An eye for an eye – sports injuries and brawls

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Eye chart image courtesy of Community Eye Health, CC https://flic.kr/p/cenNDu

The news photo of rugby league player Dylan Walker’s fractured eye socket made me feel anxious, like I get when I have an eye infection or it’s time for the annual glaucoma test. If I cover my left eye with my hand, I can navigate my way around the house, but that’s about it. No reading, watching TV or movies; definitely no writing, although I know vision-impaired people who have found ways around reading and writing.

What the auld aunties called a ‘gleyed ee’ or lazy eye was diagnosed in the late 1940s. I don’t remember wearing an eye patch when I was two, but I’ve seen the photos. It didn’t work. I say this only as an explanation if you passed me in the street and I did not say hello, it is possible you passed by on my right side.

Yes, so a serious injury to my left eye would probably see me lining up for the blind pension, although as I understand it, the aged pension replaces the (non-means tested) blind pension when the recipient reaches retirement age. An essay for another day, perhaps.

Last week the Australian Institute of Health and Welfare and Flinders University produced a report on eye injuries in Australia. The report shows 51,778 people were hospitalised due to eye injuries in the five-year period, 1 July 2010 to 30 June 2015. Two thirds of these were males. Falls (35%) and assaults (23%) were the most common causes of eye injuries. The most common type of eye injury was an open wound of the eyelid and periocular area (27%).

However, the report also showed that 86,602 people presented to an emergency department with an eye injury in the two-year period, 1 July 2013 to 30 June 2015. Only 1% of these cases (866) were admitted to hospital.

Sports-related eye injuries were seemingly uncommon by comparison, with just 3,291 males and 595 females reporting that the injury was sustained while participating in a sporting activity. However, information on what activity resulted in the injury was not reported for 69% of cases, so this is likely to be an under-estimation.

Of the known causes, more than one-third (37%) of males were participating in a form of football when they sustained an eye injury. Trail or general horseback riding (12%) was the most common sport-related activity resulting in eye injury reported by females. Over half (55%) of the sports-related cases resulted in an orbital bone fracture.

Such was the case during the Melbourne Storm-Manly rugby league game when a melee turned into a serious scrap between Manly’s Dylan Walker and the Storm’s Curtis Scott, with Scott throwing several punches, one of which broke Walker’s eye socket. Scott was sent off – red-carded as they say in soccer. Walker was given 10 minutes in the sin bin (for throwing a punch) and then had to be assessed for a head injury. Manly player Apisai Koroisau was also sent off for 10 minutes for running in and throwing a punch at Scott.

The National Rugby League (NRL) has been cracking down on such behaviour – Scott was the first person to be sent off for punching since 2015. All rugby league players know if they throw a punch they will at least be sent to the sin bin; angry flare-ups in recent years have tended to be of the push and shove variety.

But whether you follow rugby league or not, it was a bad look, for the sport and for all sports. Imagine the conversations over breakfast.

“Right, that’s it,” says Mum, whose son Billy (8) has been pestering her to play footie. “If you want to play sport you have two choices – soccer or table tennis. Those league blokes are thugs.”

Discussing the Manly/Storm fracas on the Sunday Footie Show, former Jillaroo Allana Ferguson commented: “If they did that in King’s Cross on Saturday at midnight and someone was injured they’d be off to jail.”

She makes a valid point.

A study last year by Dr Alan Pierce from La Trobe University found that repeated concussions in rugby league players have a long-term effect. He compared 25 former league players in their 50s with a control group of a similar age. The men carried out cognitive tests to measure memory and attention spans and dexterity tests to assess motor skills.

“What I’ve found is that the responses of retired rugby league players were significantly different to the healthy controls with no history of head injury,” Dr Pierce told the ABC.

