Open Journal of Ophthalmology, 2013, 3, 93-96
http://dx.doi.org/10.4236/ojoph.2013.33022 Published Online August 2013 (http://www.scirp.org/journal/ojoph)
93
A 10-Year Survey of Severe Eye Injuries in Sport in
Belgrade, Serbia 2000-2009
Miloš Jovanović1*, Dragan Vuković1, Vesna Jakšić2, Miroslav Knežević1, Lepša Žorić2,
Miloš Mirković2
1Faculty of Medicine, University of Belgrade, Belgrade, Serbia; 2Faculty of Medicine, University of Kosovska Mitrovica, Kosovska
Mitrovica, Serbia.
Received January 23rd, 2013; revised February 24th, 2013; accepted March 15th, 2013
Copyright © 2013 Miloš Jovanović et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Introduction: The eye injuries inflicted in different sport activities are relatively rare and depend upon the type of sport.
They are more common in recreational sport activities. These injuries are generally minor but may be very severe and
result in permanent vision impairment. One must be aware of the fact that these sport activities, either recreative or pro-
fessional, are exercised by young people. Methods: All analyzed patients were hospitalized at the Clinic of Eye Dis-
eases, Clinical Center of Serbia, Belgrade, for severe eye injuries which occurred in sport activities. The analyzed pe-
riod included 10 years, from the beginning of 2000 to the end of 2009. Results: In this period, a total of 117 patients
with eye injuries sustained in some of sport activities were hospitalized. There were 114 (97.5%) injured males. Mean
age of the injured was 25.8 years, and there were no individuals older than 50 years of age. Closed eyeball injures were
reported in 96.6% and open injuries were seen in the remaining 3.4% of cases. During recreational sports, the eye inju-
ries occurred in 76.1%, in the school—19.6%, and in professional sport—4.3% of the time. The injured individuals
were as follows: pupils—35.0%, students—17.9%, workers—22.2%, clerks—20.6% and professional players—4.3% of
cases. Upon completed treatment, visual acuity was normal in 77.8%, subnormal in 16.2%, impaired in 3.4% and
amaurosis in 2.6% of cases.
Keywords: Eye Injuries; Sport Activities; Recreation; Eye Protection
1. Introduction
In the past decade, the incidence of sport eye injuries
tended to have increasing growth [1,2]. Garrow, in 1923,
reported that the sport eye injuries accounted only for
0.7% of all patients admitted for treatment of their eye
injures in the Glasgow Royal Infirmary [3]. Canavan et al.
in 1980 reported the incidence of sport eye injures of
4.1% [4], and Jones, in 1988, showed the increase of
percentage to 25.1% [5], while in MacEwen’s paper,
1989, the proportion of sport eye injures was 42.2% [6].
At the beginning of 21st century such percentage was
decreased, and therefore, Barr et al., in their study in
2000, reported the sport eye injury incidence of 12.5%
[2], and in 2007 study by Len et al., such percent was
11% [7]. This paper analyzes the incidence, nature of
injury and functional sequelae of sport injuries in Serbia
in the first decade of our century.
2. Material and Methods
The paper analyzed the patients who sustained the eye
injuries in sport activities. Due to severity of eye injuries,
they were all hospitalized and treated at the Clinic of Eye
Diseases, Clinical Center of Serbia in Belgrade. The ana-
lyzed period of time was 10 years, from January 1, 2000
to December 31, 2009. Data from the Registry of in-pa-
tients of the Clinic of Eye Diseases, Clinical Center of
Serbia in Belgrade were used in this investigation. Hos-
pitalized injured patients played football, tennis, basketball,
handball, water polo and paintball as recreational activi-
ties, in school at gym classes or as professional activities.
The following parameters were analyzed: age, site of
injury, occupation, nature of the eye injury, as well as
final visual acuity of the injured eye.
The objective of this investigation was to establish the
frequency of the eye injuries in different sport activities,
types of injury, final visual acuity and probable options
*Corresponding author.

A 10-Year Survey of Severe Eye Injuries in Sport in Belgrade, Serbia 2000-2009 94
of undertaking specific preventive measures.
3. Results
In the analyzed 10-year period (2000-2009), a total of
3206 patients were hospitalized at the Clinic of Eye Dis-
eases, Clinical Center of Serbia in Belgrade, for serious
mechanical injuries. Out of this number, 117 (3.6%) pa-
tients sustained their eye injuries during some sport ac-
tivities (Table 1). All but 3 injured were males; 2 girls
had their eyes injured by tennis ball and the third girl was
injured while playing the handball. The right eye was
wounded in 70 (59.8%) cases. There was no patient with
simultaneous injuries of both eyes. In general, the injuries
occurred in children and younger adults, and not after the
age of fifty (Table 2). Mean age of the injured was 25.8
years.
Closed injuries were reported in 113 (96.6%) patients
and open injuries were evident in the remaining 4 (3.4%)
cases. In closed bulbar injuries, there were different
damages of the intraocular structures, and in open injuries
two cases manifested penetrating injuries and two other
cases had rupture of the eye ball (Table 3).
The majority of injuries occurred in recreational sport
activities—76.1%, followed by school—19.6% and in
professional sports—only 4.3%.
The occupation of the injured patients was different
and with different percentage of involvement: pupils,
students, workers, clerks, and professional players (Table
4).
Upon completed treatment, visual acuity was normal in
77.8%, subnormal in 16.2%, impaired vision in 3.4% and
amaurosis in 2.6% of cases (Table 5).
