OCULAR INJURIES IN PICKLEBALL: CLINICAL EVIDENCE, INJURY SURVEILLANCE, PROTECTIVE TECHNOLOGY, AND PREVENTION - A NARRATIVE REVIEW

Alicja Maj; Karol  Knysak; Maja Piątek; Michał Jastrzębski; Aleksandra Hejnosz; Mateusz Szczerba; Krystyna Wilkowska; Wojciech Kaczorowski; Maciej Karol Michałowski; Maria Sudomir; Julia Strumińska-Szularz

doi:10.31435/ijitss.3(51).2026.6437

Authors

Alicja Maj Faculty of Public Health, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0005-2665-6889
Karol Knysak Doctoral School of the Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0007-7159-3762
Maja Piątek M. Skłodowska-Curie District Hospital. SPZZOZ, Dubois 68, 07-300 Ostrów Mazowiecka, Poland https://orcid.org/0009-0009-3706-1804
Michał Jastrzębski The Infant Jesus Clinical Hospital UCC, Medical University of Warsaw, W. H. Lindleya 4, 02-005 Warsaw, Poland https://orcid.org/0009-0008-8012-0702
Aleksandra Hejnosz Faculty of Public Health, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0003-3224-1001
Mateusz Szczerba Faculty of Public Health, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0000-1787-7405
Krystyna Wilkowska Faculty of Public Health, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0003-2875-7224
Wojciech Kaczorowski Independent Public Health Care Facility in Siedlce, Kilińskiego 29, 08-110 Warsaw, Poland https://orcid.org/0009-0004-8142-7221
Maciej Karol Michałowski Szpital Praski pw. Przemienia Pańskiego, Solidarności 67, 03-401 Warsaw, Poland https://orcid.org/0009-0004-9220-8788
Maria Sudomir Szpital Praski pw. Przemienia Pańskiego, Solidarności 67, 03-401 Warsaw, Poland https://orcid.org/0009-0002-4973-1333
Julia Strumińska-Szularz Samodzielny Publiczny Wojewódzki Szpital Zespolony w Szczecinie, Arkońska 4, 71-455 Szczecin, Poland https://orcid.org/0009-0007-7338-3670

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6437

Keywords:

Pickleball; Ocular Trauma; Injury Surveillance; Protective Eyewear; Sports Technology; Injury Prevention

Abstract

Pickleball participation has expanded rapidly, while evidence on ocular and orbital injury remains dispersed across case reports, emergency-department surveillance, computational modelling, and prevention research. This narrative review aimed to synthesize the epidemiology, mechanisms, clinical spectrum, management, and prevention of pickleball-related eye injury, with particular attention to injury-surveillance methods and protective technology. PubMed/MEDLINE, Google Scholar, publisher databases, reference lists, and authoritative safety documents were searched through July 17, 2026. Direct pickleball evidence was prioritized, and studies from related racket sports were used as indirect context. Reported injuries range from corneal abrasion and traumatic iritis to hyphema, angle recession, lens or intraocular-lens displacement, retinal tears and detachment, traumatic glaucoma, eyelid laceration, and orbital fracture. Mechanism estimates depend on case definition: direct ball impact predominates in detailed globe-injury reports and one manually reviewed surveillance analysis, whereas broader eye, face, and head datasets identify a larger contribution from falls and paddle contact. Finite-element modelling supports the plausibility of damage to the angle, zonules, vitreous, and retina, but current models remain simplified. Dedicated protective-eyewear use is limited, and direct effectiveness data in pickleball are unavailable. Prevention therefore requires a combined approach involving certified eyewear, acceptable product design, player education, facility practices, and improved exposure-based surveillance.

