Refractive Correction in Athletes: From Spectacles and Contact Lenses to Refractive Surgery - Performance, Safety and Return-to-Sport Implications. A Narrative Review

Background: Vision supports sporting performance, but refractive correction requires consideration of ocular safety. Aim: To review correction methods in athletes in relation to performance, safety and return to sport. Material and methods: This narrative review considered the Scale for the Assessment of Narrative Review Articles (SANRA) criteria. PubMed, ScienceDirect, SpringerLink and the Quality in Sport archive were searched in October 2026 for English- or Polish-language publications from 2005-2026. Twenty-seven publications were synthesised narratively. Results: Contact lenses predominated during sport, while many spectacle wearers participated without correction. Performance effects depended on the task and impairment pattern. Standards-compliant protective eyewear reduced injury frequency and severity. Water exposure during lens wear increased Acanthamoeba keratitis risk; water sports were associated with non-infectious keratitis in orthokeratology users. Refractive surgery yielded favourable visual outcomes, but LASIK flaps remained vulnerable to late trauma. Safe return-to-sport intervals were not established. Conclusions: Correction should reflect age, sporting demands, trauma risk and water exposure. Prescription protective eyewear is recommended in high-risk sports; surface ablation merits consideration when surgery is chosen. Pre-participation ophthalmic assessment, lens hygiene education and research on postoperative return to sport are needed.