4. Discussion
Our study showed that the percentage of sport eye inju-
Table 1. The number of the injuries in different sports.
Sport No. of sports %
Football 95 81.2
Tennis 10 8.5
Basketball 4 3.4
Paint ball 4 3.4
Water polo 3 2.6
Handball 1 0.9
Total 117 100.0
Table 2. Distribution by age of patients with sport eye inju-
ries.
Year 0 - 9 10 - 19 20 - 2930 - 39 40 - 49 Total
3 42 39 22 11 117
No. of
patients
% 2.6 32.9 33.318.8 9.4 100.0
Table 3. Types of the sustained injuries.
Injury No. %
Closed globe 113 96.6
Hyphaema 96 82.1
Iridodialysis 17 14.6
Subluxatio lentis 9 7.7
Cataract 3 2.6
Vitreous hemorrhage 15 12.8
Retinal hemorrhage and edema 36 30.8
Open globe 4 3.4
Penetrating 2 1.7
Rupture 2 1.7
Total 117 100.0
Table 4. Occupation of patients with the eye sport injuries.
ProfessionPupilStudentWorkerClerk Professional playerTotal
No. of
patients 4121 26 22.2 5 117
% 35.017.924 20.6 4.3 100.0
Table 5. Final visual acuity (VA) of patients.
Final VA N0 of patients %
20/25 - 20/20 91 77.8
20/50 - 20/30 19 16.2
1 m to 20/60 4 3.4
Amaurosis 3 2.6
ries on the territory of the city of Belgrade of 3.6% was
significantly less in comparison to percentage of the same
injuries reported by other authors [3-7]. There are several
reasons for the aforementioned. The first reason is that,
under current conditions in Serbia, the eye injuries occur
most commonly in public places, at home and during
work. In this way, an overall involvement of sport inju-
ries has been reduced [8]. The second reason is that the
indications for hospitalization are narrowed, and accord-
ingly, a large number of sport eye injuries is managed on
outpatient basis, and our study analyzed only sport eye
injuries in hospitalized patients. The same reason for re-
duction of sport eye injuries was reported by other au-
thors in their papers [9,10]. The third reason is a modifi-
cation of population age structure. In today’s Serbia, the
percentage of adult young people has been continuously
decreasing, and these young people are actually the indi-
viduals going in for sports. Unfortunately, better eye pro-
tection cannot be reported as the reason for lower per-
centage of eye injuries, because no protection devices,
except in paintball, are generally used in our setting.
Football was the commonest cause of the eye injuries.
Such cause was mentioned by other authors as well [11,12].
Football is the most popular sport in Serbia, being played

A 10-Year Survey of Severe Eye Injuries in Sport in Belgrade, Serbia 2000-2009 95
in different professional leagues or more often, just for
recreation purposes. That is why the eye injuries are more
frequent in football players playing it for fun. Only three
cases were reported among professional football players.
In one case, the injury was caused by blow of the oppo-
nent player’s elbow, resulting in bulbar rupture and
amaurosis. Other two open (penetrating) wounds of the
eyeball occurred in recreating football players, namely,
one sustained it while falling down and hitting the eye
against some prominent object on the ground and another
in similar way, by some sharp object on the playground.
The second game by frequency of the eye injuries was
tennis. Out of 10 (8.5%) tennis injuries, seven was caused
by racquet and three by ball. In all cases it was the ques-
tion of contusion globe injuries. Regarding the basketball,
the injuries were present in only 4 (3.4%) of all intrahos-
pitally-treated sport eye injuries. One of these injuries
occurred in professional basketball player. Three injuries
were reported in water polo, i.e. one in professional
player, which was caused by blow of the opponent player
and resulted in rupture of the globe. Only one patient
with the eye injury was reported in case of handball. It
was the contusion of the globe in a school-girl who sus-
tained her injury during gym class.
Although all these aforementioned sports after football
are relatively popular in Serbia, far lower percentage of
the eye injuries in other sports than football is accounted
for their lesser prevalence in recreational sport activity.
Recently introduced sport—paintball—is played in Serbia
only as recreation activity. Although adequate protective
devices are provided by regulations, 4 very serious inju-
ries were noted. All injuries occurred at the moment
when players’ goggles were off. In all 4 cases the patients
were adults, and 2 of them sustained severe injuries with
consequent loss of vision. One of these two patients was
a surgeon whose loss of vision disabled him to continue
with his surgical profession.
It is interesting that, during 10-year analyzed period,
there was no hockey player or boxer, although these two
sports represent activities with frequent eye injuries, what
was also reported by other authors [13-15].
Opposite to high proportion of injuries in recreational
sports, the reason for so small number of injuries in pro-
fessional players lies in their well-coordinated team play,
instructions given by their coaches and respect of the
basic rules of game.
Eye protection measures of sport players analyzed in
this study, other than paintball, are not provided by regu-
lations and, therefore, they are not applied. Nevertheless,
it does not mean that it is the issue not to be contemplated
on in future.
5. Conclusion
The conclusion has been reached that the eye injuries
during different sports mostly occurred in young people
who exercised sport as recreation. In a largest number of
cases, it was the question of contusion injuries of the
globes with the damage of intraocular structures. One-
third of the injured had the impaired vision of the injured
eye. For this reason, the prevention of injuries with strict
respect of the rules of games and wearing of protection
devices, if provided for specific game or sport, should be
given preference.
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