The NRL took steps in 2015 to introduce mandatory head injury assessments (HIA), where players who have suffered a head knock have to leave the field for 15 minutes and be assessed by a doctor. If found to be concussed, they are not allowed to return to the field that match. An NRL injury surveillance report by Dr Donna O’Connor found that head injury assessments increased from 210 in 2015 to 276 in 2016, largely due to strengthened concussion guidelines. Sixty-six per cent of these cases were cleared to continue playing in 2016, compared to 54% in 2015.

If you have seen the excellent Will Smith movie Concussion (about brain injuries in American football), you may well ask why it took the NRL so long to act.

Cheek and eye socket fractures are common injuries in rugby league. They come about through (accidental) contact in tackles, as big bodies collide. Sometimes it happens through ‘friendly fire’ collisions with teammates.

Such was the case with Broncos forward Josh McGuire, whose injury in 2011 required surgery and he is now effectively blind in one eye.

Sports Medicine Australia says the incidence of sports-related eye injuries is low, but severity is usually quite high, as injuries to the eye can result in permanent eye damage and loss of eyesight.

“Research has shown that 30% of sports-related eye injuries in children have the potential for permanent loss of eyesight.

“A blow to the eye from sporting equipment, fingers or balls can lead to injuries ranging from lid haemorrhages or lacerations, corneal abrasions, retinal detachments and hyphaema (bleeding inside the eye) to permanent loss.”

Rugby league is rated a ‘moderate’ risk sport (in relation to sustaining eye injuries) compared to high-risk categories including baseball/softball, basketball, cricket and racquet sports. Any sport that involves small projectiles moving at speed is considered high-risk.

Our family GP once told me most serious eye injuries he had encountered were caused by squash balls and champagne corks.

If you lose an eye, the alternatives are an ocular prosthesis (a glass eye) or an eye patch, the latter having a bad press courtesy of movie bad guys. Think John Wayne’s bullying Rooster Cockburn in True Grit, Adolfo Celi’s menacing Emilio Largo in Thunderball, or John Goodman’s itinerant bible salesman Big Dan Teague (O Brother Where Art Thou).

If it came down to it, I’d opt for a good quality prosthesis, although the price (from $2,500), makes a $10 eye patch look like a bargain.

I’d make it a different colour just because I love that line in the Paul Kelly song about falling for a girl with different coloured eyes.

In the meantime, I will keep wearing Australian Standard safety glasses when I mow the lawns or use the brush cutter. You should too.

 

Falls a risk for over-65s

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Elderly couple out for a stroll – falls and the over-65s photo courtesy pixabay.com

You may know this statistic about falls among older people, but it is shocking all the same to learn that 74% of people who were hospitalised after a fall had broken their hips. Head injuries were the next most serious (22%) with limb fractures further down the list.

About a third of all Australians in the 65+ age group will have a fall each year, but most are not serious. About 10% of people in this cohort who suffer a fall end up with a serious injury.

An Australian Institute of Health and Welfare (AIHW) reports states that about 100,000 people aged 65 and over were admitted to hospital after falls in 2012-2013. While that is a few years ago, the statistics are part of a 10-year study done at the time, so are representative. Discuss, as people say when posting something contentious on social media.

The falls could be as relatively minor as the tumble I took down our steep terraced acreage recently, which resulted only in bad language and a few minor scrapes. I few years ago I had a rather more serious fall – a broken rib and a bruised thigh – what rugby league commentators scoffingly dismiss as a ‘cork’. I was carrying two folding chairs in each hand while walking down the stairs. Did I mention it was raining and the soles of my shoes were wet? Duh!

Which brings me to She Who Is Ambidextrous (SWIA), who has taken the lead (2-1) in the Domestic Falls Stakes. Excuse me for making light of a poor but not overly serious situation.

SWIA had what’s known in the medical business as a FOOSH (Fall on Outstretched Hand). She sustained the injury as a result of tripping down some stone steps in the front garden.

As a young friend who rather more seriously injured his arm last year said when hearing this news, “At least it wasn’t a PAFO.”  (let me know if you can’t figure it out..)

