ARTICLE
Effectiveness of Protective Eyewear in Reducing Eye
Injuries Among High School Field Hockey Players
AUTHORS: Peter K. Kriz, MD,a R. Dawn Comstock, PhD,b,c,d
R. David Zurakowski, PhD,e Jon L. Almquist, VATL, ATC,f
Christy L. Collins, MA,b and Pierre A. d’Hemecourt, MDg
aDivision of Sports Medicine, Department of Orthopedics, Warren
Alpert Medical School, Brown University, Injury Prevention Center,
Rhode Island Hospital/Hasbro Children’s Hospital, Providence,
Rhode Island; bCenter for Injury Research and Policy, The
Research Institute at Nationwide Children’s Hospital, Columbus,
Ohio; cDepartment of Pediatrics, College of Medicine, and
dDivision of Epidemiology, College of Public Health, Ohio State
University, Columbus, Ohio; eDepartment of Anesthesia, and
gDivision of Sports Medicine, Boston Children’s Hospital, Harvard
Medical School, Boston, Massachusetts; and fFairfax County
Public Schools, Falls Church, Virginia
WHAT’S KNOWN ON THIS SUBJECT: Data from several states that
have implemented protective eyewear mandates at the scholastic
level have shown a substantial reduction in eye injuries. However,
there are no studies that critically evaluate the effectiveness of
protective eyewear in girls’ field hockey.
WHAT THIS STUDY ADDS: Data collected from regional/national
high school sports injury surveillance databases by certified
athletic trainers has resulted in the largest prospective national
study examining the effectiveness of mandated protective
eyewear in reducing head, eye/orbital, concussive, and facial
injuries performed to date.
KEY WORDS
girls’ field hockey, eye injuries, protective eyewear, injury
prevention, injury surveillance
ABBREVIATIONS
AE—athletic exposure
AT—certified athletic trainer
CI—confidence interval
HS—high school
IRR—incidence rate ratio
MPE—mandated protective eyewear
abstract
OBJECTIVE: To determine if injury rates differ among high school field
hockey players in states that mandated protective eyewear (MPE) versus states with no protective eyewear mandate (no MPE).
Dr Kriz conceptualized and designed the study, collected and
analyzed data from the 2 databases, drafted the initial
manuscript, and approved the final manuscript as submitted; Dr
Comstock designed the data collection instruments, coordinated
and supervised data collection at one of the 2 sites, assisted
with study design, reviewed and revised the manuscript, and
approved the final manuscript as submitted; Dr Zurakowski
carried out the statistical analyses, contributed tables and
figures, reviewed and revised the manuscript, and approved the
final manuscript as submitted; J. Almquist and C. Collins
designed the data collection instruments, coordinated and
supervised data collection at one of the 2 sites, and approved
the final manuscript as submitted; and Dr d’Hemecourt assisted
with study design, reviewed and revised the manuscript, and
approved the final manuscript as submitted.
www.pediatrics.org/cgi/doi/10.1542/peds.2012-1492
doi:10.1542/peds.2012-1492
Accepted for publication Jul 24, 2012
(Continued on last page)
METHODS: We analyzed field hockey exposure and injury data collected
over the 2009–2010 and 2010–2011 scholastic seasons from national
and regional databases.
RESULTS: Incidence of all head and face injuries (including eye injuries,
concussion) was significantly higher in no-MPE states compared with
MPE states, 0.69 vs 0.47 injuries per 1000 athletic exposures (incidence
rate ratio [IRR] 1.47; 95% confidence interval [CI]: 1.04–2.15, P = .048).
Players in the no-MPE group had a 5.33-fold higher risk of eye injury
than players in the MPE group (IRR 5.33; 95% CI: 0.71–39.25, P = .104).
There was no significant difference in concussion rates for the 2
groups (IRR 1.04; 95% CI: 0.63–1.75, P = .857). A larger percentage
of injuries sustained by athletes in the no-MPE group required .10
days to return to activity (32%) compared with athletes in the MPE
group (17%), but this difference did not reach statistical significance
(P = .060).
