Pickleball Eye Injuries Are Growing at an Alarming Rate — But Context Matters

The conversation around protective eyewear in pickleball has reached a new level of intensity. A recent study published in JAMA Ophthalmology has brought eye injuries in our sport into sharp focus, presenting data that suggests we might need to rethink our approach to safety on the court. The findings are concerning enough to warrant serious discussion, yet nuanced enough to require careful interpretation rather than knee-jerk reactions.

On-court eye injuries have undeniably spiked in the past few years. The question we need to grapple with is whether this represents the inevitable byproduct of pickleball’s explosive growth, or whether it serves as alarming proof that more proactive preventative measures need to be taken. The answer, as is often the case with complex issues, lies somewhere in between these two poles.

Understanding the Study and Its Scope

The research team used data from the US National Electronic Injury Surveillance System, examining records from 2005 through 2024. They specifically searched for injuries tied to pickleball variations in spelling that involved the eye or face. This marks the first comprehensive study focused specifically on eye injuries in our sport, filling a notable gap in the research literature.

The timing of this research is particularly relevant. While pickleball’s popularity has soared to approximately 20 million U.S. players by 2024, representing a staggering 300% increase since 2020, the eye-injury dimension of the sport hasn’t received proportional attention from researchers. This study changes that dynamic considerably.

Between 2014 and 2024, the weighted national estimate reached approximately 3,100 eye injuries tied to pickleball. That number alone might not sound particularly alarming when spread across a decade, but the trend line tells a more concerning story. From 2021 to 2024, the incidence increased by an estimated 405 cases per year. In 2024 alone, the estimate reached about 1,262 injuries. The acceleration is unmistakable, even if the absolute numbers remain relatively small compared to the total player population.

The study found that about 70% of eye injuries occurred in players 50 years or older, though there wasn’t a statistically significant difference between genders. This age distribution makes sense given the demographics of pickleball participation, but it also raises questions about whether age-related factors like slower reaction times might play a role in injury rates.

The Nature and Severity of These Injuries

Not all eye injuries are created equal, and understanding the spectrum of severity helps contextualize the risk. The most common injuries reported were periocular lacerations, accounting for approximately 35% of cases, and corneal abrasions at around 16%. These injuries, while certainly unpleasant and requiring medical attention, generally fall into the category of minor scrapes to the eyelid or the clear, dome-shaped outer layer of the eyeball itself.

However, the study also documented more severe injuries that carry significantly higher risks for long-term vision problems. These include hyphema, which is blood accumulation in the eye, retinal detachment at approximately 3% of cases, globe trauma at roughly 3%, and orbital fracture at about 2%. While these severe cases represent a much smaller percentage of the total, they’re the ones that should genuinely concern us. Vision loss or permanent damage from these injuries can be life-altering, affecting not just a person’s ability to play pickleball but their overall quality of life.

The mechanism of injury provides additional insight. Direct ball strikes accounted for about 43% of the documented eye injuries, which aligns with what most players would intuitively expect. More surprisingly, approximately 28% resulted from falls on the court, while another 12% were caused by paddle impact. This distribution suggests that protective eyewear, while primarily thought of as defense against ball strikes, might also provide valuable protection during the chaotic moments when players are scrambling for position or recovering from off-balance shots.

Why Modern Paddle Technology Matters

The equipment evolution in pickleball has been nothing short of remarkable. Modern paddles incorporating materials such as ethylene-vinyl acetate foam can now generate exit velocities approaching 96 kilometers per hour or 60 miles per hour. That’s a significant increase from the wooden paddles that characterized the sport’s early years, and it fundamentally changes the risk calculus.

Given that players are often positioned just 4.2 meters or 14 feet apart at the non-volley zone line commonly known as the kitchen, these high speeds leave players with extremely limited time to react and avoid impact. The human reaction time simply hasn’t evolved to match the pace at which paddle technology has advanced. What once might have been an uncomfortable but relatively harmless ball strike can now potentially cause serious injury.

This technological progression mirrors developments in other sports. Tennis rackets have become more powerful, baseball bats have been engineered for maximum exit velocity, and in each case, safety protocols have eventually caught up with the equipment advances. The question is whether pickleball will learn from these other sports or whether we’ll need to accumulate more injury data before making changes.

