Lacrosse Eye Injuries
Common Eye Injuries in Lacrosse
The cornea is the clear front surface of your eye, and it can be scratched when a ball or stick makes contact with your face. These corneal abrasions are one of the most common lacrosse eye injuries we see in our practice. A scratch on the cornea typically causes sharp pain, tearing, and sensitivity to light.
Most minor corneal abrasions heal within 24 to 48 hours with proper treatment. However, deeper scratches may take longer and require closer monitoring to prevent infection or scarring that could affect your vision.
A hyphema occurs when blood collects in the front chamber of your eye, usually after a direct blow from a lacrosse ball. You may notice a visible layer of blood in the front chamber of the eye, in front of the colored iris, and your vision may become blurry. This is a serious injury that requires immediate medical attention.
Protect the eye with a rigid shield, keep your head elevated 30 to 45 degrees, avoid strenuous activity, and avoid aspirin and NSAIDs. Use acetaminophen for pain unless we advise otherwise.
- Blood can increase pressure inside the eye and damage the optic nerve
- Rebleeding can occur within the first few days after injury
- Rest and elevation of the head are critical during healing
- Some cases require medication to control eye pressure and prevent complications
- We prescribe cycloplegic drops and often topical steroids to reduce inflammation
- Antiemetics help prevent vomiting that can trigger rebleeding
- Patients with sickle cell trait or disease require closer IOP targets and specific medication choices
- Rebleeding risk peaks around days 3 to 5, so activity restrictions and follow up are critical
The bones surrounding your eye socket can break when struck by a lacrosse ball or stick. These orbital fractures often affect the thin floor or inner wall of the socket. You might experience double vision, numbness in your cheek, or difficulty moving your eye in certain directions.
Do not blow your nose after the injury, since air can be forced into the orbit. Use cold compresses to the bony area around the eye, not directly on the globe. We may recommend an oral antibiotic if there is a fracture that communicates with the sinus.
Swelling and bruising around the eye are common signs of orbital trauma. We work closely with facial specialists to determine whether surgery is needed or if the fracture can heal on its own with careful observation.
- Urgent surgical evaluation is needed for trapdoor fractures with muscle entrapment, bradycardia, nausea, or vomiting
- Nasal decongestants can reduce sinus pressure when appropriate
The retina is the light-sensitive tissue at the back of your eye, and forceful impact can cause it to tear or pull away from its normal position. Retinal injuries are medical emergencies because they can lead to permanent vision loss if not treated quickly. Warning signs include sudden flashes of light, new floaters, or a curtain-like shadow in your field of vision.
Young athletes may not realize how serious these symptoms are and delay seeking care. We emphasize to all lacrosse players that any changes in vision after an impact should be evaluated immediately, even if the symptoms seem minor at first. Blunt trauma can also cause commotio retinae, a transient whitening of the retina that affects vision and requires activity restriction and follow up.
The conjunctiva is the clear membrane covering the white part of your eye and the inside of your eyelids. Contact with equipment or another player can cause this tissue to tear or develop a bright red patch of bleeding called a subconjunctival hemorrhage. While these injuries can look frightening, they are usually not serious and heal without treatment.
- Subconjunctival hemorrhages typically resolve in one to two weeks
- Conjunctival tears may need lubrication and monitoring for infection
- Persistent redness or pain suggests a more serious underlying injury
- A 360 degree subconjunctival hemorrhage can signal a globe rupture and needs emergency evaluation
- Larger conjunctival lacerations may need sutures and careful inspection for a scleral tear
Sticks and elbows can cut the eyelid or tear duct system at the inner corner of the eye. These injuries may look minor but often need precise repair to prevent lid notching, scarring, or tearing problems.
We evaluate lid wounds for involvement of the lid margin, canaliculus, and deeper tissues. Canalicular lacerations usually require timely repair by an oculoplastic surgeon to preserve tear drainage.
Recognizing Symptoms of Lacrosse Eye Injuries
Eye pain following a hit during lacrosse is your body's signal that something is wrong. The pain might feel sharp and stabbing, or it could be a dull ache depending on the type of injury. Redness often appears immediately as blood vessels in the eye react to trauma.
Excessive tearing is a natural protective response that helps flush debris and cushion the injured area. While discomfort and tearing can occur with minor injuries, they can also signal more serious damage that needs professional evaluation.
Changes in your vision after being struck in the eye should never be ignored. Blurred vision can result from corneal swelling, blood in the eye, or damage to internal structures. Distorted vision, where straight lines appear wavy or objects seem misshapen, may indicate retinal injury or swelling in the macula.