CONCLUSIONS: Among high school field hockey players, playing in a noMPE state results in a statistically significant higher incidence of head
and face injuries versus playing in an MPE state. Concussion rates
among players in MPE and no-MPE states were similar, indicating that
addition of protective eyewear did not result in more player-player contact injuries, challenging a perception in contact/collision sports that
increased protective equipment yields increased injury rates. Pediatrics
2012;130:1069–1075
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1069
Field hockey is among the most frequently played team sports in the world,
second only to soccer.1 Epidemiological
studies demonstrate that field hockey
injuries are numerous and can be serious1–3; in a recent National Collegiate
Athletic Association study, 25% of field
hockey game injuries involved the
head and neck.3 Most serious injuries
result from being struck by the stick
or ball.1–3 Although eye injuries are
infrequent, they tend to be severe
and, on occasion, catastrophic.4 One
in 25 field hockey players reportedly
will experience an eye injury over an
8-year career.5
Over the past 2 decades, several
changes to equipment, playing surfaces, and styles of play have potentially
increased the risk and magnitude of
field hockey injuries: (1) advances in
stick construction have allowed players
to generate more power and velocity,
with ball speeds .50 mph achieved by
high school (HS) girls5 and nearly 100
mph by elite players6; (2) artificial turf
creates a smoother, faster playing
surface; and (3) the ball is being elevated off the field more frequently.3
Additionally, there has been a 29% increase in participation at the HS level
from 1990 to 2010.7
Despite policy8–11 and position statements12,13 that strongly recommend
certified protective eyewear from
organizations including the American
Academy of Ophthalmology, the American Academy of Pediatrics, the International Federation of Sports Medicine,
the American Optometric Association,
the US Department of Health and
Human Services, Prevent Blindness
America, and the Coalition To Prevent
Sports Eye Injuries, the governing
body of field hockey in the United
States (US Field Hockey) does not mandate protective eyewear use for field
hockey players. After the initiation of
this study in 2009 and effective with
the 2011–2012 scholastic season, the
1070
National Federation of State High
School Associations has mandated
that HS field hockey players wear
protective eyewear meeting the
current American Society for Testing
and Materials standard for field
hockey.14,15
Currently, field hockey is a sanctioned
HS sport in 19 US states with .63 000
girls participating annually.7 At the
initiation of this study in fall 2009,
only 6 state interscholastic athletic
associations mandated protective
eyewear (MPE) for all HS field hockey
players (Connecticut, Maine, Massachusetts, New Hampshire, New York,
and Rhode Island). This disparity
among states regarding protective
eyewear mandates before the 2011–
2012 HS season provided a novel opportunity to investigate whether risk
of eye injury for HS field hockey
players differs in states with MPE
compared with states with no protective eyewear mandate.
METHODS
The primary objective of this study
was to examine whether risk of eye/
orbital injury during practices and
games differs for HS field hockey
players in states with MPE compared
with players in states with no MPE.
Secondary objectives included examining differences between cohorts
for (1) all head, face, eye/orbital, and
concussive injuries; (2) concussive
injuries only; (3) head and face injuries only (excluding eye/orbital and
concussive injury); and (4) all injuries
resulting in delayed return to activity
(time loss .21 days and/or medical disqualification for remainder of
season).
A prospective cohort study was conducted during 2 seasons of play (fall
2009, fall 2010), immediately before
a national protective eyewear mandate
in field hockey exercised by the NFHS,
effective fall 2011. The study population
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was HS field hockey players. Cohorts
were defined by their participation in
a state interscholastic league that either MPE or had no protective eyewear
mandate (no MPE). Inclusion criteria
were the following: HS field hockey
players; male or female; play occurring
during the HS-sanctioned season; and
participating HS covered by a certified
athletic trainer (AT). Exclusion criteria
were the following: injuries sustained
during field hockey play unrelated to
practice or competition, off-season field
hockey practices or competitions, or
activity unrelated to field hockey practices or games.
Given the prospective nature of the
study design, no intervention of any kind
was performed, no personal data were
collected, and thus informed consent
was not obtained from study participants. Institutional review board approval was granted from Rhode Island
Hospital for the study.