References

Alkawally, M., & Dang, V. T. (2021). Pickleball associated abrasion and iritis: A case study. Clinical & Refractive Optometry, 32(2), 367–372. https://doi.org/10.57204/001c.36828

ASTM International. (2024). ASTM F3164-24: Standard specification for eye protectors for racket sports (racquetball, squash, tennis, pickleball). https://doi.org/10.1520/F3164-24

Atkinson, C. F., Patron, M. E., & Joondeph, B. C. (2022). Retinal tears due to pickleball injury. Retinal Cases & Brief Reports, 16(3), 312–313. https://doi.org/10.1097/ICB.0000000000000965

Boopathiraj, N., Wagner, I. V., Krambeer, C. J., Lentz, P. C., Miller, D. D., Mashayekhi, A., & Dorairaj, S. K. (2024). In a pickle: Cases of pickleball-related ocular injuries. American Journal of Ophthalmology Case Reports, 35, 102082. https://doi.org/10.1016/j.ajoc.2024.102082

Dewhurst, N., Tangri, D., Arslan, J., Ashraf, G., Chakrabarti, R., & Crock, C. (2024). Ocular trauma in badminton: A 5-year review of badminton-related eye injury emergency department presentations. Emergency Medicine Australasia, 36(6), 915–919. https://doi.org/10.1111/1742-6723.14473

Easterbrook, M. (1981). Eye injuries in racket sports: A continuing problem. The Physician and Sportsmedicine, 9(1), 91–101. https://doi.org/10.1080/00913847.1981.11710991

Eime, R., Finch, C., Wolfe, R., Owen, N., & McCarty, C. (2005). The effectiveness of a squash eyewear promotion strategy. British Journal of Sports Medicine, 39(9), 681–685. https://doi.org/10.1136/bjsm.2005.018366

Forrester, M. B. (2020). Pickleball-related injuries treated in emergency departments. The Journal of Emergency Medicine, 58(2), 275–279. https://doi.org/10.1016/j.jemermed.2019.09.016

Guo, T., Shi, W., Yi, X., Huang, T., Huang, P., & Xue, K. (2023). Clinical evaluation and management of badminton-related eye injuries: A retrospective case series. BMC Ophthalmology, 23(1), 258. https://doi.org/10.1186/s12886-023-02972-8

Haring, R. S., Sheffield, I. D., Canner, J. K., & Schneider, E. B. (2016). Epidemiology of sports-related eye injuries in the United States. JAMA Ophthalmology, 134(12), 1382–1390. https://doi.org/10.1001/jamaophthalmol.2016.4253

Henick, D., Debroff, B., & Tahvildari, M. (2026). Pickleball players’ reported use of protective eyewear. JAMA Ophthalmology, 144(4), 309–313. https://doi.org/10.1001/jamaophthalmol.2026.0027

Hoskin, A. K., Watson, S., & Kamalden, T. A. (2023). Badminton-related eye injuries: A systematic review. Injury Prevention, 29(2), 116–120. https://doi.org/10.1136/ip-2022-044564

Huang, H., & Greven, M. A. (2024). Traumatic lens subluxation from pickleball injury: A case series. Retinal Cases & Brief Reports, 18(1), 15–17. https://doi.org/10.1097/ICB.0000000000001312

Kamboj, A., Kistamgari, S., Mokhtarzadeh, A., Harrison, A. R., & Smith, G. (2026). Pickleball-related eye injuries presenting to United States emergency departments, 2010–2023. Digital Journal of Ophthalmology, 32(2). https://doi.org/10.5693/djo.01.2025.12.001

Kasiga, T., & Bro, T. (2024). Padel: An increasing cause of sport-related eye injuries in Sweden. Acta Ophthalmologica, 102(1), 74–79. https://doi.org/10.1111/aos.15685

Lacher, C. R., Koc, I., & Tsui, J. C. (2025). Pickleball-related ocular injuries among patients presenting to emergency departments. JAMA Ophthalmology, 143(11), 938–944. https://doi.org/10.1001/jamaophthalmol.2025.3577

Lincoln, A. E., Caswell, S. V., Almquist, J. L., Dunn, R. E., Clough, M. V., Dick, R. W., & Hinton, R. Y. (2012). Effectiveness of the women’s lacrosse protective eyewear mandate in the reduction of eye injuries. The American Journal of Sports Medicine, 40(3), 611–614. https://doi.org/10.1177/0363546511428873

