ONLINE EXCLUSIVE
November 2025
by Liz Hillman
Editorial Co-Director
Pickleball is the fastest-growing sport among U.S. adults, with 19.8 million Americans participating. Engagement in this paddleball sport that’s a cross between tennis, badminton, and ping-pong has increased 45.8% since 2024 and by 311% since 2022, according to the Sports & Fitness Industry Association.1
This increase in activity has also resulted in a rise in pickleball-associated ocular injuries. According to a recent cross-sectional study published in JAMA Ophthalmology, drawing data from the National Electronic Injury Surveillance System between 2005 and 2024, ocular injuries related to the sport increased by about 405 injuries per year between 2021 and 2024.2
Jonathan Tsui, MD, the study’s corresponding author, said he became interested in the topic when an OR nurse he knew experienced one such injury. “I had only played a few times, but after seeing his injury and how popular pickleball had become, I became interested in studying the national incidence of these injuries,” Dr. Tsui wrote in an email to EyeWorld.
During the whole study period (2005–2024), there were 3,112 pickleball-related ocular injuries; 1,262 of these occurred in 2024 alone. The authors wrote that these injuries occurred more frequently in patients who were 50 years and older. Some of the more severe injuries were retinal detachment, orbital fracture, globe trauma, and hyphema after being hit by a pickleball or paddle or falling while playing.
“Many patients in the study were found to have injuries associated with falls, so although some consults from pickleball may not seem related, a comprehensive exam including dilated fundus exam is worthwhile for all patients,” Dr. Tsui said. “In the study, injuries ranged from lid lacerations to retinal detachments, highlighting both superficial and posterior effects of ocular trauma.”
While eye protection is not required for pickleball, even among professional players, the study’s authors advocated for providers and the sport regulatory bodies to consider eye protection guidelines. Dr. Tsui said that the data didn’t explicitly note that patients were not wearing protective eyewear, but most narratives support that there was no eye protection, and those that mentioned glasses described injuries from the glasses themselves.
“The AAO has published several recommendations regarding standardized testing material thresholds, but it’s important for major pickleball organizations, like USA Pickleball, to campaign for better eye protection for the long-term safety of all players,” Dr. Tsui said. “As pickleball increases in popularity, we should remind our patients and their families that while eye protection might seem cumbersome, proper use may mean the difference between losing or saving vision.”
About the physician
Jonathan Tsui, MD
Clinical Assistant Professor
Rutgers RWJ Barnabas Jersey City Medical Center
Director, Vitreoretinal Surgery
U.S. Dept. of Veterans Affairs
New Jersey Medical Center
East Orange, New Jersey
References
- Sports & Fitness Industry Association. SFIA’s topline participation report shows 247.1 million Americans were active in 2024. https://sfia.org/resources/sfias-topline-participation-report-shows-247-1-million-americans-were-active-in-2024/. Accessed October 22, 2025.
- Lacher CR, et al. Pickleball-related ocular injuries among patients presenting to emergency room departments. JAMA Ophthalmol. 2025. Online ahead of print.
Relevant disclosures
Tsui: None
Contact
Tsui: jctsui7@gmail.com