The injury surveillance systems used
in this study included: (1) High School
Reporting Information Online, an
Internet-based data collection tool developed by one of the authors (R.D.C.) to
track epidemiological data used in the
National High School Sports-Related
Injury Surveillance Study, and (2) Fairfax County (Virginia) Public Schools
Athletic Training Program, a large
public school system with 25 member
HSs. Fairfax County Public Schools used
a district-mandated electronic medical
record program for injury surveillance
(J.L.A.). ATs collected field hockey–
related athletic exposure (AE) and injury information throughout the study
period, submitting reports either daily
or weekly. Included in the data collection was whether MPE was in effect in
the injured player’s state of HS attendance. An AE was defined as 1 athlete
participating in 1 practice or competition. A reportable injury was defined as
one that (1) occurred as a result of
an organized HS athletic practice or
ARTICLE
competition, (2) required medical attention from a team AT or physician,
and (3) resulted in restriction or alteration of the athlete’s participation
status. For each injury, the AT completed a detailed report that included
the date of injury, type of exposure
(eg, practice versus competition),
characteristics of the injury (eg, body
site, diagnosis, severity, time loss),
and circumstances leading to the injury (eg, mechanism, specific activity
at time of injury). Data sets from both
databases were combined, and the
authors (R.D.C., J.L.A.) regularly
maintained and monitored them
to maximize compliance and data
quality.
Incidence rate ratios (IRRs) for each of
the injury outcomes were estimated
with 95% confidence intervals (CIs) by
using Poisson log-linear regression.16
The Z test was used to determine
whether the IRR differed from 1. Time
in days to return to field hockey after
injury was compared by using 6 time
interval categories with groups compared by x2. We also evaluated whether
athletes in the MPE group were less
likely to require .10 days to return to
field hockey compared with those in
the no-MPE group by using logistic
regression analysis with the likelihood
ratio test used to assess significance.
Data analysis was performed by using
SPSS version 19.0 (SPSS Inc./IBM,
Chicago, IL). Two-tailed values of
P , .05 were considered statistically
significant.
RESULTS
One hundred eighty HSs participated in
the study. HS field hockey players sustained 212 eye/orbital, head, and facial
injuries during 329 601 AEs. Table 1
summarizes the study population
characteristics. Players from 14 of the
19 states that sanction HS field hockey
were represented. The proportion of
schools participating from states with
protective eyewear mandates was
similar to the proportion of states that
had protective eyewear mandates
during the study period (39/141, 28%
and 6/19, 32%, respectively).
Thirty-one injuries were reported in the
MPE group in 66 286 AEs, and 181
injuries were reported in the no-MPE
group in 263 315 AEs. Cohort-specific
injury rates and the corresponding
IRRs for total head and face injuries
(including eye/orbital and concussion),
concussive injuries, head/facial injuries (excluding eye/orbital and concussion), eye/orbital injuries only, and
severe injuries are summarized in
Table 2. Injury rates were lower in the
MPE group compared with the no-MPE
group for all injury subcategories, although our sample size did not provide enough power to demonstrate
statistical significance.
Among total head and face injuries including eye/orbital and concussions,
the IRR comparing the MPE and no-MPE
groups was 1.47 (95% CI: 1.04–2.15, P =
.048). The incidence of total head and
face injuries was 0.69 injuries per 1000
AEs in the no-MPE group compared
with 0.47 injuries per 1000 AEs in the
MPE group, resulting in a 32% lower
injury rate in the MPE group. There was
no difference in concussion rates for
the 2 groups (IRR 1.04; 95% CI: 0.63–
1.75, P = .857).
Only 1 eye/orbital injury was recorded
in the MPE group: a corneal abrasion of
the right eye in a junior varsity forward
that was shooting during practice. This
injury resulted from contact with
a stick; the injured player was wearing
off-the-shelf protective eyewear at the
time of injury. The athlete returned to
activity within 3 to 6 days. In contrast,
21 eye/orbital injuries were recorded
in the no-MPE group. Of these 21 injuries, 4 (14%) resulted in time loss .21
days; none resulted in medical disqualification for the season. The eye/
orbital injury rate for the MPE group
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compared with the no-MPE group was
0.015/1000 AEs versus 0.080/1000 AEs,
respectively: an 80% lower injury rate
in the MPE group. Players in the noMPE group had a 5.33-fold higher risk
of eye injury than players in the MPE
group (95% CI: 0.71–39.25). However,
given the small numbers of injuries,
this did not reach statistical significance (P = .104).
