Wearing visors decreased the number of eye injuries players experienced during the 2010 to 2011 and 2017 to 2018 National Hockey League (NHL) seasons, according to a new study in the Canadian Journal of Ophthalmology.
To combat eye and face injury, the NHL instituted a policy for the 2013 to 2014 season for most rookie players, mandating visors with half-face coverage, the study explains. By the 2014 to 2015 season, 87% of players league-wide opted to use visors. To evaluate the impact of this policy, researchers reviewed all eye and orbital injuries incurred by players between the 2010 to 2011 and 2017 to 2018 seasons, focusing on injuries that were clinically serious enough to cause a player to miss a game.
They found a total of 31 injuries, which caused 233 missed NHL games and $8,951,000 in financial losses. A total of 10 eye injuries in the 2010 to 2011 season, a rate of 0.62 per 1000 athlete exposures, cost the NHL $2,092,000, the report explains. The study noted no clinically significant eye injuries during the 2017 to 2018 season.
Researchers also discovered a strong trend of fewer yearly eye injuries (P =.01) and a moderate trend toward fewer missed games per season (P =.09). This indicated approximately 1 fewer eye injuries and 9 fewer missed games per year.
Taller athletes (76 inches vs 72.83 inches, P =.004) were more likely to incur retinal injuries compared with players with other eye injuries. Players who were taller and heavier (74.7 inches vs 72.7 inches, P =.04; 217 lbs vs 201 lbs, P =.03) were also more likely to require surgery than conservative management.
When researchers compared their findings with baseline data of eye injury rates before the NHL instituted its visor policy, they found a significant reduction in the number of yearly eye injuries, games missed due to injury, and inflation-adjusted financial losses.
The use of visors in the NHL has increased steadily, particularly between 2014 and 2015 and 2017 and 2018, supporting the conclusion that visors prevent eye injuries.
The study also demonstrates that puck injuries are especially high risk, causing more than 3 times more missed games on average than injuries due to hockey stick strikes. However, 1 player out of 11 (9%) did incur a puck-related eye injury while wearing a visor.
“Despite clear improvements, visors did not prevent all eye injuries. Eye injuries did still occur in players wearing visors (8/28; 28.6%), with the majority of these being stick injuries,” the research says. “This is likely because the NHL only mandates half-face coverage with visors, whereas many other leagues require full facial protection.”
The study was limited in that it likely underestimated the eye injury total because scientists only studied injuries significant enough to cause players to miss a game.
Based on their findings, researchers recommend combining campaigns to improve injury awareness and player education with partial mandates to improve safety. They feel this would allow players to make their own decisions while weighing considerations about game performance.
Pradeep T, Arun S, Ravipati A, Poudel B, Aradhya A, Pradeep K. Eye injuries in the National Hockey League from 2010 to 2018: an analysis of injury rates, mechanisms and the National Hockey League visor policy. Can J Ophthalmol. 2021;56(1):17-23.doi:10.1016/j.jcjo.2020.08.003.