Pediatric Ocular Trauma Associated with Sports and Recreational Activities: An 11-Year Retrospective Cohort Study

Purpose To characterize the features of pediatric ocular trauma associated with sports and recreational activities presenting to a Level 1 pediatric trauma center.Methods A retrospective study was conducted using an ocular trauma registry of patients ≤ 18 years presenting to the emergency department between January 1, 2010, and March 10, 2021. Cases were categorized as activity-related or non-activity-related. Activity-related injuries were further grouped into contact sports, non-contact sports, and recreational activities. Demographic, clinical, and treatment variables were analyzed. Continuous variables were compared using t-tests or analysis of variance (ANOVA), and categorical variables using chi-square or exact tests.Results Of 3,965 ocular trauma cases, 278 were activity-related. Patients with activity-related injuries were significantly older (p < 0.0001) and more frequently male (p < 0.0001) than those with non-activity-related injuries, while race distribution was similar (p = 0.155). Basketball (21.6%), biking (12.2%), baseball (11.9%), and football (11.5%) were the most common activities. Recreational activities predominated among children aged 0–6 years, whereas contact sports increased with age (p < 0.0001). Primary diagnoses varied by age (p = 0.006), with adnexal lacerations occurring more frequently in younger children (p = 0.008). Orbital fractures differed by activity type (p < 0.001), occurring predominantly in non-contact, projectile-related activities, and were more common among White than Black children (p = 0.047).Conclusion Activity-related pediatric ocular trauma disproportionately affects older children and males. Injury patterns vary by age and activity type, with high-velocity projectile sports causing a disproportionate number of orbital fractures. These findings support targeted prevention strategies, including age-appropriate education and increased use of protective eyewear.