- Vision changes may worsen over the first few hours after injury
- Difficulty focusing or seeing clearly at any distance requires evaluation
- Shadows or missing areas in your visual field suggest serious damage
- Color vision changes can accompany retinal or optic nerve injuries
Certain symptoms indicate a vision-threatening emergency that requires you to seek care within minutes to hours, not days. If you notice blood visible inside the eye, sudden vision loss, severe pain that does not improve, or bulging or sunken appearance of the eye, you need emergency medical attention right away.
We also consider it urgent if you cannot move your eye normally, if your pupil appears irregular or does not respond to light, or if you see flashes and floaters that came on suddenly after impact. Seek urgent care for new double vision, nausea or vomiting after eye trauma, or a large ring of blood under the white of the eye. These signs suggest injuries that can lead to permanent vision loss without rapid treatment.
Not all lacrosse eye injuries show symptoms immediately. You might feel fine right after the game, only to develop increasing pain, redness, or vision changes several hours later as swelling progresses. Traumatic glaucoma, where eye pressure rises dangerously, can develop days after the initial injury.
This is why we recommend that any player who takes a direct hit to the eye should have a comprehensive eye exam, even if they feel okay initially. Monitoring for delayed symptoms during the first 24 to 48 hours is essential for catching problems early.
How We Diagnose Lacrosse-Related Eye Injuries
When you come to our office after a lacrosse eye injury, we begin with a detailed history of how the injury happened and what symptoms you are experiencing. Understanding the force and angle of impact helps us anticipate which structures might be damaged. We also ask about your current vision and any changes you have noticed since the injury occurred.
Our goal is to conduct a thorough but gentle examination that identifies all injuries while keeping you as comfortable as possible. We explain each step of the process so you know what to expect and can cooperate fully with the exam.
If we suspect a ruptured globe based on your history or exam, we will not measure eye pressure. We will place a rigid eye shield, keep you from eating or drinking, control nausea, obtain urgent imaging, and arrange emergency surgical care.
We start by measuring how well you can see using an eye chart, comparing your current vision to your baseline if we have that information on file. This visual acuity test helps us understand the functional impact of your injury. Next, we measure the pressure inside your eye using a tonometer, which gently touches the surface of your eye after we apply numbing drops.
- Elevated pressure may indicate bleeding or inflammation inside the eye
- Very low pressure can suggest a ruptured globe or severe internal damage
- We compare readings between both eyes to detect abnormalities
- Follow-up pressure checks track healing or identify developing complications
- We avoid tonometry when an open globe is suspected to prevent further injury
The slit lamp is a specialized microscope that allows us to examine the front structures of your eye in great detail. We can see even tiny corneal abrasions, foreign bodies, or signs of inflammation that would not be visible to the naked eye. Special dye drops make scratches glow under blue light, showing us the exact size and location of corneal damage.
During this exam, we also evaluate the anterior chamber for blood, cells, or abnormal debris. The iris, pupil, and lens are carefully examined for tears, irregularities, or displacement that could affect your vision or require specific treatment. When globe integrity is uncertain, we perform a fluorescein Seidel test without applying pressure to the eye to look for aqueous leakage.
Examining the retina and other structures at the back of your eye requires dilating your pupils with eye drops. The drops take about 20 to 30 minutes to work, temporarily blurring your near vision and making you sensitive to light. Once your pupils are wide, we use special instruments to view the entire retina, optic nerve, and blood vessels.
This exam is crucial because serious injuries like retinal tears, detachments, or bleeding in the vitreous gel can occur even when the front of the eye looks normal. We carefully examine the peripheral retina where impact-related tears most commonly develop in young athletes. We may limit your activity until the retina is cleared and stable on repeat examinations.
When we suspect that the bones around your eye may be fractured, we may recommend imaging such as a CT scan. This provides detailed pictures of your orbital bones and helps us see the exact location and severity of any breaks. Imaging also shows soft tissue swelling and whether any eye muscles are trapped in the fracture site.
- CT scans are quick and provide excellent detail of bone structures
- Limited cuts focused on the orbit reduce radiation exposure
- Imaging helps determine whether surgical repair is necessary
- Follow-up scans may be needed to monitor healing in complex fractures
- We avoid MRI if a metallic foreign body is suspected
Treatment and Recovery for Lacrosse Eye Trauma
If you have a simple corneal scratch without complications, we typically treat it with antibiotic eye drops or ointment to prevent infection while the surface heals. Lubricating drops help keep your eye comfortable and support the natural healing process. We usually see you back within 24 to 48 hours to make sure the abrasion is healing properly.
Do not use topical anesthetic drops at home, since they can delay healing and harm the cornea.
- If you wear contact lenses, remove and discard the lens from the injured eye and use an antibiotic with antipseudomonal coverage. Do not wear contacts again until we clear you
- Cycloplegic drops may be prescribed to reduce light sensitivity and pain
- Avoid patching the eye for contact lens related abrasions
- We update tetanus status when indicated for contaminated or open injuries
For pain relief, we usually recommend acetaminophen. Avoid aspirin and NSAIDs if there is any concern for bleeding inside the eye. Dark glasses can help if you are sensitive to light during healing. Most patients feel significantly better within a day or two as the corneal surface repairs itself.
