Paintball and air guns account for one in 10 sports-related eye injuries and one-quarter of cases with vision impairment, a U.S. study suggests.
While other sports like basketball, baseball and softball accounted for more injuries overall, air gun injuries are completely preventable, said lead study author Dr. Sterling Haring, a public health researcher at Johns Hopkins University in Baltimore.
"Wearing appropriate protective eyewear (not just sunglasses) can mean the difference between great vision and near-blindness, and it couldn't be more appropriate than in air gun sports," Haring said by email.
"Most of these sports, such as basketball and baseball, involve only incidental contact with other players; with air guns, however, the entire point is to shoot a small projectile at another player," Haring added. "Some of these projectiles are bound to hit someone in the eye, and when they do, it could be disastrous."
Sports-related eye injuries send an estimated 30,000 people to emergency departments in the U.S. each year, researchers report in JAMA Ophthalmology.
In addition to vision problems, these injuries can also have a lasting impact on quality of life and increase the odds of additional injuries, depression and chronic illness, researchers note.
To assess the risk associated with different sports, researchers examined data on more than 120,000 sports-related eye injuries treated in U.S. emergency departments nationwide from 2010 to 2013.
In more than 70 percent of these cases, eye injuries were the primary diagnosis.
Injured people were 22 years old on average, and 60 percent of cases involved people who were 18 years old or younger.
Roughly four in five injured patients were male.
Most often, injuries happened as a result of playing basketball; the sport accounted for 23 percent of the cases in the study. The next most common source of injuries was baseball and softball, accounting for 14 percent, and air guns, responsible for 12 percent.
Although most sports-related eye injuries were superficial, more than one-fifth of baseball-related injuries were fractures of the bones surrounding the eye.
Just 3.1 percent of the cases with a diagnosis of ocular trauma involved vision impairment.
The sports most likely to result in injuries with vision impairment were paintball and air gun activities, racket sports and soccer, the study found. The odds of vision problems increased with age.
Paintball, for example, was almost five times more likely to result in vision problems than football. Air guns were almost four times as likely to lead to vision problems.
Compared to football, hockey and soccer were more than twice as likely to result in vision impairment, the study also found.
One limitation of the study is that it didn't include people treated for eye injuries outside the emergency room, the authors note. Researchers also lacked data on long-term outcomes after the injuries.
"While hospital records are a valid source, it represents only the tip of the iceberg," said Dr. Swarup Mukherjee, a researcher at Nanyang Technological University in Singapore who wasn't involved in the study.
"The actual eye injury incidence in sports may be much bigger than reported," Mukherjee added by email. "Moreover, there is minimal data from populations outside the USA."
Even though the vast majority of eye injuries can be prevented with the use of protective eye wear, most young athletes in particular don't use protection even in high risk sports, Mukherjee noted.
"It is important to know that using 'street wear' rather than certified protective eyewear actually increases the risk and severity potential of an eye injury compared to not wearing any eyewear protection," Mukherjee said.