Finite Element Analysis of Ocular Impact Forces and Potential Complications in Pickleball-Related Eye Injuries.

Pickleball, the fastest-growing sport in the United States, has seen a rapid increase in participation across all age groups, particularly among older adults. However, the sport introduces specific risks for ocular injuries due to the unique dynamics of gameplay and the physical properties of the pickleball. This study aims to explore the mechanisms of pickleball-related eye injuries, utilizing finite element modeling (FEM) to simulate ocular trauma and better understand injury mechanisms. A multi-modal approach was employed to investigate pickleball-related ocular injuries. Finite element modeling (FEM) was used to simulate blunt trauma to the eye caused by a pickleball. The FEM incorporated detailed anatomical models of the periorbital structures, cornea, sclera, and vitreous body, using hyperelastic material properties derived from experimental data. The simulations evaluated various impact scenarios, including changes in ball velocity, angle of impact, and material stiffness, to determine the stress distribution, peak strain, and deformation in ocular structures. The FEM outputs were correlated with clinical findings to validate the injury mechanisms. The FE analysis revealed that the rigid, hard-plastic construction of a pickleball results in concentrated stress and strain transfer to ocular structures upon impact. At velocities exceeding 30 mph, simulations showed significant corneal deformation, with peak stresses localized at the limbus and anterior sclera. Moreover, our results show a significant stress applied to lens zonules (as high as 0.35 MPa), leading to potential lens dislocation. Posterior segment deformation was also observed, with high strain levels in the retina and vitreous, consistent with clinical observations of retinal tears and vitreous hemorrhage. Validation against reported injuries confirmed the model's accuracy in predicting both mild injuries (e.g., corneal abrasions) and severe outcomes (e.g., hyphema, globe rupture). Finite element analysis provides critical insights into the biomechanical mechanisms underlying pickleball-related ocular injuries. The findings underscore the need for preventive measures, particularly among older adults, who exhibit age-related vulnerabilities. Education on the importance of wearing protective eyewear and optimizing game rules to minimize high-risk scenarios, such as close-range volleys, is essential. Further refinement of the FEM, including parametric studies and integration of protective eyewear, can guide the development of safety standards and reduce the socio-economic burden of these injuries.