Pickleball Eye Injuries Are Growing at an ‘Alarming Rate’ — With a Few Caveats

On-court eye injuries have spiked in the past few years. Is this the inevitable byproduct of pickleball’s booming popularity, or alarming new proof that more proactive preventative measures need to be taken?

Back when I was a kid, nobody wore helmets out on the ski slopes. We just bombed down Double Blacks blissfully unaware. Now, everyone does. Is pickleball headed in the same direction when it comes to protective eyewear?

A new study from JAMA Ophthalmology is making the rounds with some scary-sounding conclusions, providing perhaps the best data-backed case yet for making eyewear mandatory at the recreational, and even the pro, levels. But it comes with a few caveats.

Yes, the rate of eye injuries in the sport is increasing, especially in the last few years. But this study’s scope is far from comprehensive, and even still, we’re talking tiny percentages compared to the number of people playing every year in the U.S.

The First Injury Study Focused on the Eyes

The authors used the US National Electronic Injury Surveillance System (NEISS), taking data from 2005 through 2024, looking specifically for injuries tied to “pickleball” or “pickle ball” (plus other common misspellings) that involved the eye or face. Even though the sport’s popularity has soared — think approximately 20 million U.S. players by 2024, a 300%+ increase since 2020 — the eye-injury side of things hasn’t been heavily studied, until now.

What they found is concerning, to be sure. Between 2014 and 2024, the weighted national estimate was approximately 3,100 eye injuries tied to pickleball. But here’s the kicker: from 2021 to 2024, the incidence increased by an estimated 405 cases per year. In 2024 alone, the estimate was about 1,262 injuries. So yes, as pickleball’s popularity surges, the eye-injury count appears to be climbing too.

The researchers combed through nearly two decades of data to understand how eye injuries in pickleball have evolved alongside the sport’s explosive growth. The data revealed patterns that had previously gone largely unexamined in the pickleball community. While other aspects of pickleball injuries have been studied, the specific focus on eye and facial trauma provides new insights into one of the more vulnerable areas of the body during play.

The methodology involved filtering through emergency department records to identify cases specifically related to pickleball activities. This approach allowed researchers to track trends over time and correlate them with the sport’s growth trajectory. The use of the NEISS database, which represents a sample of hospitals across the country, enabled the researchers to project national estimates from a subset of emergency departments.

How Bad Are These Injuries?

About 70% of the eye injuries were in players 50 years or older. There wasn’t a statistical difference found between genders. But here’s where the study starts to turn heads.

The most common injuries reported were periocular lacerations (approximately 35%) and corneal abrasions (approximately 16%). Think minor scrapes to the eyelid or the clear, dome-shaped outer layer of the eyeball itself. But more severe injuries were found as well, including hyphema (blood in the eye), retinal detachment (approximately 3%), globe trauma (approximately 3%), and orbital fracture (approximately 2%).

Severe cases like these are far lower in number, but they’re high in risk in terms of potential vision loss or more long-term effects. The distinction between minor and severe injuries is significant because while lacerations and abrasions are painful and require medical attention, they typically heal without permanent damage. However, injuries like retinal detachment and orbital fractures can lead to lasting vision problems or even blindness if not treated promptly and appropriately.

The demographics of these injuries tell an important story. The fact that 70% of injuries occur in players aged 50 and older reflects both the sport’s demographic makeup and potentially the physical vulnerabilities that come with age. Older players may have slower reaction times, making it harder to dodge or deflect balls coming at high speeds. Additionally, the tissues around the eye may be more susceptible to injury as we age.

Understanding the severity spectrum helps contextualize the risk. While most players who sustain eye injuries will recover fully with appropriate treatment, the potential for serious complications exists. Retinal detachment, for instance, requires surgical intervention and can result in permanent vision loss if not addressed quickly. Globe trauma, which involves damage to the eyeball itself, can be particularly devastating and may require extensive medical treatment.

We Can’t Just Blame It on the Ball

Play long enough and you’ll take a ball or two off the face. It’s an occupational hazard, especially knowing the court dimensions stay constant while paddle technology continues to innovate and improve. “Modern paddles, incorporating materials such as ethylene-vinyl acetate foam, can now generate exit velocities approaching 96 km/h (60 mph),” the study said.

