Skip to main content
SpringerLink
Log in

Ocular Problems in Extreme Sports

High-Altitude Trekking and Surfing

  • Chapter
  • First Online:
Extreme Sports Medicine

  • 2905 Accesses

Abstract

The prevalence of severe ocular problems due to extreme sports is empirically rare. Nevertheless, since normal visual acuity can be crucial in extreme situations, the knowledge of etiology and prevention of ocular problems in extreme sports is a helpful asset to the athlete. Ocular pathologies under these circumstances are mainly caused by three different pathogenic mechanisms, which can induce both acute and chronic damage to the eye:

  • Hypoxia

  • Irradiation

  • Trauma

The authors have chosen two representative types of sports to examine, namely, high-altitude trekking and surfing, during which the above-mentioned pathogenic mechanisms can occur.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Houston CS. High altitude illness: disease with protean manifestations. JAMA. 1976;236(19):2193–5.

    Article  CAS  PubMed  Google Scholar 

  2. Meehan RT, Zavala DC. The pathophysiology of acute high-altitude illness. Am J Med. 1982;73(3):395–403.

    Article  CAS  PubMed  Google Scholar 

  3. Hackett PH, Roach RC. High-altitude illness. N Engl J Med. 2001;345(2):107–14.

    Article  CAS  PubMed  Google Scholar 

  4. Schneider M, Bernasch D, Weymann J, Holle R, Bartsch P. Acute mountain sickness: influence of susceptibility, preexposure, and ascent rate. Med Sci Sports Exerc. 2002;34(12):1886–91.

    Article  PubMed  Google Scholar 

  5. Turk AJ, Maggiorini M, Hess T, Merz T, Bosch MM, Barthelmes D, Hefti U, Pichler J, Senn O, Schoch OD. Effect of ascent protocol on acute mountain sickness and success at Muztagh Ata, 7546m. Bloch KE1. High Alt Med Biol. 2009. Hypoxia. 10(1):25–32.

    Google Scholar 

  6. Bosch MM, Barthelmes D, Merz TM, Knecht PB, Truffer F, Bloch KE, et al. New insights into changes in corneal thickness in healthy mountaineers during a very-high-altitude climb to Mount Muztagh Ata. Arch Ophthalmol. 2010;128(2):184–9.

    Article  PubMed  Google Scholar 

  7. Flynn WJ, Miller 2nd RE, Tredici TJ, Block MG. Soft contact lens wear at altitude: effects of hypoxia. Aviat Space Environ Med. 1988;59(1):44–8.

    CAS  PubMed  Google Scholar 

  8. Bosch MM, Barthelmes D, Merz TM, Truffer F, Knecht PB, Petrig B, et al. Intraocular pressure during a very high altitude climb. Invest Ophthalmol Vis Sci. 2010;51(3):1609–13.

    Article  PubMed  Google Scholar 

  9. Mader TH, Blanton CL, Gilbert BN, Kubis KC, Schallhorn SC, White LJ, et al. Refractive changes during 72-hour exposure to high altitude after refractive surgery. Ophthalmology. 1996;103(8):1188–95.

    Article  CAS  PubMed  Google Scholar 

  10. White LJ, Mader TH. Refractive changes with increasing altitude after radial keratotomy. Am J Ophthalmol. 1993;115(6):821–3.

    Article  CAS  PubMed  Google Scholar 

  11. Boes DA, Omura AK, Hennessy MJ. Effect of high-altitude exposure on myopic laser in situ keratomileusis. J Cataract Refract Surg. 2001;27(12):1937–41.

    Article  CAS  PubMed  Google Scholar 

  12. Nelson ML, Brady S, Mader TH, White LJ, Parmley VC, Winkle RK. Refractive changes caused by hypoxia after laser in situ keratomileusis surgery. Ophthalmology. 2001;108(3):542–4.

    Article  CAS  PubMed  Google Scholar 

  13. Hackett PH, Rennie D. Rales, peripheral edema, retinal hemorrhage and acute mountain sickness. Am J Med. 1979;67(2):214–8.

    Article  CAS  PubMed  Google Scholar 

  14. Honigman B, Noordewier E, Kleinman D, Yaron M. High altitude retinal hemorrhages in a Colorado skier. High Alt Med Biol. 2001;2(4):539–44.