Injuries involving bleeding in the eye, moderate inflammation, or secondary pressure elevation require more intensive medical management. You may need prescription anti-inflammatory drops, medications to control eye pressure, or drugs to prevent pupil movement during healing. Some patients require oral medications in addition to eye drops.
- Activity restrictions protect the eye during the critical healing period
- Sleeping with your head elevated reduces pressure and bleeding risk
- Avoiding blood thinners and certain pain relievers prevents rebleeding
- Frequent follow-up visits monitor for complications like secondary hemorrhage
- Treatment may continue for several weeks until the eye fully stabilizes
- We avoid aspirin and NSAIDs when bleeding risk is present, and use acetaminophen instead
Some lacrosse eye injuries require surgical repair to restore anatomy and preserve vision. Retinal tears or detachments typically need laser treatment or surgery to reattach the retina before permanent damage occurs. Orbital fractures may need surgical repair if they cause persistent double vision, trap eye muscles, or create significant deformity.
Globe ruptures, where the wall of the eye is torn open, require emergency surgery to repair the damage and save the eye. For suspected globe rupture, we place a rigid shield, start systemic antibiotics, confirm tetanus status, keep you NPO, control nausea, obtain urgent imaging, and proceed to surgical repair. We coordinate closely with retinal surgeons and oculoplastic specialists to provide comprehensive care for complex injuries that extend beyond our scope of primary treatment.
Following your at-home care instructions carefully is essential for proper healing and avoiding complications. We typically recommend avoiding all sports and strenuous activities until we clear you. You should protect your injured eye from further trauma by avoiding situations where you might get hit again or rub your eye.
Use all prescribed medications exactly as directed, and do not skip doses even if you start feeling better. Keep your follow-up appointments so we can monitor your progress and adjust treatment if needed. Contact our office immediately if you develop new symptoms or if existing symptoms worsen despite treatment.
- Wear a rigid eye shield as directed, including during sleep if prescribed
- Do not swim or use hot tubs until the eye surface has healed
- Do not restart contact lenses until you are cleared at follow up
The first follow-up visit usually occurs within one to three days after the initial injury, depending on the severity and type of damage. We recheck your vision, eye pressure, and healing progress to make sure everything is improving as expected. Some injuries require weekly visits for the first month, then less frequent monitoring over several months.
- Each visit includes careful examination for signs of delayed complications
- Pressure checks identify late-onset traumatic glaucoma
- Retinal exams detect late tears or detachments that can occur weeks after injury
- Long-term monitoring watches for scar tissue formation or chronic problems
Returning to lacrosse too soon can risk reinjury when your eye has not fully healed. We make clearance decisions based on the specific injury, how completely it has healed, and whether you have normal vision and eye function. Minor corneal abrasions may clear you to play in a week, while serious injuries might require several months of recovery before we allow contact sports.
Before you return to the field, we want to be certain that your eye has regained normal strength and that the risk of complications has passed. We also strongly encourage protective eyewear for all future play to prevent recurrence and protect your healthy eye.
Return-to-play clearance includes:
- No eye pain, photophobia, or tearing at rest or with exertion
- Vision back to baseline and normal eye pressure
- Retina attached and no new retinal pathology on dilated exam when indicated
- No hyphema or active inflammation
- Full, pain-free eye movements without double vision
- Sport-appropriate protective equipment available and properly fitted
Preventing Lacrosse Eye Injuries
Eye injuries in lacrosse can happen to anyone, but certain groups face higher risk. Young players who are still developing their skills and reaction times may have difficulty avoiding or deflecting balls and sticks. Female lacrosse players, who traditionally play with less protective equipment than males, experience significant numbers of eye injuries.
Players who have already had one eye injury are at increased risk for problems if reinjured. Athletes with high myopia or certain retinal conditions have eyes that are more vulnerable to impact damage and require extra protection during sports.
Different positions on the lacrosse field carry different levels of eye injury risk. Goalies face repeated high-speed shots directly toward their face and head area, making eye protection critical. Attack and midfield players are often in close-quarters battles for the ball where sticks and elbows are more likely to make contact with the face.
- Goalies experience the fastest ball speeds and most direct shots
- Attackers work in tight spaces where stick contact is more frequent
- Defenders may strike opponents with sticks during checking
- Midfielders face combined risks from both ends of the field
If you have certain eye conditions, your risk for serious injury increases when playing lacrosse. Lattice degeneration, a thinning of the peripheral retina, makes you more susceptible to retinal tears with blunt trauma. Previous retinal surgery or a history of detachment in one eye puts your remaining healthy eye at higher value and requires maximum protection.