The Case for Mandated Protective Eyewear

The study’s authors make a compelling argument by drawing parallels to other popular sports. Ocular injuries in baseball and tennis followed similar upward trends during their early growth phases but have long since plateaued or declined. The difference? Both sports implemented more formal guidelines and cultural norms around protective eyewear.

Currently, eye protection is not mandated for casual or professional pickleball players. This stands in stark contrast to sports like racquetball and squash, where protective eyewear has become standard. Most recently in March 2024, USA Pickleball, the governing body for pickleball in the United States, disapproved a rule change that would have mandated players wear eye protection in USA Pickleball tournaments, citing challenges with enforcement.

That decision now looks increasingly difficult to defend in light of this new data. The study’s authors urge that “efforts to curtail this increasing trend by increasing awareness and developing standardized guidelines for eye protection should be considered.” It’s a measured recommendation that stops short of demanding immediate mandates but clearly signals that the status quo isn’t acceptable.

The professional level presents an interesting case study. There are no eyewear mandates in professional pickleball, though some players choose to protect their eyes. Notably, Anna Leigh Waters regularly wears protective eyewear, setting an example that other players might consider following. While reflexes and reaction times are undoubtedly faster at the professional level, injuries remain possible regardless of skill. If anything, the higher ball speeds at the pro level might argue for even greater protection.

Putting the Numbers in Perspective

While the study’s findings deserve serious consideration, it’s important to maintain perspective about what the data actually shows. Some media coverage has leaned heavily into alarm, with Vice proclaiming that “people are getting their retinas detached and their eyesockets broken” and highlighting the “uptick in something called hyphema, the medical term for when your eyeball starts bleeding internally.”

These statements are factually accurate but lack crucial context. As the New York Times notes in its coverage, an editorial accompanying the study “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.”

This limitation is significant. If the study captured only 2% of emergency departments, the actual national numbers could be substantially different from the estimates. Additionally, with approximately 20 million people playing pickleball in the U.S., even 1,262 eye injuries in a year represents a tiny fraction of total participation. That doesn’t make each individual injury less serious, but it does help frame the overall risk level.

Dr. Jonathan C. Tsui, the study’s senior author and a professor at Rutgers New Jersey Medical School, offers perhaps the most insightful perspective on the underlying cause. “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,” he explains. “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 suggests that education and experience might be just as important as equipment mandates. New players need to understand the risks they’re taking and the precautions available to them. Veterans can play a role in modeling good safety practices and helping newcomers understand court positioning and defensive techniques.

What This Means for the Average Player

If you’re relatively new to pickleball or haven’t given much thought to eye protection, this research should prompt some reflection about your own risk tolerance and safety practices. The good news is that serious eye injuries remain statistically rare. The concerning news is that they’re becoming less rare as the sport grows and evolves.

Think of it this way: every time you step on a pickleball court, you’re making an implicit calculation about acceptable risk. Most of us have taken a ball to various parts of our body at some point. Usually, it’s just a momentary sting and maybe a bruise. But the eyes are different. They’re remarkably fragile, and damage to them can be permanent. Unlike a twisted ankle or a sore shoulder, eye injuries can affect your vision for the rest of your life.

The study shows that injuries happen from multiple sources, not just direct ball strikes. Falls account for a significant portion, as do paddle strikes. This means that protective eyewear offers benefits beyond just shielding you from an errant drive. The glasses themselves provide a physical barrier that can prevent scratches and impacts during the chaotic scrambles that happen during intense rallies.

For players over 50, who comprise 70% of the eye injuries documented in the study, the case for protection becomes even stronger. Reaction times naturally slow with age, and recovery from injuries becomes more complicated. If you’re in this demographic, protective eyewear should be a serious consideration even if you’ve played for years without incident.

The Cultural Shift That May Be Coming

Cultural norms around safety equipment often take years or even decades to fully shift. Think about bicycle helmets, which were rare in the 1970s and 1980s but are now standard for children and increasingly common for adults. Or consider skiing and snowboarding, where helmet adoption went from unusual to nearly universal over the course of about 20 years. These changes didn’t happen overnight, and they didn’t happen solely because of mandates. They happened because of a combination of education, evidence, cultural modeling by prominent figures, and yes, some regulation.

