Pickleball and Ball Sports-Related Ocular Trauma in the United States

OBJECTIVE: To characterize national patterns of ocular trauma related to pickleball, dodgeball, and kickball in the United States, with emphasis on incidence, demographics, injury mechanisms, and diagnoses. METHODS: Data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System (2014-2023) were reviewed. Injury cases were identified using body part codes for the eye, face, and head combined with product code 3235 ("Other Ball Sports"). Trauma narratives were subsequently manually reviewed to confirm sport involvement alongside ocular and/or orbital injury. National injury estimates were calculated using the NEISS-provided sample weights. Annual incidence per million people was calculated using data from the U.S. Census Bureau and American Community Survey. Statistical analyses included descriptive statistics and inferential testing using chi-square tests, ANOVA, and linear regression. RESULTS: A total of 120 confirmed cases were identified, corresponding to an estimated 7974 ocular injuries (95% CI: 7184-8764). Weighted estimates attributed 3874 cases (95% CI: 3429-4319) to dodgeball, 2573 (95% CI: 2218-2928) to pickleball, and 1527 (95% CI: 1255-1799) to kickball. Pickleball injuries primarily affected older adults (mean age 58.27 years), whereas dodgeball and kickball injuries occurred mostly in youth (mean ages 13.32 and 14.88 years). Direct ball impact was the leading mechanism, with corneal abrasion as the most frequent diagnosis. Falls (15.38%) and orbital fractures (11.54%) were more common with pickleball. Linear regression demonstrated a significant increase in pickleball-related ocular trauma from 2014 to 2023 (P = 0.04). CONCLUSIONS: Pickleball-related ocular trauma is increasing nationally, particularly among older adults. These largely preventable injuries highlight the need for sport-specific preventive strategies and increased access to protective eyewear.