Yes, it seems we are now in that age group who are more prone to falls, and, having fallen, are more likely to suffer an injury with a longer and sometimes problematic recovery time. Moreover, the fallout from falls can have psychological ramifications, making people less sure of themselves and reluctant to do ‘normal’ things which might result in falls.

It can happen to anyone, anytime.

The AIHW statistics quoted above include the telling observation that 72% of falls occur in the home or residential aged care facilities.

Stay on your feet – join an exercise class

Several Australian states have started a “Stay on Your Feet” campaign, which makes sense when you consider that in Queensland alone, falls cost the state more than $100 million a year.

Most people aged 60 and older are quite aware of the risk involved in taking a tumble and many attend exercise classes designed to shore up core strength and improve balance. So in many ways SWIA’s fall last week is a bit ironic as she is dutiful about attending exercise classes and daily doing what I never do (a morning stretch routine).

One of my regular readers says the thing he likes about the weekly read is that it so often addresses issues affecting ‘our’ age group (he means the over-60s).

So this is for you, mate. Core strength is the overall fitness and flexibility of the core muscles that help us keep our balance, sit down, stand up, lie down, kneel and squat. If your core strength is suspect (like me, down on one knee to get a dish out of the bottom cupboard), you will be found out using your hand/s for support.

Try these tests (and absolve me of all responsibility if you fall in a heap).

Sit on a hard-backed chair for 10 minutes. Now get up without using your arms for leverage. Do the same thing from a sofa, recliner or armchair.

As Billy Connolly says: “Ye know how auld you are by how long it takes to get out of a beanbag.”

The other trick is to stand on one leg for as long as you are able to hold the position, say 30 seconds (no hand support). Now try the other leg. Notice the difference?

The real test is how successful you are at putting on your underpants while standing.

Some people make provisions as they age by retrofitting their homes in some way, for example putting grab bars in the bathroom and toilet. Some even have ramps built to avoid going up and down steps or stairs. People aged 70 and over who live alone are often encouraged to wear a device which they can use to call for help.

Scientists in Australia, the US, UK and Europe are working to develop devices which can prevent falls by predicting the likelihood of a person having a fall. The University of Missouri is collating data from sensors built in to the walls of homes were aged pensioners live. The university’s researchers found that even small changes can predict if an elderly person is about to suffer a dangerous fall.

The risk quadruples if walking speed slows; for example when walking speed decreases by 5.1cm per second, the person has an 86% chance of toppling within three weeks, compared to just a 20% chance with no change. A drop in stride length of 7.6cm predicted a 51% chance of tripping within three weeks. Scientists elsewhere have developed wearable devices which can measure a person’s gait and ability to perform tasks like sitting down and standing up again. These can also reliably predict the likelihood of a pending fall. Scientists are finding these various devices helpful in predicting falls among people who have an illness which affects gait (Parkinson’s Disease, MS, joint pain (arthritis), spinal cord compression injuries and peripheral neuropathy, often associated with diabetes.

If all else fails, there are a range of alert buttons one can wear and press if in need of help. The help buttons trigger a monitoring station which will investigate and, if necessary, dispatch an ambulance.

The main risk of hurting yourself is if you are elderly and live alone, especially in a big, impersonal city. Chances are you could lie on the floor a long time before anyone discovered what had happened to you. I was reminded about this scenario when watching a new TV reality show, Ambulance, which is an inside look at London’s ambulance service. In the first episode, a man in his 90s has fallen to the floor and can’t get up. It’s been three hours and ambulances keep getting diverted to more urgent situations. To add to his woes, an ambulance is about to pull up at his front door when they get sent to help a woman who says she is having a miscarriage. Turns out to be a serial hoaxer

Good thing we live in a small community, where the first responders attending SWIA were prompt, thorough and cheerful. Medical staff at Maleny Soldiers Memorial Hospital were also very thorough, leaving nothing to chance.

Now you’ll have to excuse me, SWIA needs me to tie her shoelaces, take the lid off the pickle jar, and adjust the recliner… (and explain that the title of this article does not, of course, refer to said SWIA. Ed)

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