by Leonardo M. Antaris, M.D.
Quad Cities Retina Consultants
Winter can be a wonderful time. Some indoor sports, such as basketball, are played year round; others can only be enjoyed with frigid temperatures and snow. Ice hockey, skiing, snowboarding, snowmobiling are just a few of the more popular activities.
In many activities, particularly those that are non-contact, common sense eye care precautions are all that are necessary.
Cold outdoor air and dry indoor air can quickly evaporate tears, especially when the person is moving. Who hasn’t experienced this drying effect, and discomfort, when driving in a top-down convertible, running into the wind, or ice-skating? Contact lens wearers are at particular risk, for when the tears dry up the lenses can stick painfully to your eyes. Fortunately, the solution is simple. Winter’s fast movers – skiers, snowboarders and snowmobilers, for example – should wear goggles to block UV rays, reduce the wind’s drying effect, and offer some protection from tree branches, ski poles, or the errant snowball.
Snowballs, hockey pucks and eye trauma
Contact sports or sports that involve flying projectiles, like hockey pucks or racquetballs, can result in far more serious injury. According to the American Academy of Family Physicians, most of the more than 40,000 sports-related eye injuries every year are preventable. And that includes the most serious injuries. In fact, more than 90% of the injuries causing damaged or lost vision can be avoided by protective eyewear.
In general, the smaller and more rapidly moving the projectile, the higher the risk is for ocular damage. The main reason relates to the eye’s protected environment. The eye is about the size of a walnut, nestled securely within a bony socket. Only the front is visible, like the tip of an iceberg – the sides are protected by our brow, nose, and cheekbones.
The problem comes with a frontal assault.
If the object is large, like a volleyball or basketball, the bones around the eye usually soak up the damage. True, you might end up with a black eye – a classic shiner – but if you were lucky, the eye may have been spared. You get a lot of sympathy from your friends and family, have to answer a lot of embarrassing questions, but your eye will see another day.
Smaller objects, especially the fast moving ones that can fit in your eye socket, have the potential for far more damage. Under those circumstances, your eye has nowhere to hide. The eye gets compressed, distorted, and may even rupture. Internal bleeding, cataract formation (when the focusing lens in your eye gets cloudy), and retinal tears and detachment are common and serious complications. Reduced vision or unusual pain might signal internal damage, and if you have either, you should seek medical care.
Retinal tears and detachment
Interestingly, neither retinal tears nor detachments are associated with any pain. The first sign may be lightning flashes or a burst of floaters (that often reflects blood in the eye). If you get seen promptly, it may be possible to laser around the tear and prevent further damage. The laser is a quick and straightforward procedure that is performed in the physician’s office.
If you are not so lucky, the tear may progress to a detachment, characterized by a shadow that comes across your vision. Detachments are much more serious, for without treatment, you will likely become blind.
There are a number of ways that retinal detachments may be repaired. In pneumatic retinopexy, an expanding gas bubble is injected into the eye, holding the retina in position until it can be more permanently sealed with a laser or cryopexy (freezing) treatment. Frequently, retinal detachments require more complicated surgery. In some cases, the detachment can be internally repaired with a vitrectomy (whereby the gel inside the eye is replaced with a clear fluid, gas, or silicone oil). Under other circumstances, the repair may require a scleral buckle, in which a silicone band is placed around the eye to afford external support.
It’s important to seek prompt medical attention if you suspect you have a retinal tear or detachment. The sooner the retina is attached, the better the chance for visual return after surgery.
Sports are a wonderful recreation and often provide a venue that can be enjoyed by the whole family. But real life isn’t Hollywood and real injuries are rarely healed by the next week’s sequel. Eye injuries can be devastating, and the best prevention can hardly be excused as an inconvenience. Be careful of your eyes; they need to serve you the rest of your life.
About Dr. Antaris: Dr. Leonardo M. Antaris, Quad Cities Retina Consultants, is a board-certified Ophthalmologist whose practice has been limited to vitreoretinal disorders for the past 18 years. Office: 1230 East Rusholme, Suite 107, Davenport, IA. Phone: (563) 326-8181.
