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| Dr. John Minkowski: | |
| An Eye Specialist Weighs in to Explain Why Eye Protection for Squash |
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By Dr. John Minkowski © 2004 , Baltimore MD 2.24.1999 Comments on eye protection in squash
WHO
SHOULD WEAR EYE PROTECTION?
Everyone!!!
The question of whether everyone should be required to wear eye
protection is too controversial for this article, but a few facts
should be understood when considering this subject:
....Only
hackers get hurt. WRONG!! Studies have shown
that 'A' players are injured as frequently as 'D' players, presumably
because court time (exposure) is so much higher in 'A' players.
My own practice has confirmed this ratio.
....Doctors
can fix my eye even if I get hit.WRONG!!
Surgical results in traumatized eyes are usually disappointing,
even in high-powered centers.
....I
know my opponent's game so there is minimal danger. WRONG!!
I, myself, was hit in 1998 by an opponent I have played almost every
week for ten years. Why? Because he was partially injured, I am
not as quick, and I didn't use my own glasses because I had lent
them to one of my children on another court.
My own
opinion is that all junior players should be required to wear eye
protection . Doubles players, players with only one good eye, and
anyone with any history of medical problems or surgical procedures
on the eye should definitely wear eye protection. Everyone else
can make their own choice. But remember - health care reimbursements
to physicians keep going down, and we eye doctors can always use
a little more work --- don't let it be you! WHAT
EYE PROTECTION IS BEST?
Early
studies of eye protection in racquet sports showed that non-hinged
frames and back-supported polycarbonate lenses provided superior
protection in the case of direct (head-on) impact of projectiles
(e.g. squash balls) with the eye.
You can refer to authoritative articles by Dr. Paul Vinger
if you are interested. After those studies, these types of eye-guard
were introduced and helped significantly reduced the incidence of
eye injury among people wearing them.
However
these "first generation" eye-guards didn't completely solve the
problem. It turned out that oblique and glancing trauma led to continued
eye injuries from indirect positions: That is, for example, a crosscourt
from backcourt striking the side of the head These
problems led to the use of curved frames
and lenses which wrap around the face and orbital bones.
To manufacture an optically neutral curved piece of plastic turns
out to be non-trivial, and so up until recently the expense of such
protective devices was considerably higher than it is today. Now
you can get excellent protection in the $30-60$ price range.
So far,
prescription corrections have not been available in the one-piece
wrap-around style.
There
are a variety of single-piece wrap-around clear or semi-clear protective
eyewear styles available today from several different manufacturers.
All are better than nothing. For those individuals with only one
good eye or a history of medical problems or surgical procedures
on either or both eyes, I would recommend
curved wrap-around framed polycarbonate lenses such as
are available from RECSPECS.
Two issues
regarding the use of protective eyewear require further comment:
1)
Many players complain of foggy or sweaty lenses during play.
Foggy lenses occur when the temperature of the lenses is considerably
less than the air temperature, especially when the air is humid.
2)
Proper maintenance of eye protection is under-emphasized.
Not only should one protect the lenses from scratching in-between
play but also regular inspection of the frames and lenses for cracks
and yellowing is a good idea. I have had two patients whose eye
protection has failed because of pre-existent stress fractures induced
by either direct trauma or temperature stress to the frames.
If you keep dropping the frames, are hit by a ball or racquet, and/or
leave your frames in the car in both summer and winter, your protective
eyewear is more likely to fail. Consider replacing every two
years. (If you are like me, the lenses get lost or too scratched
to use long before frames are vulnerable.)
III)
WHAT TO DO IF INJURED:
The sad
truth is that ophthalmologists are not usually on call in the hospital
when you arrive. Reduced health care reimbursements haven't helped
the situation either. Furthermore, more experienced sub-specialty
surgeons are generally less available for emergency problems, and
so (typically) when you arrive at the hospital with an eye injury;
you can expect it will be handled by ER doctors or ophthalmology
residents at best. In the 90's, ER doctors are much better trained
about eye trauma than before, but it is
CRUCIAL to insist on being seen by an ophthalmologist or opthalmology
resident.
Most cities
with squash courts also have hospitals with ophthalmology training
programs so if injured on the court, I would suggest at least the
following:
Hopefully,
you will only need medical therapy and will be treated and told
to see your regular ophthalmologist soon. If you need hospitalization
or surgery, the results will depend mostly on the extent of the
initial injuries and then mostly on the attending surgeon. Don't
worry so much about who is actually operating.
Remember
this above all else - surgical results in traumatized eyes are usually
disappointing to patients and family because nothing is as good
as the normal eye. The best treatment is always prevention.
Baltimore, Maryland vorpal@pol.net [ About the author ] |
....My
opponent would never hit me. WRONG!! I know
of (and you do too) more than three instances of where players tried
to hit their opponent with the ball or racquet, all in major tournaments.
or frames and ricocheting into the eye or eye cavity (orbits).
Therefore,
keeping the lenses in the car in the winter and putting them on
just before play just won't work. Warm up your protective eyewear
in a pocket or sauna (briefly) and keep wearing, including between
games, except for brief interludes to wipe away perspiration. There
are antifogging chemical coatings available, too, but I would go
with temperature control first. Sweaty lenses can be avoided with
headbands or even visors and hats. Better yet - get in shape.