Pickleball may be at the beginning of a similar trajectory with protective eyewear. A few years ago, you rarely saw anyone wearing eye protection on recreational courts. Now, it’s becoming more common, though still far from universal. Professional players like Anna Leigh Waters who choose to wear protection help normalize the practice, making it seem less unusual or overly cautious.

The question is whether this cultural shift will happen quickly enough, or whether it will require more injuries, more research, and more advocacy before protective eyewear becomes standard. Some in the pickleball community resist the idea of mandates, arguing that individual players should make their own risk assessments. Others counter that we have a collective responsibility to create a safety culture, particularly when the evidence suggests preventable injuries are occurring.

Practical Considerations for Eye Protection

For players who are convinced by the evidence and want to start wearing protective eyewear, several practical considerations come into play. The eyewear needs to be comfortable enough to wear for extended play sessions, secure enough not to slip during movement, and clear enough not to impair vision. Some players who already wear prescription glasses may wonder if those provide adequate protection or if specialized sports eyewear is necessary.

The good news is that the market for pickleball-specific eyewear has grown substantially as awareness of the issue has increased. Options range from basic protective glasses to more sophisticated designs that incorporate features like anti-fog coatings, UV protection for outdoor play, and wraparound designs that protect from side impacts. Some are designed to fit over prescription glasses, while others can be fitted with prescription lenses directly.

Cost is another factor, though protective eyewear is generally quite affordable compared to other pickleball equipment. Basic options start around $20-30, while more advanced models might run $80-150. When weighed against the potential medical costs and personal impact of an eye injury, the investment seems relatively modest.

Comfort and habituation matter too. Some players find eyewear distracting or uncomfortable at first, particularly if they’re not accustomed to wearing glasses. But most report that they quickly adapt, much like players adjust to new shoes or paddles. The key is finding eyewear that fits properly and committing to wearing it long enough to get past the initial adjustment period.

What Happens Next

This study represents an important data point in an ongoing conversation about pickleball safety. It’s unlikely to be the final word on the subject, but it provides the most comprehensive look yet at eye injury trends in the sport. The findings will certainly fuel continued debate about whether protective eyewear should become mandatory at some or all levels of play.

USA Pickleball’s decision to reject mandatory eye protection in March 2024 may come under renewed scrutiny. While enforcement challenges are real—how do you monitor compliance at thousands of recreational courts across the country—other sports have managed to navigate similar issues. Youth sports, in particular, have shown that equipment requirements can be implemented effectively when there’s sufficient will to do so.

The professional tours face their own considerations. Would mandating eyewear at the pro level help drive cultural change at the recreational level, or would it be seen as overreach? Would sponsors embrace the requirement as an opportunity to showcase eyewear products, or resist it as an aesthetic imposition? These questions don’t have obvious answers, but they’re worth exploring as the conversation evolves.

For individual players, the decision remains personal for now. You can choose to wear protective eyewear or not, based on your own assessment of the risks and benefits. But that choice should be informed by the best available evidence, and this study adds significantly to our understanding of what those risks actually are. The data shows that eye injuries are increasing, that they can be serious, and that they’re happening to players across skill levels and demographics.

The Bigger Picture on Pickleball Safety

Eye injuries represent just one facet of the broader conversation about safety in pickleball. Previous research has examined overall injury patterns, with one study finding that 30% of pickleball players admit they play through pain. That statistic suggests a culture that sometimes prioritizes participation over prudence, a tendency that can lead to both acute injuries and chronic problems.

The sport’s rapid growth brings benefits and challenges. More players mean more courts, more equipment options, better media coverage, and a more vibrant community. But rapid growth also means an influx of players who haven’t been properly educated about risks and safety practices. It means court crowding and scheduling pressure that might lead people to play when tired or not properly warmed up. It means a sport that’s still developing its safety culture rather than relying on decades of established norms.

Looking at the trajectory of pickleball, which has seen participation surge to nearly 20 million players