More than 600,000 Americans will suffer an eye injury while playing a sport this year, says the National Eye Institute. Of these, about 42,000 will be serious enough to require treatment in a hospital emergency room.
Children under the age of 14 will suffer more than 40 percent of reported eye injuries, according to the National Society to Prevent Blindness.
More than 90 percent of these injuries could be prevented if the athletes were wearing protective eyewear, say the NEI and the national associations of ophthalmologists and optometrists.
Some of the sports where the NEI says the risk of eye injury is high are pretty obvious -- boxing, hockey, paintball, racquetball and squash.
Others may surprise you. Children 14 and under are most likely to hurt their eyes while playing baseball or softball. For children 15 and older, basketball is the leading source of eye injuries.
All baseball and softball leagues require helmets to be worn when batting or running the bases. Some for younger children also require chest protection. But only a handful have rules about protective eyewear.
Shannen Knight is the owner of A Sight for Sport Eyes, an Oregon firm that sells protective eyewear for sports. She was motivated to start her company 14 years ago because her little brother hurt an eye while playing baseball.
"It didn't affect him very much until now, but now [his doctors] are telling him he's slowly going to lose vision out of that eye," Ms. Knight said.
Baseball and softball leagues should require that protective eyewear be worn, she said, "especially for younger kids who are less well coordinated."
Francis S. Mah, a surgeon at UPMC's Eye Center, agrees. "Most of the injuries that occur are not blinding conditions," he said. "But blinding conditions can occur, and with a child, that's pretty terrible if it's preventable."
The number of eye injuries reported every year probably is underestimated, said Kenneth Cheng of Wexford, president of the Pennsylvania Academy of Ophthalmology. But "to require every Little League player to wear eye protection is probably excessive, and probably is not going to happen because of the added cost involved," he said.
Jeanne Doperak, a primary care sports medicine physician at UPMC, also said requiring eyewear has a down side.
"Eyewear comes at a cost," she said. It can be uncomfortable, and the additional cost could prevent some kids from playing baseball and softball.
"There is not enough data to show we should not leave it up to the individual," Dr. Doperak said.
James "Chip" Hanlon has coached children's baseball and softball for 13 years, and currently is president of the South Park Girls Softball Association.
None of the organizations he is affiliated with publish or enforce rules or guidelines with regard to protective eyewear.
"Some years back we considered such a policy, but to our surprise it was met with some resistance by players and parents," Mr. Hanlon said. "Consequently, we verbally recommend the use of protective facegear and provide it for our softball teams."
"A lot of kids think it is uncool to wear eye protection," Dr. Mah said. "Their favorite sports heroes aren't wearing eye protection. Adults should be wearing eye protection to be good role models."
"Parents don't really understand," Ms. Knight said. "They don't want to spend the money. They think it's hindering [their children's] performance. They don't want their kids to look like dorks."
A possible compromise, said Dr. Mah, would be to require face shields on batting helmets. "Either an actual shield or a little bar like a face mask in football would help prevent facial fractures, help prevent eye injuries," he said.
But children playing the field suffer more than three times as many injuries from batted balls as hitters do from pitched balls.
"I've had two kids this summer who were hurt when the ball bounced up into their faces," Dr. Cheng said.
"I've seen a kid get hit in the eye, but I don't think glasses would have helped," said Harold Wagner, 31, who coaches the Homewood Mets 12-year-old Little League team. "He was in the field. He wasn't paying attention."
"Last year a kid playing left field was wearing sports glasses. The ball hit him in the face and the glasses kind of exploded. He ended up with a broken nose and a black eye," said David Shirey, 45 who coaches 10-year-old Little Leaguers in Squirrel Hill. "In seven years, that's the closest thing I've seen to an eye injury."
Tom O'Connor volunteers at the national headquarters in Washington, Pa., of Pony League Baseball and Softball. "In the case of softball, all the infielders who play wear a mask," he said. But, he added, "I do not recall ever seeing a person injured in the eye in 40 years of being a volunteer in the sport."
"You see [eye injuries], but it's pretty rare," said Steve Barr, who heads the media relations department for Little League International in Williamsport, Pa.
More baseball and softball leagues would require that protective eyewear be worn if the companies that sell them insurance insisted upon it. Few do. The comments of Mr. Shirey and Mr. O'Connor indicate why.
"We rely a great deal on our insurance carrier to monitor injuries," Mr. O'Connor said.
The eye institute's data present a somewhat misleading picture. Children 14 and under are most likely to suffer eye injuries while playing baseball or softball because so very many children play the sports, and they play them so often. But the statistical probability a child will hurt his or her eye playing baseball or softball is lower than for other types of injuries, and relatively few injuries are more serious than a black eye.
Nearly 109,000 children ages 5-14 were treated at hospital emergency rooms for injuries suffered playing baseball and softball in 2009, according to data compiled by the Consumer Product Safety Commission. Less than 40 percent were eye injuries.
John Sadler, president of Sadler Sports and Recreation Insurance in Florida, apologized for being vague because the actuarial data he's gathered is proprietary. But he cautioned against rushing to require new bits of protective equipment.
"There is a lot more to the decision to mandate equipment than you can fit into a slogan," Mr. Sadler said.
Both those who think protective eyewear should be required for baseball and softball, and those who think the decision should be left up to parents agree that if your child wears glasses, or wears sunglasses while playing, he or she must wear protective glasses.
"Regular glasses do not qualify as protective eyewear," Dr. Doperak said. "[Children] need to have protective glasses that are made exclusively for the particular sport."
The fact that his Little Leaguer who was struck in the face with a fly ball was wearing protective glasses rather than regular glasses probably prevented serious injury, Mr. Shirey said.
Ms. Knight lists 28 protective goggles and glasses for baseball on her company's website. They range in price from $20 to $125. Prescription goggles/glasses cost more.
She recommends sports goggles manufactured by Hilco and Rec-Specs, but she said any eyewear that is ASTM rated is satisfactory.
Formerly known as the American Society for Testing and Materials, ASTM International, headquartered in suburban Philadelphia, develops voluntary consensus technical standards for a wide range of products.
Protective eyewear for baseball should have polycarbonate lenses (which are 10 times more impact-resistant than other plastic lenses), a durable frame design, and protection from ultraviolet radiation, Ms. Knight said.
Eye injuries in basketball come not from the ball but from flying elbows, and the likelihood of serious injury is greater than in baseball.
"Basketball injuries are potentially the worst eye injuries because people are looking up at the ball and not at the elbow coming," Dr. Cheng said.
Ms. Knight lists 23 sports goggles and glasses for basketball, ranging in price from $20 to $110. In addition to having polycarbonate lenses and a durable frame, basketball glasses should cover the entire eye socket, and the frame should be padded at the temple and bridge points to cushion the blow, she said.
More information about sports specific protective eyewear can be found on Ms. Knight's website at www.sporteyes.com; 1-888-223-2669.
Dick's Sporting Goods sells protective eyewear for sports; call your local store to see if protective eyewear for your sport is in stock.
Correction/Clarification: (Published July 19, 2011) David Shirey is a Little League coach in Squirrel Hill. His last name was misspelled in a story Monday about eye protection.
Jack Kelly: firstname.lastname@example.org or 412-263-1476.