    Article  CAS  PubMed  Google Scholar 

  15. Wiedman M. High altitude retinal hemorrhage. Arch Ophthalmol. 1975;93(6):401–3.

    Article  CAS  PubMed  Google Scholar 

  16. Barthelmes D, Bosch MM, Merz TM, Petrig BL, Truffer F, Bloch KE, et al. Delayed appearance of high altitude retinal hemorrhages. PLoS One. 2011;6(2):e11532.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. McFadden DM, Houston CS, Sutton JR, Powles AC, Gray GW, Roberts RS. High altitude retinopathy. JAMA. 1981;245(6):581–6.

    Article  CAS  PubMed  Google Scholar 

  18. Brinchmann-Hansen O, Myhre K, Sandvik L. Retinal vessel responses to exercise and hypoxia before and after high altitude acclimatisation. Eye. 1989;3(Pt 6):768–76.

    Article  PubMed  Google Scholar 

  19. Arora R, Jha KN, Sathian B. Retinal changes in various altitude illnesses. Singapore Med J. 2011;52(9):685–8.

    CAS  PubMed  Google Scholar 

  20. Willmann G, Fischer MD, Schatz A, Schommer K, Messias A, Zrenner E, et al. Quantification of optic disc edema during exposure to high altitude shows no correlation to acute mountain sickness. PLoS One. 2011;6(11):27022.

    Article  Google Scholar 

  21. Frayser R, Houston CS, Bryan AC, Rennie ID, Gray G. Retinal hemorrhage at high altitude. N Engl J Med. 1970;282(21):1183–4.

    Article  CAS  PubMed  Google Scholar 

  22. Rennie D, Morrissey J. Retinal changes in Himalayan climbers. Arch Ophthalmol. 1975;93(6):395–400.

    Article  CAS  PubMed  Google Scholar 

  23. Shults WT, Swan KC. High altitude retinopathy in mountain climbers. Arch Ophthalmol. 1975;93(6):404–8.

    Article  CAS  PubMed  Google Scholar 

  24. Butler FK, Harris Jr DJ, Reynolds RD. Altitude retinopathy on Mount Everest, 1989. Ophthalmology. 1992;99(5):739–46.

    Article  CAS  PubMed  Google Scholar 

  25. Duane TD, Osher RH, Green WR. White centered hemorrhages: their significance. Ophthalmology. 1980;87(1):66–9.

    Article  CAS  PubMed  Google Scholar 

  26. Roth M. Über Netzhautaffectionen bei Wundfiebern. I. Die embolische Panophthalmitis. Deutsche Zeitschrift für Chirurgie. 1872;1:471–84.

    Article  Google Scholar 

  27. Rodriguez-Adrian LJ, King RT, Tamayo-Derat LG, Miller JW, Garcia CA, Rex JH. Retinal lesions as clues to disseminated bacterial and candidal infections: frequency, natural history, and etiology. Medicine (Baltimore). 2003;82(3):187–202.

    Google Scholar 

  28. Wechsler DZ, Tay TS, McKay DL. Life-threatening haematological disorders presenting with ophthalmic manifestations. Clin Experiment Ophthalmol. 2004;32(5):547–50.

    Article  PubMed  Google Scholar 

  29. Bosch MM, Barthelmes D, Landau K. High altitude retinal hemorrhages–an update. High Alt Med Biol. 2012;13(4):240–4.

    Article  PubMed  Google Scholar 

  30. Bosch MM, Barthelmes D, Merz T, Bloch KE, Turk AJ, Hefti U, et al. High incidence of optic disc swelling at very high altitudes. Arch Ophthalmol. 2008;126(5):1–7.

    Article  Google Scholar 

  31. Blumthaler M, Ambach W, Daxecker F. On the threshold radiant exposure for keratitis solaris. Invest Ophthalmol Vis Sci. 1987;28(10):1713–6.

    CAS  PubMed  Google Scholar 

  32. Schein OD. Phototoxicity and the cornea. J Natl Med Assoc. 1992;84(7):579–83.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Fraunfelder FT, Hanna C. Spherodial degeneration of cornea and conjunctiva. 3. Incidences, classification, and etiology. Am J Ophthalmol. 1973;76(1):41–50.

    Article  CAS  PubMed  Google Scholar 

  34. Mendez-Villanueva A, Bishop D. Physiological aspects of surfboard riding performance. Sports Med. 2005;35(1):55–70.

    Article  PubMed  Google Scholar 

  35. Taylor KS, Zoltan TB, Achar SA. Medical illnesses and injuries encountered during surfing. Curr Sports Med Rep. 2006;5(5):262–7.

