Pickleball, the fastest-growing game in the United States, has begun to show a cost that its cheerful popularity once hid: a sharp rise in injuries to the eye. Researchers writing in JAMA Ophthalmology have traced how the number of emergency visits for such injuries climbed steeply after 2021, falling hardest on players past fifty, whose bodies and balance are less forgiving of a fast ball crossing a short court. The sport's governing body has so far declined to make protective eyewear mandatory, leaving a familiar question at the edge of a new pastime: how much protection do people need befor
Pickleball Eye Injuries Climb Sharply as the Sport Surges in Popularity
Over 3,100 pickleball players were treated in emergency rooms for eye injuries between 2014 and 2024, some at risk of vision loss.
A ball at 30 mph can deform the cornea, retina, and vitreous
Mark
Start with the headline number. Why does 1,262 matter if 19.8 million people play?
Mimi
Because of the trend. The estimate sat around 200 a year through 2021, then grew by about 405 cases a year. In 2024 alone it was more than a third of the whole decade's total.
Mark
And the injuries aren't minor?
Mimi
Some are. Retinal detachments, orbital fractures, blood in the front of the eye. Those can cost people vision.
Luke
Keep in mind these are estimates. They're extrapolated from a sample of hospitals, and the editorial writers say that registry covers only 2 percent of US emergency departments.
Mark
So the true count could differ.
Luke
It could. The editorial still backs the call for guidelines, but the exact figures are modeled, not tallied.
Mark
Why are players over 50 so hit?
Mimi
They were 70 percent of cases. The authors point to weaker muscle, bone, and balance, though that's their suggestion.
Luke
Right, it's a possible explanation, not something the study proved. Also, we don't know how many of those players were in the age group simply because of who plays in the daytime or how often.
Mark
And the rules?
Mimi
Nothing requires eyewear. USA Pickleball rejected a tournament requirement last year, calling it hard to enforce, while ophthalmologists recommend ASTM F3164 eyewear.
Il Polso
- Emergency visits for pickleball eye injuries surged past 1,200 in 2024 alone, a steep climb from roughly 200 a year before 2021.
- Players aged 50 and older account for seven in ten cases, with retinal detachments and eye socket fractures raising the risk of lasting vision loss.
- Courts sit only about 14 feet apart, and paddles can launch balls near 60 miles per hour, leaving little time for reaction.
- Eye protection remains optional in both casual and professional play, while researchers press USA Pickleball to write guidelines and launch education campaigns.
Pickleball, the fastest-growing game in the United States, has begun to show a cost that its cheerful popularity once hid: a sharp rise in injuries to the eye. Researchers writing in JAMA Ophthalmology have traced how the number of emergency visits for such injuries climbed steeply after 2021, falling hardest on players past fifty, whose bodies and balance are less forgiving of a fast ball crossing a short court. The sport's governing body has so far declined to make protective eyewear mandatory, leaving a familiar question at the edge of a new pastime: how much protection do people need before the game itself is asked to change?
A 76-year-old woman felt her vision blur the moment she was struck on a pickleball court, and she went looking for care. A 77-year-old man waited ten days after a game before his worsening sight sent him to a doctor. Both cases involved dislocated lenses, and both now sit inside a new study in JAMA Ophthalmology that documents a sharp rise in eye injuries across the sport.
The research, led by Tsui, drew on a nationally representative sample of hospital emergency rooms. Tsui had become interested after a colleague arrived at work with an injury from a weekend game. The numbers held near 200 injuries a year through 2021, then climbed by roughly 405 cases a year as the sport took off. More than 1,200 visits came in 2024 alone.
The injuries are rare against the millions who play, but some threatened vision seriously: retinal detachments, fractured eye sockets, and bleeding inside the front of the eye. Players 50 and older made up seventy percent of cases, a pattern the authors link to slower reflexes, thinner bone, and weaker balance.
The court itself contributes to the danger. Players stand close together, and the fast, hollow balls and powerful paddles leave little time to react. Tsui urged players to wear protective eyewear, yet no gear is required in professional or casual play. Last year USA Pickleball rejected a tournament rule requiring it, citing enforcement concerns, even as the American Academy of Ophthalmology recommended eyewear meeting the ASTM F3164 standard.
An accompanying editorial warned that registry data covers only a small share of U.S. emergency departments, yet urged the governing body to act. Whether USA Pickleball will reconsider its position on enforcement remains the open question.
A 76-year-old woman developed blurry vision the moment she was hurt on a pickleball court and went looking for medical care. A 77-year-old man waited 10 days after a game, until he noticed his vision getting worse. Both cases, described in recent medical reports, involved dislocated lenses, and they sit behind a new study published Thursday in JAMA Ophthalmology that documents a sharp rise in eye injuries among players of the fastest-growing sport in the United States.
The researchers, led by Tsui, counted pickleball eye injuries that sent people to hospital emergency rooms from 2005 to 2024. They extrapolated from an injury database built on a nationally representative sample of hospitals. Tsui became interested in the subject after a colleague showed up to work with an injury from a weekend game.
From 2014 to 2021, the estimate held at around 200 eye injuries a year. Then the sport took off, and the numbers rose by about 405 cases a year from 2021 to 2024. Of the just over 3,100 emergency room visits estimated for 2014 through 2024, more than a third, some 1,262, happened in 2024 alone.
The injuries are small in number next to the estimated 19.8 million Americans who play, at minimum. But some were serious enough to threaten vision: retinal detachments, fractures of the bones forming the eye socket, and hyphema, blood pooling in the front of the eye. Earlier case reports described retinal tears and detachments treated with cryotherapy and laser, along with dislocated natural or implanted lenses. Eye injuries in tennis and baseball, by contrast, have been declining.
Players 50 and older were more likely to suffer eye injuries than younger players and made up 70 percent of all cases. The authors suggested that age-related declines in muscle mass, bone density, and balance may leave them more vulnerable. That stands out because the largest group of players, according to the Sports & Fitness Industry Association, is 25 to 34.
The court itself is part of the problem. Players are often just 14 feet apart, leaving little time to dodge a ball or a flying paddle. Newer paddles can send balls flying at up to 60 miles per hour, the study said, and biomechanical analyses show that a ball at 30 mph or more can deform the cornea, retina, and vitreous, with enough pressure to dislocate the lens. Tsui noted that hollow, perforated pickleballs meet little air resistance and move fast, and that newer players are not used to how quickly projectiles travel or how close other players stand. He urged players to wear protective eye gear.
No such gear is required in professional or casual play, and clubs and courts do not require it. Last year USA Pickleball, the sport's U.S. governing body, disapproved of a rule change that would have required eye protection in its tournaments, saying it would be hard to enforce. The American Academy of Ophthalmology, also last year, recommended eyewear meeting the ASTM F3164 standard, the benchmark for most racket sports.
An accompanying editorial, by Dr. Dolly Ann Padovani-Claudio of the University of Michigan's Kellogg Eye Center and Adam R. Glassman of the Jaeb Center for Health Research in Tampa, Fla., warned of the limits of registry data like this, which covers just 2 percent of U.S. hospital emergency departments. Still, they urged USA Pickleball to develop protective eyewear guidelines and launch educational programs on the risk. Whether the governing body shifts from its position on enforcement is the open question.
Citazioni salienti
Players are not used to how fast the projectiles move or how close other players are, and should wear protective eye gear.— Tsui, study author (paraphrased)
USA Pickleball should develop protective eyewear guidelines and educational programs on the risk.— Dr. Dolly Ann Padovani-Claudio and Adam R. Glassman, editorial (paraphrased)
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