Prevalence, Patterns, and Characteristics of Eye Injuries in Professional Mixed Martial Arts

Michael J Fliotsos,1 Donovan Stephen Reed,2 Gregory Giles,3 Adam HH Altman,2 Joseph A Santamaria,2 Sidra Zafar,1 Darrel K Carlton,3 Anthony J Johnson,3 Brett W Davies,2 Gary L Legault,3,4 Fasika A Woreta,1 Grant A Justin3,4 1Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Department of Ophthalmology, Wilford Hall Eye Center, San Antonio, TX, USA; 3Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA; 4Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USACorrespondence: Michael J FliotsosWilmer Eye Institute, The Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USATel +1-260-409-7314Email michael.fliotsos@yale.eduPurpose: To describe the frequency and type of eye injuries in fighters in mixed martial arts (MMA) competition.Methods: Fight result data were collected from the Nevada Athletic Commission database from 2001 to 2020. Any fighters in a professional mixed martial arts (MMA) contest with an eye injury were included. Main outcome measures included frequency and rate of eye injuries per fight and the types of eye injuries. Secondary outcome measures were gender, laterality, decision type, and length of no-contact recommended.Results: Of the 256 MMA events in the database, 187 events (73.3%) had at least one eye injury. Of a total 2208 fights at these events, there were 363 fighters who sustained 369 eye injuries, with the yearly rate of eye injuries per 100 fighters ranging from 2.56 to 12.22. The most common injuries were eyebrow and eyelid lacerations (n=160, 43%), lacerations around the eye (n=98, 27%), and orbital fractures (n=62, 17%). Most eye injuries were right sided (n=197, 53.3%) and the majority of fighters with eye injuries lost their match (n=228, 62.8%). Fifty-seven fighters were recommended for further ophthalmology clearance after the match. The most common reasons for recommended ophthalmology follow-up was orbital fracture (n=25, 44%) and retinal injury (n=7, 12%). Forty-three fighters received no-contact requirements relating to their injury for an average of 8.9 weeks (range 1– 24 weeks).Conclusion: Ophthalmic injuries in professional MMA were prevalent, were most often lacerations surrounding the eye, and often accompanied the fighter losing their match.Keywords: ophthalmic trauma, eye trauma, mixed martial arts, boxing, MMA, combat sport