    Article  PubMed  Google Scholar 

  36. Lowdon BJ, Pateman NA, Pitman AJ. Surfboard-riding injuries. Med J Aust. 1983;2(12):613–6.

    CAS  PubMed  Google Scholar 

  37. Nathanson A, Haynes P, Galanis D. Surfing injuries. Am J Emerg Med. 2002;20(3):155–60.

    Article  PubMed  Google Scholar 

  38. Moran K, Webber J. Leisure-related injuries at the beach: an analysis of lifeguard incident report forms in New Zealand, 2007–12. Int J Inj Contr Saf Promot. 2014;21(1):68–74.

    Article  PubMed  Google Scholar 

  39. Renneker M. Medical aspects of surfing. Phys Sportsmed. 1987;15(12):96–105.

    Article  Google Scholar 

  40. Schein OD, Hibberd PL, Shingleton BJ, Kunzweiler T, Frambach DA, Seddon JM, et al. The spectrum and burden of ocular injury. Ophthalmology. 1988;95(3):300–5.

    Article  CAS  PubMed  Google Scholar 

  41. Hall G, Benger RS. Missed diagnosis of an intraorbital foreign body of surfboard origin. Ophthal Plast Reconstr Surg. 2004;20(3):250–2.

    Article  PubMed  Google Scholar 

  42. Nathanson A, Bird S, Dao L, Tam-Sing K. Competitive surfing injuries: a prospective study of surfing-related injuries among contest surfers. Am J Sports Med. 2007;35(1):113–7.

    Article  PubMed  Google Scholar 

  43. Taylor DM, Bennett D, Carter M, Garewal D, Finch CF. Acute injury and chronic disability resulting from surfboard riding. J Sci Med Sport. 2004;7(4):429–37.

    Article  PubMed  Google Scholar 

  44. Grenfell RD. Beach-related injuries. Med J Aust. 1997;166(7):390.

    CAS  PubMed  Google Scholar 

  45. Zoumalan CI, Blumenkranz MS, McCulley TJ, Moshfeghi DM. Severe surfing-related ocular injuries: the Stanford Northern Californian experience. Br J Sports Med. 2008;42(10):855–7.

    Article  CAS  PubMed  Google Scholar 

  46. Kim JW, McDonald HR, Rubsamen PE, Luttrull JK, Drouilhet JH, Frambach DA, et al. Surfing-related ocular injuries. Retina. 1998;18(5):424–9.

    Article  CAS  PubMed  Google Scholar 

  47. Fountain TR, Albert DM. The histopathology of sports-related ocular trauma, 1980–1986. Int Ophthalmol Clin. 1988;28(3):206–10.

    Article  CAS  PubMed  Google Scholar 

  48. Squire T, Sherlock M, Wilson P, Tan B, Hope N, Anderson SE. Surfinoma: a case report on a pseudotumor developing after a surfing sports injury. Skeletal Radiol. 2010;39(12):1239–43.

    Article  PubMed  Google Scholar 

  49. Angeras MH, Brandberg A, Falk A, Seeman T. Comparison between sterile saline and tap water for the cleaning of acute traumatic soft tissue wounds. Eur J Surg. 1992;158(6–7):347–50.

    CAS  PubMed  Google Scholar 

  50. Erickson JG, von Gemmingen GR. Surfer’s nodules and other complications of surfboarding. JAMA. 1967;201(2):134–6.

    Article  CAS  PubMed  Google Scholar 

  51. Bailey Jr JP, Stevens SJ, Bell WM, Mealing Jr HG, Loebl DH, Cook EH. Mycobacterium marinum infection. A fishy story. JAMA. 1982;247(9):13–4.

    Article  Google Scholar 

  52. Bailey PM, Little M, Jelinek GA, Wilce JA. Jellyfish envenoming syndromes: unknown toxic mechanisms and unproven therapies. Med J Aust. 2003;178(1):34–7.

    PubMed  Google Scholar 

  53. McDonald TD. Perceptions of surfboard riders regarding the need for protective headgear. Wilderness Environ Med. 2005;16(2):75–80.

    Article  Google Scholar 

  54. Starr K, Geoff B, Renneker M. Sick surfers ask the surf docs and Dr Geoff. Palo Alto: Bull Publishing Co; 1993.

    Google Scholar 

  55. Yam JC, Kwok AK. Ultraviolet light and ocular diseases. Int Ophthalmol. 2014;34(2):383–400.

    Article  PubMed  Google Scholar 

  56. Moran DJ, Hollows FC. Pterygium and ultraviolet radiation: a positive correlation. Br J Ophthalmol. 1984;68(5):343–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. Kheirkhah A, Safi H, Molaei S, Nazari R, Behrouz MJ, Raju VK. Effects of pterygium surgery on front and back corneal astigmatism. Can J Ophtalmol. 2012;47(5):423–8.

