Detached Retinas, Fractured Sockets: Pickleball Eye Injuries Soar Alongside Sport’s Popularity

NEWARK, N.J. — America’s fastest-growing sport is sending more people to the emergency room with serious eye injuries than ever before. Pickleball-related ocular injuries jumped by an estimated 405 cases each year between 2021 and 2024, according to a recent study. In 2024 alone, an estimated 1,262 pickleball-related eye injuries occurred nationwide, based on emergency department data.

Patients suffered retinal detachments, fractured eye sockets, severe damage to the eyeball itself, and bleeding inside the eye. Some injuries threatened permanent vision loss. Yet despite the mounting toll, neither casual players nor professionals are required to wear eye protection when they step onto the court.

Researchers from Rutgers New Jersey Medical School analyzed two decades of emergency department data (eye injuries were documented from 2014 to 2024) and found that 88% of estimated pickleball eye injuries occurred between 2022 and 2024. As pickleball participation exploded to approximately 19.8 million players in 2024 (a 311% increase since 2020), eye injuries climbed right alongside it.

Why Older Pickleball Players Face Higher Eye Injury Risk

Players aged 50 and older accounted for 70% of eye injuries in the study. The average age of an injured patient was nearly 54 years old, with cases ranging from age 6 to 80. Age-related factors may increase vulnerability. Older adults often experience decreased muscle mass, reduced bone density, and balance issues. These changes can make them more susceptible to falls and slower to react when a ball comes flying toward their face.

People in this age group who wear glasses face additional risks if their frames aren’t shatterproof. Those with high myopia, a family history of retinal detachment, or cataracts that cause blur or glare should be especially cautious.

Falls caused 28% of eye injuries in the study, with an average victim age of 68. Ball strikes accounted for 43% of injuries, affecting patients who averaged about 53 years old. Paddle hits caused 12% of injuries and tended to affect younger players, with an average age around 30, though ages varied widely.

A pickleball traveling faster than about 30 miles per hour (82 km/h) can deform the cornea, retina, and vitreous humor while exerting enough stress on the tiny fibers holding the lens in place to knock it loose. Modern paddle technology has made this threshold easier to reach. Advanced paddles made with materials like ethylene-vinyl acetate foam can now launch balls at speeds approaching 60 mph (96 km/h).

Speed becomes especially dangerous given how close players stand to each other during play. At the kitchen line, the no-volley zone where much of the action happens, opponents face each other from just 14 feet apart. A ball rocketing across that distance at 60 mph leaves almost no time to react.

What Types of Eye Injuries Can Pickleball Cause?

Direct ball strikes accounted for 34 unweighted cases in the study’s dataset, representing an estimated 1,322 injuries nationwide. Periocular lacerations (cuts around the eye) were the most common injury overall, affecting an estimated 1,112 people. Corneal abrasions came next at 490 cases. Corneal abrasions occur when the clear front surface of the eye gets scratched, causing pain, light sensitivity, and blurred vision.

More troubling diagnoses appeared further down the list. Hyphema (bleeding in the front chamber of the eye) affected 141 people. Retinal detachment occurred in 79 cases. Retinal detachment happens when the light-sensitive tissue at the back of the eye pulls away from its normal position, which can lead to permanent vision loss if not treated quickly. Globe trauma (severe damage to the eyeball itself) affected 81 patients. Orbital fractures (breaks in the bones surrounding the eye) occurred in 49 cases.

Patients also suffered from iritis (inflammation of the colored part of the eye), posterior vitreous detachment (when the gel inside the eye separates from the retina), subconjunctival hemorrhage (broken blood vessel on the eye’s surface), and traumatic mydriasis (a pupil that stays dilated after injury).

Because the study, published in JAMA Ophthalmology, only captured patients who went to emergency departments, the true number of injuries is almost certainly higher. Many people with minor injuries likely visited their regular eye doctors or urgent care clinics instead. The dataset also couldn’t track long-term outcomes, so researchers don’t know how many patients suffered permanent vision damage or required surgery.

Eye Protection Not Required Despite Rising Injury Rates

USA Pickleball (the sport’s governing body) considered mandating eye protection for tournament play in March 2024 but rejected the proposal. Officials cited enforcement challenges as the reason. No policy on eye protection has been issued since then. Most pickleball clubs and public recreation areas don’t require protective eyewear either.

In the absence of official mandates, the American Academy of Ophthalmology stepped in with recommendations. The organization suggests players wear eyewear meeting American Society for Testing and Materials F3164 standards, which cover most racket sports. These guidelines spell out requirements for safe designs, optics, and materials. They include options for people who need corrective lenses.

Standards mean little if players don’t know about them or can’t easily tell which products meet the requirements. Many retailers don’t clearly disclose what materials they use in frames and lenses or whether their products comply with recommended standards. Without a universal standard that’s actively promoted by pickleball organizations and clearly labeled on products, players must navigate a confusing marketplace on their own.

Pickleball injuries of all types cost the health care system an estimated $250 million to $500 million in 2023 alone. Eye injuries represent just one slice of that total, but they can be particularly expensive to treat. A 2011–2012 study from Finland found that orbital fractures required an average of about $7,100 (in equivalent U.S. dollars) in follow-up care per patient over three months. Retinal detachments and other severe injuries likely carry similar or higher costs when accounting for surgery, specialist visits, and ongoing monitoring.

Pickleball vs Tennis and Basketball: Eye Injury Comparison

Other racket sports show different injury patterns. Tennis-related eye injuries actually decreased between 2000 and 2019, dropping to about 450 cases in the final year of that period. Basketball eye injuries also declined, falling by an estimated 333 cases per year between 2012 and 2021. Baseball ocular injuries followed a similar downward trend. Pickleball stands out, with eye injuries rising sharply even as rates for comparable sports decline.

Recent surveys show that pickleball’s growth has been driven primarily by casual players (those who play fewer than eight times per year). Core players who hit the courts at least eight times annually make up a smaller portion of the sport’s expansion. Casual players may face higher injury risks due to limited experience, unfamiliarity with the game’s pace and dynamics, or lower overall fitness levels.

The sport’s accessibility is part of its appeal. Pickleball’s rules are straightforward, the court is smaller than a tennis court, and the underhand serve is easier on aging shoulders. These factors have helped pickleball spread rapidly across retirement communities, suburban recreation centers, and urban parks. But that same accessibility may create a false sense of security, leading players to underestimate the risks.

While players aged 50 and older still represent the majority of cases, that proportion is lower than the 91% reported in an earlier analysis covering 2001 to 2017. The average pickleball player in 2024 was about 35 years old, down from older averages in previous years. As the sport continues attracting younger participants, the age distribution of injuries may shift.

Protective equipment doesn’t guarantee injury prevention, but it can dramatically reduce risk. Clear, widely promoted standards for eye protection combined with education campaigns would help. Making protective eyewear as routine as court shoes or paddles would require buy-in from USA Pickleball, equipment manufacturers, facility operators, and players themselves. Until that happens, emergency departments will likely continue seeing patients who learned the hard way that a perforated plastic ball traveling at high speed can do serious damage to an unprotected eye.

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