Pickleball’s boom has brought an unexpected side effect: a surge in serious eye injuries. A new study has revealed a sharp rise in pickleball-related eye trauma, promoting calls for protective eyewear standards.
Given how popular pickleball is these days, it’s hard to believe that the sport has been around since 1965. For those who are unfamiliar, pickleball combines elements of tennis, badminton, and ping-pong, and is played on a 20-by-44-foot (6.1-by-13-m) court with a perforated ball.
However, a new study by three medical doctors from Rutgers New Jersey Medical School, Rutgers Robert Wood Johnson Medical School, and Veterans Affairs New Jersey Health Care has found that accompanying the surge in the sport’s popularity has been a noticeable rise in the number of pickleball-related eye injuries.
The researchers undertook a cross-sectional study examining the incidence, types, and causes of pickleball-related eye injuries in the US over a 20-year period, from 2005 to 2024. They focused particularly on the last four years, when injuries rose sharply. Using data from the National Electronic Injury Surveillance System (NEISS), a national database that collects emergency department injury data from a representative sample of about 100 American hospitals, the researchers applied statistical weighting to estimate national injury rates.
There were no reported cases of eye injuries related to pickleball before 2014. However, from 2021 to 2024, the number of eye injuries increased by about 405 cases per year. In 2024 alone, there were an estimated 1,262 pickleball-related eye injuries. Nearly nine out of 10 (88%) injuries occurred between 2022 and 2024, coinciding with when the sport’s popularity took off. The average age of people injured was 54 (median 58 years), with 70% of injuries occurring in people aged 50 and older. Men and women were equally affected: 56% vs 44%, respectively, which was not a statistically significant difference.
In 43% of cases, injury was caused by a direct hit by the ball, followed by falls while playing (28%), and being hit by the paddle (12%). “Unspecified” causes accounted for 17% of injury cases. In terms of the types of injuries sustained, 35% were periocular lacerations (cuts near the eye), 16% were corneal abrasions, iritis (inflammation of the iris, the colored part of the eye) accounted for 8%, and contusions/bruises 5%. The category of “severe injuries,” which included retinal detachment, fracture of the orbit (the bones surrounding the eye), eyeball rupture, and hyphema (bleeding inside the eye), all of which carry a risk of permanent vision loss, accounted for 13% combined.
The researchers acknowledge that their study had limitations. It was a small sample of only 73 cases from 100 hospitals, which may not represent all 5,000-plus US hospitals. It’s likely that many cases were missed, especially mild ones treated outside emergency departments. Pickleball wasn’t common before 2014, and database text fields were shorter before 2019, possibly omitting earlier cases. And, the NEISS database doesn’t track visual outcomes or recovery, so total vision loss or cost burden is unknown.
Regardless, the dramatic rise in eye injuries mirrors the sport’s explosive popularity. There were nearly 20 million US players in 2024, and a 311% growth since 2020. Casual or new players may be more prone to accidents simply due to inexperience.
Despite the risks, eye protection isn’t mandatory across casual or professional pickleball play. USA Pickleball, the sport’s national governing body, rejected a proposed 2024 rule requiring protective eyewear to be worn, citing enforcement difficulties. While the American Academy of Ophthalmology (AAO) recommends eyewear meet American Society of Testing and Materials (ASTM) F3164 safety standards – which is applicable to other racquet sports – adoption remains low in pickleball.
On the basis of their findings, the researchers have called for standardized eye protection guidelines, public awareness campaigns, and further research into injury prevention and long-term outcomes.
The study was published in the journal JAMA Ophthalmology.