    Article  Google Scholar 

  58. Taylor HR. Aetiology of climatic droplet keratopathy and pterygium. Br J Ophthalmol. 1980;64(3):154–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Lee GA, Williams G, Hirst LW, Green AC. Risk factors in the development of ocular surface epithelial dysplasia. Ophthalmology. 1994;101(2):360–4.

    Article  CAS  PubMed  Google Scholar 

  60. Sun EC, Fears TR, Goedert JJ. Epidemiology of squamous cell conjunctival cancer. Cancer Epidemiol Biomark Prev Publ Am Assoc Can Res Am Soc Prev Oncol. 1997;6(2):73–7.

    CAS  Google Scholar 

  61. Younan N, McClellan K. Squamous cell carcinoma with necrotizing scleritis. Aust N Z J Ophthalmol. 1999;27(2):149–51.

    Article  CAS  PubMed  Google Scholar 

  62. Grimm C, Wenzel A, Hafezi F, Yu S, Redmond TM, Reme CE. Protection of Rpe65- deficient mice identifies rhodopsin as a mediator of light-induced retinal degeneration. Nat Genet. 2000;25(1):63–6.

    Article  CAS  PubMed  Google Scholar 

  63. Taylor HR, Munoz B, West S, Bressler NM, Bressler SB, Rosenthal FS. Visible light and risk of age-related macular degeneration. Trans Am Ophthalmol Soc. 1990;88:163–73; discussion: 73–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Grimm C, Wenzel A, Williams T, Rol P, Hafezi F, Reme C. Rhodopsin-mediated blue light damage to the rat retina: effect of photoreversal of bleaching. Invest Ophthalmol Vis Sci. 2001;42(2):497–505.

    CAS  PubMed  Google Scholar 

  65. Nilsson SE, Sundelin SP, Wihlmark U, Brunk UT. Aging of cultured retinal pigment epithelial cells: oxidative reactions, lipofuscin formation and blue light damage. Doc Ophthalmol. 2003;106(1):13–6.

    Article  PubMed  Google Scholar 

  66. Maeyens E, Jr. Aquatic skin disorders. In: Wilderness medicine. Mosby: Philadelphia; 2011. p. 82.

    Google Scholar 

  67. Tlougan BE, Podjasek JO, Adams BB. Aquatic sports dermatoses: part 3. On the water. Int J Dermatol. 2010;49(10):1111–20.

    Article  PubMed  Google Scholar 

  68. Bischof RO. Surf rider’s dermatitis. Contact Dermatitis. 1995;32(4):247.

    Article  CAS  PubMed  Google Scholar 

  69. Dart JK, Saw VP, Kilvington S. Acanthamoeba keratitis: diagnosis and treatment update 2009. Am J Ophthalmol. 2009;148(4):487–99.

    Article  PubMed  Google Scholar 

  70. Radford CF, Minassian DC, Dart JK. Acanthamoeba keratitis in England and Wales: incidence, outcome, and risk factors. Br J Ophthalmol. 2002;86(5):536–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Bos HJ, Volker-Dieben HJ, Kok-van Alphen CC. A case of Acanthamoeba keratitis in the Netherlands. Trans R Soc Trop Med Hyg. 1981;75(1):86–91.

    Article  CAS  PubMed  Google Scholar 

  72. Allen RH, Eiseman B, Straehley CJ, Orloff BG. Surfing injuries At waikiki. JAMA. 1977;237(7):668–70.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Zurich, Vista Diagnostics, Limmatquai 4, Zurich, 8001, Switzerland

    Martina M. Bosch

  2. Department of Ophthalmology, University of Zurich, Zurich, Switzerland

    Pascal B. Knecht

  3. Augenpraxis Centerpassage, Wettingen, Switzerland

    Pascal B. Knecht

  4. Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, NSW, Australia

    Stephanie Watson

Authors
  1. Martina M. Bosch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pascal B. Knecht
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephanie Watson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martina M. Bosch .

Editor information

Editors and Affiliations

  1. Local Health Trust of Romagna Department of Diagnostic Imaging, S. Maria delle Croci Hospital, Ravenna, Italy

    Francesco Feletti

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Bosch, M.M., Knecht, P.B., Watson, S. (2017). Ocular Problems in Extreme Sports. In: Feletti, F. (eds) Extreme Sports Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-28265-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-28265-7_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28263-3

  • Online ISBN: 978-3-319-28265-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation