Home Science Medicine Fighting Blindfolded: The 101 on Eye Injuries (Warning: Graphic Content)

Fighting Blindfolded: The 101 on Eye Injuries (Warning: Graphic Content)

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Photo via "Fist of Legend" Movie

There are number of fighters out there who would probably make the statement that they could successfully compete blindfolded, but lack of vision is a serious matter and eye injuries are a common occurrence in combat sports.

Some of these injuries can be prevented or mitigated with proper screening and early diagnosis. Ophthalmologist Dr. Pierre Pang, based out of Honolulu, Hawaii provides SciFighting.com readers with information about injury awareness to keep fighters in the cage.

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Corneal Abrasion

Corneal abrasion is the most common eye injury in most combat sports. It occurs because of a disruption in the integrity of the corneal epithelium or because the corneal surface is abraded.

Corneal abrasions usually heal rapidly, without causing any serious or long-term damage. However, deep corneal involvement may result in scaring on the eye and the injury itself can be extremely painful.

“They say it is worse than a kidney stone,” says Dr. Pang. “It’s a sharp, painful like a knife going into your eye, but it is really pretty minor unless it gets infected. The recovery is about 3-4 days usually.”

Some examples of how corneal abrasions occur in combat sports may involve, but are not limited to the following:

  • Receiving a punch to the eye
  • Having part of a marital arts gi drug across the eye
  • A finger poke to the eye
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Georges St. Pierre receives an eye poke from Jake Shields at UFC 129

The likelihood of sustaining an abrasion increases in each of these situations if the eye is open.

Orbital Blow-Out

An orbital “blow-out” fracture consists of a fracture of the bones of the eye “socket.” This is most commonly caused by blunt trauma of the head such as a punch, kick or knee and more likely than not will be grounds for immediate stoppage to a fight.

This type of injury may involve a number of bones along the orbital floor, roof or wall though the floor is most common.

  • Restricted vertical movement of the eye
  • Subconjunctival hemorrhage
  • Swollen eyelid
  • Loss of sensation over upper cheek area around the eye socket
  • Double vision

The bony orbits play very important role in establishing eye aesthetics and proper function of the eye. Depending on the degree of damage reconstruction may be crucial.

“The recovery time for an orbital blow is six months to a year. If you have a small fracture it may heal itself. If it is a large fracture where the globe starts dropping or is recessed from the orbit then you make need surgery,” said Dr. Pang. “I’m sure there are people with corneal abrasion that don’t stop the fight. It is hard to diagnose eye injuries during the fight. Sometimes you can diagnose an orbital fracture. Actually I have done that twice. One time I could tell because hit in the eye and the eye sunk back.”

Former UFC Welterweight Joe Riggs sustained a orbital fracture prior to his scheduled bout in September of last on the Bellator reality series “Fight Master.” The injury came in the form of a head kick issued by Riggs’ sparing partner, which was hard enough to damage even through headgear.

Retinal Detachment

Retinal detachment is a serious eye condition that happens when the retina separates from the tissue around it. The retina is a light-sensitive layer of tissue, lining the inner surface of the eye. This condition could cause permanent loss of vision if not repaired quickly.

“A retinal detachment occurs when the lining of the eye comes off. You can think of the retina like an egg. You have an egg and you take the egg out, the whites and the yolk and then there is the very lining of the eggshell. The retina is thin like the lining in the eye and is responsible for vision.

If that thin layer develops a tear in it, the whole retina can come off and you can go blind. If you have a tear in the retina it can be treated with a laser or freezing of the tear and it will scar down. If you have an undiagnosed tear or hole in the retina fluid can go underneath it and cause it to detach.”

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A retinal tear can be detected with proper diagnostics preventing escalation to detachment.

Retinal tears are not the same as detachment, though they can be a precursor. If fluid from within the eye passes through a retinal tear in can cause the separation of the retina from its underlying tissue resulting in detachment.

“This is why all fighters should have retinal exams to make sure they don’t have any retinal tears or holes. If you don’t look for it you don’t find it. It is probably one of the most devastating eye injuries and it is preventable with early diagnosis.

It more likely to detach a second time than it is for someone who has never had a detached retina, but usually when you do the repair it scars up pretty well. You are at a higher risk of another detachment if you get hit again in that same eye.”

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Micheal Bisping is still recovering from retinal surgery

UFC Fighter Michael Bisping suffered a detached retina late last year causing the cancellation of his UFC Fight Night 30 bout against Mark Munoz and nearly the cancellation of his career. This was his second time sustaining this same injury.

After being rushed to the hospital with an eye filled with blood, he emerged two surgeries later with the news that so much scar tissue had built up that part of his retina had to be cut away. This will certainly extend Bisping’s recovery time, but doctors seemed hopeful that it will go well.

Ruptured Globe

A less common injury is a ruptured globe, which is defined as a traumatic breakdown in the integrity of the wall of the eye.

“This would occur if someone got hit in the eye so hard that the globe actually perforates. Opens up and the contents of the eye come out,” said Dr. Pang. “That is an emergency. The globe has to be closed and the injury repaired in order to save the eye. That is a very horrible thing to have happen. That can happen with a fist to the eye or a knee to the eye. It is like hitting a grape and squishing it.”

Lid laceration

“The only reason to stop a fight because of eye injuries would be a big laceration causing bleeding to the eye, when the fighter states he can’t see anymore, or if there is an orbital fracture,” said Dr. Pang, who has been an official doctor for many MMA events on the island of Oahu.

The skin of the eyelid is thin and can be torn fairly easily. Such tears are often horizontal and can either expose the eye through the tear or cause severe bleeding. Either way, this would be grounds to stop a fight.

UFC Welterweight fighters Diego Sanchez and Martin Kampmann have both sustained fairly sever lid lacerations in their careers.

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Martin Kampmann sustains laceration over eyelid

Prevalence of Injury

Over the last year discussion has escalated in the MMA world regarding the possibility of altering the shape of the gloves used in order to reduce eye-poking injuries. No changes have come to fruition, but eye-pokes continue to be the cause of frequent damage.

Boxers don’t have the issue of exposed finger like MMA, but the risks of eye damage are certainly not less.

Sugar_Ray_Leonard
Boxing Champion Sugar Ray Leonard still shows signs from previous eye injury

“I can say which sport would have more eye injuries, but in boxing you are almost always aiming to the face, so all boxers have to have retinal exams,” said Dr. Pang. “Sugar Ray Leonard had a detached retina. That’s why his left eye is kind of sunken in. That is because of the buckle effect. In MMA you have alternatives, but in boxing you are usually going for the knockout, so I would speculate that there would be more eye injuries in boxing.”

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When asked if there were any protective measures that could be taken to reduce eye injuries Dr. Pang stated that the best advice he could give is “Don’t get hit.”