As pickleball cements its status as America’s fastest-growing sport, ophthalmologists are sounding the alarm over an emerging public health concern: a steep rise in pickleball-related ocular injuries.
A cross-sectional study, conducted at Rutgers New Jersey Medical School, Newark, and published in JAMA Ophthalmology, has analyzed two decades of data from the National Electronic Injury Surveillance System (NEISS) to quantify the incidence and demographics of eye injuries linked to pickleball between 2005 and 2024.
The findings reveal that pickleball-related ocular injuries increased dramatically over the past four years, mirroring the sport’s exponential growth in popularity.
Between 2005 and 2024, an estimated 3,112 pickleball-related eye injuries were reported nationally, with more than 1,200 occurring in 2024 alone. The researchers calculated an average annual increase of 405 cases between 2021 and 2024.
The mean age of injured players was 54 years, with 70% of cases occurring in individuals aged 50 or older. The study attributes this vulnerability to age-related decreases in muscle mass, bone density, and balance — factors that can exacerbate injury severity in older adults.
Although both sexes were affected equally, older players were more likely to experience severe trauma, including retinal detachment, orbital fracture, hyphema, and globe injury. More common but less severe diagnoses included periocular lacerations, corneal abrasions, and iritis.
The most frequent mechanism of injury was a direct hit from the ball (43%), followed by falls (28%) and paddle strikes (12%). The study notes that modern paddle technology has increased ball velocity — with impacts reaching speeds up to 60 mph (96 km/h) — and players positioned just 14 feet apart at the net having little time to react to these extreme speeds.
Despite the clear rise in injuries, eye protection remains optional in both recreational and competitive pickleball. Efforts to mandate eyewear in sanctioned tournaments were rejected by USA Pickleball – the governing body for the sport in the US – in 2024, leaving safety recommendations largely voluntary. The American Academy of Ophthalmology (AAO) has since urged players to adopt ASTM (American Society for Testing and Materials) F3164–compliant protective eyewear, similar to standards used in other racket sports.
With approximately 19.8 million players now participating in the sport, ophthalmologists are likely to see increasing cases in both emergency and outpatient settings. The study authors are calling for standardized guidelines for eye protection for this hugely popular sport.