Given that players are often positioned 4.2 meters (14 feet) apart at the “no-volley” or “kitchen” line, these high speeds leave players with limited time to react and avoid impact. The eye-related injuries documented in this study were largely the result of a direct hit by the ball (43%). Interestingly, about 28% were the result of falls on the court while another 12% were caused by impact made by a paddle.

The evolution of paddle technology has been one of the most significant developments in pickleball over the past several years. As manufacturers have pushed the boundaries of what’s possible with materials science, paddles have become more powerful and capable of generating higher ball speeds. This technological advancement has enhanced the competitive nature of the sport, but it has also introduced new safety considerations that weren’t as prominent when the sport first gained popularity.

The proximity of players on the court amplifies the risk. Unlike tennis, where players are separated by significantly more distance, pickleball’s compact court means that even recreational players regularly engage in rapid-fire exchanges at the kitchen line. When you’re standing 14 feet from your opponent and they hit a ball at 60 miles per hour, you have less than a quarter of a second to react. For many players, especially those new to the sport or in older age groups, this reaction time simply isn’t sufficient to consistently protect themselves from errant shots.

The fact that falls account for 28% of eye injuries is particularly noteworthy. This suggests that eye protection considerations extend beyond just getting hit by the ball. When players fall, they may hit their face on the court surface, collide with equipment, or strike the net post. These scenarios underscore that eye safety in pickleball involves multiple risk factors, not just the obvious threat of ball impact.

A Case for Mandated Protective Eyewear

Ocular injuries in popular sports like baseball and tennis followed similar upward trends in their infancy, the study noted, but have long since plateaued or declined. This, the study’s authors urge, is a good reason to look at more formal guidelines for protective eyewear in the sport.

“Despite the risks of eye injury, eye protection is not mandated for casual or professional pickleball players,” they said. “Most recently in March 2024, USA Pickleball, the governing body for pickleball in the United States, disapproved of a rule change that would mandate that players wear eye protection in USA Pickleball tournaments, citing challenges with enforcement.”

Perhaps this data will cause them to change course? “Efforts to curtail this increasing trend by increasing awareness and developing standardized guidelines for eye protection should be considered,” the study concluded.

There are no eyewear mandates in professional pickleball. Some players choose to protect their eyes – notably, Anna Leigh Waters – but most go without. Without a doubt, reflexes and reaction times are much faster at this level. But injuries are still possible at any level.

The comparison to other sports provides valuable perspective. In racquetball and squash, protective eyewear became standard practice after similar injury trends emerged. Youth baseball leagues have implemented face guards on batting helmets. Tennis, while not requiring eye protection, has seen injury rates stabilize as the sport matured and safety awareness increased. These precedents suggest that pickleball may be at a similar inflection point where proactive measures could prevent the injury rate from continuing to climb.

The enforcement challenge cited by USA Pickleball is real. Unlike equipment requirements such as paddle specifications, which can be checked before play, ensuring that all players wear protective eyewear throughout matches would require constant monitoring. However, many other sports have successfully implemented similar requirements, suggesting that these logistical challenges are surmountable with the right approach.

The resistance to mandatory eyewear likely stems from multiple factors. Some players find protective eyewear uncomfortable or believe it impairs their vision or peripheral awareness. Others may view it as unnecessary equipment that changes the aesthetic or feel of the sport. There’s also the practical consideration that implementing such a requirement would impose additional costs on players, which could be seen as a barrier to entry for a sport that prides itself on accessibility.

Understanding the Issue for Beginners

If you’re new to pickleball or just hearing about this issue for the first time, it’s helpful to understand what we’re really talking about. Pickleball is played on a court about one-third the size of a tennis court, with players using solid paddles to hit a perforated plastic ball back and forth over a net. The game is particularly popular among older adults, though players of all ages enjoy it.

An eye injury in pickleball typically happens in one of three ways. Most commonly, the ball hits someone directly in the face during play. Because players often stand close together at what’s called the “kitchen line” (the area near the net), and because the ball can travel at speeds up to 60 miles per hour, there’s sometimes not enough time to react and protect yourself. Second, players can fall on the court and hit their face on the ground or against equipment. Third, a paddle can accidentally strike someone in the face, particularly during doubles play when partners are moving around in close proximity.

