Baseball, Biking and Softball Implicated in Orbital Fractures from Sports in US

In this study, nearly 14% of patients with orbital fractures sustained additional ocular injuries, ranging in severity from mild such as subconjunctival hemorrhage (10.9%) to severe injuries, including hyphema (9.2%) and ruptured globe (3.4%). Photo: Richard Mangan, OD. Click image to enlarge. The orbit is a structurally complex region composed of thin bony walls that are susceptible to fractures upon impact. Orbital fractures are common injuries in sports-related trauma, often leading to substantial morbidity, functional impairment and cosmetic deficits. These injuries frequently involve significant ocular trauma. Using data from the National Electronic Injury Surveillance System (NEISS), researchers from Bascom Palmer Eye Institute in Miami recently provided a comprehensive analysis of the epidemiology of sports-related orbital fractures in the United States over the past decade in Ophthalmology. They determined that sports-related orbital fractures remain a significant cause of facial trauma in the country, particularly among adolescent and young adult men. Baseball and bicycling were leading contributors.A total of 1,468 cases of sports-related orbital fractures were identified from 2014 to 2023, corresponding to a national estimate of 49,765 cases after using NEISS statistical weights. The mean age was 27.1 years, with the highest frequency in the 10- to 19-year age group, and men comprised 79.0% of cases. The researchers noted that, compared to adults, adolescents are at higher risk due to increased sports participation, lack of fully developed motor skills and occasional noncompliance with safety measures.The most frequently involved sports were baseball (28.6%), bicycling (23.1%) and softball (6.7%). The orbital floor was the most fractured site (59.8%). Biking has proven to similarly affect vulnerable populations worldwide. Among 865 cases with secondary injury data from 2019 to 2023, 13.8% had associated ocular or periocular injuries, including eyelid lacerations (17.6%), corneal abrasions (13.4%) and hyphema (9.2%).“While often overlooked in the presence of orbital fracture, these associated injuries are critical and often need immediate evaluation and specialized follow-up to evaluate potential long-term visual consequences,” the study authors wrote in their paper.While the NEISS database provided valuable information on national injury incidences and trends, the researchers highlighted its inherent limitations. The potential for underreporting or misclassification of injuries may lead to inaccuracies in the reported incidence of orbital fractures and associated ocular injuries. Also, this lack of detailed data on injury severity, clinical outcomes and treatment limits the ability to draw conclusions regarding long-term visual and functional recovery.“These findings underscore the critical need for preventive measures, including the widespread adoption of protective eyewear, the implementation of safety regulations in organized sports and the need for continued advocacy and policy enforcement to improve eye safety in sports,” the study concluded.Click here for the journal source. Bineshfar N, Shields C, Davila N, et al. The epidemiology of sports-related orbital fractures in the United States. Ophthalmology. June 21, 2025. [Epub ahead of print].