Players who are very nearsighted have longer eyeballs with thinner retinal tissue that is more vulnerable to tearing. We recommend discussing your individual risk factors with our eye doctor before participating in lacrosse, especially if you have any history of eye problems or surgery.
Protective goggles designed specifically for lacrosse meet standards set by ASTM International, an organization that tests sports safety equipment. These goggles can substantially reduce your risk of eye injury when properly fitted and worn consistently. The eye protectors feature a cage or shield design that deflects balls and sticks away from your eyes while maintaining your peripheral vision.
In women's field lacrosse, goggles should meet the relevant ASTM F803 standard. In men's lacrosse, helmets with a face mask are required and provide integrated eye protection. Standard glasses or sunglasses do not provide adequate protection and can actually cause more damage if they shatter on impact. Only eyewear specifically rated for lacrosse offers the impact resistance needed to protect your eyes from the forces involved in the sport.
Sports goggles work best when they fit your face correctly and stay in place during intense play. We can help you select goggles that match your head size and shape, ensuring they sit comfortably without gaps where a ball or stick could slip through. The nose bridge and temple areas should be snug but not painfully tight, and the goggles should not slide down when you move your head.
- Adjustable straps help maintain proper positioning during play
- Foam or rubber padding increases comfort and prevents chafing
- Prescription inserts are available if you need vision correction
- Regular inspection for cracks or damage keeps your protection effective
- Replacing worn or damaged eyewear immediately prevents protection failure
- Anti-fog coatings or inserts help maintain clear vision in varying weather
Many lacrosse leagues and organizations now require protective eyewear for certain age groups or playing levels. Youth leagues often mandate goggles for all players, recognizing that young athletes need maximum protection. Some adult leagues have also adopted protective equipment requirements, particularly for recreational players.
Even if your league does not require eye protection, we strongly recommend wearing it every time you play or practice. The cost and minor inconvenience of goggles are insignificant compared to the potential for vision loss or permanent eye damage from an unprotected injury.
Frequently Asked Questions
Contact lenses are generally safe to wear during lacrosse and can be combined with protective goggles for clear vision and eye safety. Regular prescription glasses are not recommended because they do not meet impact resistance standards and can shatter if hit, causing additional eye injury. If you need vision correction, we can fit you with sports goggles that have a prescription insert or recommend contact lenses under protective eyewear. After an eye injury or corneal abrasion, do not wear contact lenses until your eye doctor clears you.
Recovery time varies widely depending on your specific injury and how well you heal. A simple corneal scratch might allow you to return in one to two weeks with protective eyewear, while a retinal tear or orbital fracture could require three to six months before clearance. We make the final decision based on complete healing, restoration of normal vision and eye function, and elimination of reinjury risk rather than following a fixed timeline.
Statistics show that goalies face a high volume of shots that increase exposure to eye injury, though their protective equipment has improved significantly in recent years. Attackers and midfielders also experience elevated risk due to close-quarters play and stick contact. However, eye injuries can occur in any position, which is why we advocate for universal use of protective eyewear regardless of where you play on the field.
Modern lacrosse goggles are designed to maximize your field of view while providing impact protection. Most players adapt to wearing them within a few practices and report no significant limitation in their ability to see or perform. The slight adjustment period is well worth the protection they offer, and many athletes find they actually play with more confidence knowing their eyes are shielded from injury.
Stop playing immediately and have a coach or trainer examine you. Do not rub the eye and do not apply pressure. If you suspect a serious injury, place a rigid eye shield without touching the eyeball. Do not remove any embedded object. Avoid nose blowing if there is facial trauma. Use a cold compress on the bony area around the eye to reduce swelling, not directly on the globe. Use acetaminophen for pain and avoid aspirin and NSAIDs. Arrange prompt transport to emergency care, especially if you have vision changes, severe pain, nausea, or visible blood in the front of the eye.
Some lacrosse eye injuries can have long-term consequences that appear months or years after the original trauma. Traumatic cataracts may develop gradually after blunt injury to the lens. Angle recession, where drainage structures inside the eye are damaged, can lead to glaucoma decades later. This is why we recommend that anyone who has had a serious eye injury should maintain regular comprehensive eye exams throughout their life, even after they stop playing lacrosse.
Getting Help for Lacrosse Eye Injuries
If you or your child experiences an eye injury during lacrosse, prompt professional evaluation is essential to protect vision and ensure proper healing. Our eye doctor can examine your injury, provide appropriate treatment, and guide your recovery and safe return to play. Do not wait to seek care if you have any concerns about eye trauma, as early intervention often makes the difference between full recovery and lasting vision problems. If a chemical gets into the eye, begin rinsing with clean water for at least 15 minutes while arranging emergency care.