The injuries range from minor to serious. A corneal abrasion is like a scratch on the clear front surface of your eye – it’s painful and requires medical attention, but usually heals completely. On the more serious end, you have injuries like retinal detachment, where the layer at the back of your eye that senses light pulls away from its normal position. This requires surgery and can cause permanent vision loss. An orbital fracture means you’ve broken one of the bones surrounding your eye, which is about as serious as it sounds.

The debate about protective eyewear centers on whether the sport should require players to wear special glasses or goggles designed to protect the eyes during play. Think of them as similar to safety glasses worn in a workshop or goggles worn in racquetball. Some people argue that with injury rates rising, it makes sense to require this equipment. Others worry about enforcement difficulties, additional costs for players, and whether such a requirement might discourage people from playing.

What makes this study important is that it provides concrete data showing that eye injuries are increasing faster than the sport’s growth alone would explain. When a sport grows by 300%, you’d expect injuries to increase proportionally. But if injuries are increasing even faster than that, it suggests there may be specific risk factors that need to be addressed beyond just having more people playing.

A Few Parting Thoughts

The findings of this study are eye-opening, but perhaps not quite as generally alarmist as some other coverage makes them out to be. “People are getting their retinas detached and their eyesockets broken,” Vice laments. “Pickleball is even responsible for an uptick in something called hyphema, the medical term for when your eyeball starts bleeding internally.”

That’s true. But while the study “found that pickleball-related eye injuries have increased at an alarming rate over the past 4 years,” its scope is far from comprehensive. An editorial accompanying the study, the New York Times notes, “cautioned that there were limitations to data drawn from registries like the one used in the new study, which included just 2 percent of all U.S. hospital emergency departments.”

And yet, the underlying cause of all this is an important one to keep in mind, especially as the sport continues to surge in popularity and reach new audiences around the world. “We’ve seen a lot more players who are not familiar with the sport entering the court, and that creates a lot of opportunity for injury,” said Dr. Jonathan C. Tsui, the study’s senior author and a professor at Rutgers New Jersey Medical School. “They’re not used to how fast the projectiles are moving and how close to the other players on the court they are.”

This observation gets at something fundamental about pickleball’s current moment. The sport has grown so rapidly that a significant portion of the playing population consists of newcomers who are still learning the game’s dynamics and risks. Unlike sports where most participants grew up playing and developed an intuitive sense of the game’s dangers, many pickleball players are discovering these risks in real time as adults. This creates a unique safety education challenge that the pickleball community is still figuring out how to address effectively.

The study’s limitations are worth keeping in mind when interpreting its conclusions. The NEISS database samples only 2% of emergency departments, which means the national estimates are extrapolations based on a relatively small subset of actual cases. There’s inherent uncertainty in this methodology, and the true numbers could be somewhat higher or lower than the estimates. Additionally, the database only captures injuries severe enough to warrant an emergency department visit. Minor injuries treated at urgent care facilities, by primary care physicians, or at home aren’t included in these figures.

Context matters enormously when evaluating these statistics. With nearly 20 million Americans playing pickleball, even 1,262 eye injuries in a year represents a tiny fraction of the total player population. The individual risk remains quite low. However, from a public health perspective, hundreds of preventable injuries – particularly those with the potential for permanent vision loss – represent a legitimate concern worthy of attention and potential intervention.

The path forward likely involves a combination of approaches rather than a single solution. Education about the risks and proper protective equipment should be part of every beginner’s introduction to the sport. Facility operators could consider posting safety guidelines or offering protective eyewear for rent or purchase. Equipment manufacturers might focus on developing protective eyewear that’s comfortable, effective, and appealing enough that players choose to wear it voluntarily.

The comparison to skiing helmets mentioned at the beginning of this article is apt. The shift from a sport where almost nobody wore helmets to one where they’re nearly universal didn’t happen overnight or through mandates alone. It involved a combination of growing safety awareness, improved helmet technology that made them more comfortable, social normalization where wearing a helmet became the expected thing to do, and yes, some resorts and racing organizations eventually implementing requirements. Pickleball may be on a similar journey with protective eyewear.

For individual players, the data provides information to make informed personal decisions. If you’re in the 50-and-older age group where most injuries occur, or if you’re new to the sport and still developing your reflexes and court awareness, protective eyewear becomes more compelling. If you play particularly aggressive, fast-paced pickleball or frequently find yourself in rapid exchanges at the kitchen line, the risk-benefit calculation shifts further toward protection. Conversely, if you play casually with experienced players who have good ball control, your personal risk assessment might be different.