Pickleball Eye Injuries Are Growing at an 'Alarming Rate' — With a Few Caveats

On-court eye injuries have spiked in the past few years. Is this the inevitable byproduct of pickleball's booming popularity, or alarming new proof that more proactive preventative measures need to be taken?

Back when I was a kid, nobody wore helmets out on the ski slopes. We just bombed down Double Blacks blissfully unaware. Now, everyone does.

Is pickleball headed in the same direction when it comes to protective eyewear?

A new study from JAMA Ophthalmology is making the rounds with some scary-sounding conclusions, providing perhaps the best data-backed case yet for making eyewear mandatory at the recreational, and even the pro, levels.

But it comes with a few caveats.

Yes, the rate of eye injuries in the sport is increasing, especially in the last few years. But this study's scope is far from comprehensive, and even still, we're talking tiny percentages compared to the number of people playing every year in the U.S.

The first injury study focused on the eyes

The authors used the US National Electronic Injury Surveillance System (NEISS), taking data from 2005 through 2024, looking specifically for injuries tied to “pickleball” or “pickle ball” (plus other common misspellings) that involved the eye or face.

Even though the sport’s popularity has soared — think ~20 million U.S. players by 2024, a 300%+ increase since 2020 — the eye-injury side of things hasn’t been heavily studied, until now.

What they found is concerning, to be sure. Between 2014 and 2024, the weighted national estimate was approximately 3,100 eye injuries tied to pickleball.

But here’s the kicker: from 2021 to 2024, the incidence increased by an estimated 405 cases per year.

So yes, as pickleball’s popularity surges, the eye-injury count appears to be climbing too.

How bad are these injuries?

About 70% of the eye injuries were in players 50 years or older. There wasn't a statistical difference found between genders.

But here's where the study starts to turn heads.

The most common injuries reported were periocular lacerations (~35%) and corneal abrasions (~16%). Think minor scrapes to the eyelid or the clear, dome-shaped outer layer of the eyeball itself.

But more severe injuries were found as well, including: hyphema (blood in the eye), retinal detachment (~3%), globe trauma (~3%), and orbital fracture (~2%).

Severe cases like these are far lower in number, but they’re high in risk in terms of potential vision loss more long-term affects.

We can't just blame it on the ball

Play long enough and you'll take a ball or two off the face. It's an occupational hazard, especially knowing the court dimensions stay constant while paddle technology continues to innovate and improve.

"Modern paddles, incorporating materials such as ethylene-vinyl acetate foam, can now generate exit velocities approaching 96 km/h (60 mph)," the study said.

The eye-related injuries documented in this study were largely the result of a direct hit by the ball (43%). Interestingly, about 28% were the result of falls on the court while another 12% were caused by impact made by a paddle.

A case for mandated protective eyewear

Ocular injuries in popular sports like baseball and tennis followed similar upward trends in their infancy, the study noted, but have long since plateaued or declined.

This, the study's authors urge, is a good reason to look at more formal guidelines for protective eyewear in the sport.

"Despite the risks of eye injury, eye protection is not mandated for casual or professional pickleball players," they said. "Most recently in March 2024, USA Pickleball, the governing body for pickleball in the United States, disapproved of a rule change that would mandate that players wear eye protection in USA Pickleball tournaments, citing challenges with enforcement."

Perhaps this data will cause them to change course?

"Efforts to curtail this increasing trend by increasing awareness and developing standardized guidelines for eye protection should be considered," the study concluded.

There are no eyewear mandates in professional pickleball. Some players choose to protect their eyes – notably, Anna Leigh Waters – but most go without. Without a doubt, reflexes and reaction times are much faster at this level. But injuries are still possible at any level.

A few parting thoughts

The findings of this study are eye-opening, but perhaps not quite as generally alarmist as some other coverage makes them out to be.

"People are getting their retinas detached and their eyesockets broken," Vice laments. "Pickleball is even responsible for an uptick in something called hyphema, the medical term for when your eyeball starts bleeding internally."

That's true. But while the study "found that pickleball-related eye injuries have increased at an alarming rate over the past 4 years," its scope is far from comprehensive.

An editorial accompanying the study, the New York Times notes, "cautioned that there were limitations to data drawn from registries like the one used in the new study, which included just 2 percent of all U.S. hospital emergency departments."

And yet, the underlying cause of all this is an important one to keep in mind, especially as the sport continues to surge in popularity and reach new audiences around the world.

“We’ve seen a lot more players who are not familiar with the sport entering the court, and that creates a lot of opportunity for injury,” said Dr. Jonathan C. Tsui, the study’s senior author and a professor at Rutgers New Jersey Medical School.

The full study can be found here.

Feature image via Anna Leigh Waters on Instagram