Functionally One-Eyed Athlete

Classification and Mechanisms

Eye injuries can be classified as blunt trauma, penetrating trauma, or radiation injury. Blunt trauma can be further classified by the anatomic location in which the injury occurs (anterior chamber, posterior chamber, and orbit and adnexa).

The type of injury that occurs depends on the equipment used in the sport, the playing field/court, and the rules of the game. For example, the injuries to the face and eye from a small, hard ball (e.g., a golf ball) are different from those imparted by a larger, deformable ball (e.g., a soccer ball). Also, the nature of soccer, with the ball often coming from the ground up to the face, will lead to different injuries than if a ball were to come from a higher elevation down toward the eye, because the forehead and the bony orbit are better able to protect the eye in the latter scenario.

Different injuries can also result from the different playing venues. Racquetball and tennis are both racquet sports, but in racquetball the athletes share the same playing space, whereas in tennis the net divides the playing surface. Therefore, the risk of hitting your opponent with the racquet is much higher in racquetball than in tennis.

Definition

Severe eye injuries can lead to permanent impairment of vision. If an athlete has an underlying severe visual impairment, an injury to his or her good eye could lead to a permanent visual disability. This type of athlete is considered functionally one eyed. If there is an injury to the initially unaffected eye, the person can be severely impaired for the rest of his or her life, and the injury could leave the athlete permanently blind. Some ophthalmologists use a cutoff of best-corrected vision in the poorer eye of 20/40 or 20/60 to determine if someone is functionally one eyed. This means that the “bad eye” can only be corrected to 20/40 or 20/60 at the very best. This leaves the athlete with only one “good eye.” If this good eye were to be injured, it could leave the person permanently disabled.

Clearance to Play

The functionally one-eyed athlete should consult an ophthalmologist prior to playing any sport. The athlete will be counseled to use protective eyewear at all practices and all games. This includes sports with other protective equipment. For example, acceptable eyewear should be worn under a standard football helmet. These athletes also should be made aware that even recreational “pickup” games are not immune from possible injury and that protective eyewear must always be used.

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