterns also differed. Most pickleball injuries happened at sports or recreational facilities, while dodgeball and kickball injuries occurred primarily in schools.

What that suggests: Prevention strategies should be tailored to setting.

• Community recreation centers and clubs may be key places for pickleball safety campaigns, while school policies may matter more for dodgeball and kickball.

What types of injuries were most common and how serious were they?

Across all three sports, corneal abrasions were the most common diagnosis.

For pickleball specifically, notable injuries included:

• Corneal abrasions (26.92%)
• Orbital fractures (11.54%)
• Iritis (11.54%)
• Vitreous detachment (7.69%)

Being hit directly in the eye by the ball was the most common injury mechanism in pickleball, accounting for 69.23% of cases.

Why were older adults hit hardest by pickleball injuries?

The study authors suggested this likely reflects both participation trends and physiology. Pickleball has become especially popular with older adults, creating greater exposure in that age group.

• At the same time, age-related declines in reflexes, visual processing, balance, and neuromuscular coordination may make fast volleys harder to track or avoid.

The paper also highlighted falls as a notable mechanism in pickleball injuries. Falls accounted for 15.38% of pickleball eye injuries, higher than in the comparison sports. That matters because falls can create blunt orbital trauma in addition to other orthopedic risks.

What limitations should be kept in mind?

Considering this was an ED database study, it likely missed injuries treated in urgent care clinics, outpatient offices, or not treated at all. That means the true burden may be higher.

NEISS also lacks detailed ophthalmic data such as visual acuity, imaging findings, long-term follow-up, and validated severity scoring.

• As such, the researchers couldn’t fully measure permanent vision outcomes or later complications.

In addition, the confirmed sample included only 120 raw cases, so subgroup findings should be interpreted carefully, the authors advised.

What prevention strategies do the authors support now?

The authors emphasized that many sports-related eye injuries are preventable with proper protective eyewear, citing earlier estimates suggesting up to 90% may be preventable.

They also referenced prior recommendations from pediatric and ophthalmology organizations such as the American Academy of Ophthalmology (AAO) supporting eye protection in sports such as pickleball, dodgeball, and kickball.

• Along those lines: Polycarbonate protective eyewear is commonly favored because it is impact resistant and lighter than standard lenses.

For pickleball specifically, the authors suggest education campaigns at clubs, public courts, and recreation centers where many injuries occur.

And finally, the take home.

Pickleball-related eye injuries rose significantly in the U.S. over the past decade, with older adults the group most often affected. Direct ball strikes, falls, corneal abrasions, and orbital fractures were all part of the injury pattern.

While most patients were treated and released, the trend suggests eye safety is becoming a real issue as the sport expands. Protective eyewear and targeted awareness campaigns are practical next steps.