Background: Since 1968, when the first commercial squash center has opened in Hamburg, squash has become very popular in Germany. Squash is played between two players in a closed court using racquets and a hollow rubber ball which could reach a maximum speed up to 225 km/h. According observations of English and American ophthalmologists there is an increased risk to get an eye injury in this game. Because of the isolation by the former existing wall, Berlin-West was an ideal place to study the ocular hazards of playing squash.
Methods: In 1991 about 40,000 squash players existed in Berlin-West playing on 118 courts of 13 commercial squash centers. During January to October 1991 case records of all hospitals with an emergency eye ambulance and of the eye residents were investigated, furthermore all patient records of 1989 and 1990 of the eye clinic of the university hospital Rudolf Virchow, department Charlottenburg, were examined retrospectively.
Results: All over 234 sports-related eye injuries were registrated, 78 (33.3%) patients sustained the injury during a squash game, 43 (18.4%) during soccer and 34 (14.5%) during playing tennis. 71 squash players were treated in an hospital ambulance, of these 15 required admission. A total of 206 injuries were sustained by the players. The majority of injuries were superficial, but in 12 cases occured an hyphaema and in 13 an angle recession. In all admitted patients visual recovery was good, during the clinical follow up there were no perimetric, ophthalmoscopic or tonometric impairments. The initial loss of visual acuity of the injured eye compared to the other side was on the average 4.5 lines, at dismissal from the hospital it was on the average 2 lines.
Conclusion: Because of the increased risk to get an eye injury during a game of squash, players should be encouraged to wear proper eye protection i.e. closed eye guards according to standards of North-American testing organisations.