MacEwen, C. J., & McLatchie, G. R. (2010). Eye injuries in sport. Scottish Medical Journal, 55(2), 22–24. https://doi.org/10.1258/rsmsmj.55.2.22

Mazarelo, J. F. D., Winter, S. L., & Fong, D. T. P. (2024). A systematic review on the effectiveness of eyewear in reducing the incidence and severity of eye injuries in racket sports. The Physician and Sportsmedicine, 52(2), 115–124. https://doi.org/10.1080/00913847.2023.2196934

Micieli, J. A., & Easterbrook, M. (2017). Eye and orbital injuries in sports. Clinics in Sports Medicine, 36(2), 299–314. https://doi.org/10.1016/j.csm.2016.11.006

Nair, A. G., & Narayanan, A. (2025). Unexpected impact: Orbital fracture from pickleball trauma—A case report and literature review. European Journal of Ophthalmology, 35(4), NP29–NP32. https://doi.org/10.1177/11206721251332977

Napier, S. M., Baker, R. S., Sanford, D. G., & Easterbrook, M. (1996). Eye injuries in athletics and recreation. Survey of Ophthalmology, 41(3), 229–244. https://doi.org/10.1016/S0039-6257(96)80025-7

Patel, P. S., Uppuluri, A., Oydanich, M., Langer, P. D., Zarbin, M. A., & Bhagat, N. (2023). Epidemiology of United States tennis-related ocular injuries from 2000 to 2019. International Ophthalmology, 43(3), 997–1003. https://doi.org/10.1007/s10792-022-02502-3

Rydz, C., Colmenarez, J. A., Shahraki, K., Dong, P., Gu, L., & Suh, D. W. (2025). Finite element analysis of ocular impact forces and potential complications in pickleball-related eye injuries. Bioengineering, 12(6), 570. https://doi.org/10.3390/bioengineering12060570

Shah, J., Pathuri, S., Shrivastava, A., Ong, J., Zheng, J., Acar, I. F., Plotnik, J., Golnik, K., Salevitz, M. I., Suh, A., & Lee, A. G. (2026). Pickleball and ball sports-related ocular trauma in the United States. Eye, 40, 646–653. https://doi.org/10.1038/s41433-025-04192-4

Stitzel, J. D., Duma, S. M., Cormier, J. M., & Herring, I. P. (2005). Blunt trauma of the aging eye: Injury mechanisms and increasing lens stiffness. Archives of Ophthalmology, 123(6), 789–794. https://doi.org/10.1001/archopht.123.6.789

Thörnland, C., & Jakobsson, G. (2021). Eye injuries related to padel. Läkartidningen, 118, 21031. https://pubmed.ncbi.nlm.nih.gov/34156668/

Toldi, J. P., & Thomas, J. L. (2020). Evaluation and management of sports-related eye injuries. Current Sports Medicine Reports, 19(1), 29–34. https://doi.org/10.1249/JSR.0000000000000677

USA Pickleball. (n.d.). Health & safety hub: Eye protection & shoes. Retrieved July 27, 2026, from https://usapickleball.org/health-and-safety-hub/

Vitale, K., & Liu, S. (2020). Pickleball: Review and clinical recommendations for this fast-growing sport. Current Sports Medicine Reports, 19(10), 406–413. https://doi.org/10.1249/JSR.0000000000000759

Waisberg, E., Ong, J., & Lee, A. G. (2024). Pickleball eye injuries: Ocular protection recommendations and guidelines. Eye, 38, 1039–1040. https://doi.org/10.1038/s41433-023-02870-9

Yu, J., Chen, Y., Miao, J., Zhao, M., Keng, C., Wang, X., Guo, J., & Liu, Y. (2020). Doubles trouble—85 cases of ocular trauma in badminton: Clinical features and prevention. British Journal of Sports Medicine, 54(1), 23–26. https://doi.org/10.1136/bjsports-2018-099496