Severe injuries were defined in this
study as those that kept the athlete from
activity .21 days after eye, head, or
facial injury and/or resulted in medical
disqualification for the remainder of the
season. There were 26 severe injuries in
the no-MPE group and 1 severe injury in
the MPE group. Severe injury rates for
the MPE and no-MPE groups were 0.015
and 0.1 per 1000 AEs, respectively.
Players in the no-MPE group had a 6.67fold increased risk of severe injuries
compared with players in the MPE
group which trended toward but did not
reach statistical significance (95% CI:
0.89–47.62, P = .065). Of the 27 injuries
resulting in delayed return to activity, 14
(51.9%) were concussions, 7 (25.9%)
were general trauma/contusion, 5
(18.5%) were fractures, and 1 (3.7%)
was a laceration. The single severe injury in the MPE group was a fracture
involving the mouth and teeth that
resulted from ball contact.
Figure 1 summarizes the percentage
of injuries in the MPE and no-MPE
groups on the basis of time to return
to activity. Seventeen percent of those
injured in the MPE group took .10
days to return to field hockey compared with 32% in the no-MPE group.
Logistic regression indicated that the
likelihood of requiring .10 days to
return to field hockey after injury
resulted in a trend that approached
statistical significance (likelihood ratio test = 3.52 on 1 degree of freedom,
P = .060), suggesting that MPE may
indeed be associated with a shorter
time to return to field hockey because
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DISCUSSION
TABLE 1 Characteristics of Study Population, 2009–2010 and 2010–2011 Seasons
Total
States participating
No. of participating HSsb,c
Large (.1000 students)
Small (,1000 students)
Percentage of study population
Age range of participants, y
AEsc
Total injuriesc
Eye/orbital
Concussion
Head/facial (excluding eye/orbital)
MPE Group
–a
39
10
20
28%
–a
66 286
31
1
18
12
14
180
68
42
100%
14-18
329 601
212
22
93
97
No-MPE Group
–a
141
58
22
72%
–a
263 315
181
21
75
85
a
Information withheld to protect student-athlete confidentiality.
Over 2 seasons, 180 schools participated. However, in total, 110 schools submitted data during the study period.
c High School Reporting Information Online collected data from 130 HSs over the study period and collected 96 total injuries
in 213 240 AEs. Fairfax County (VA) Public Schools collected data from 50 HSs over the study period, and collected 116 total
injuries in 116 361 AEs.
b
TABLE 2 HS Girls Field Hockey Injuries Stratified by Presence or Absence of Eyewear Protection
Outcome
MPE
Incidence per
1000 AEs
No MPE
Incidence per
1000 AEs
IRR (95% CI)
Z Test P Value
Total injuries
Concussive
Head or face
Eye/orbital
Severe injuryc
31
18
12
1
1
0.47
0.27
0.18
0.015
0.015
181
75
85
21
26
0.69
0.28
0.32
0.08
0.10
1.47 (1.04–2.15)
1.04 (0.63–1.75)
1.78 (0.97–3.26)
5.33 (0.71–39.25)
6.67 (0.89–47.62)
.048a
.857
.061b
.104
.065b
a
Statistically significant.
Statistical trend.
c Injury requiring time off from play for .21 days.
b
FIGURE 1
Time to return to field hockey activity after game or practice-related injury. *Statistical trend.
this significance level was close to the
criterion of P , .05.
Table 3 summarizes the injury mechanisms for eye, head, and facial injuries
evaluated in the study. Of the 212 eye/
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orbital, head, and facial injuries, 45.7%
involved the head or face (excluding
concussion and eye/orbital injuries),
43.9% were concussive injuries, and
10.4% were eye/orbital injuries.
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To our knowledge, this study is the first
prospective cohort study to use injury
surveillance to investigate the effectiveness of MPE in reducing rates and
severity of eye injuries in HS field hockey
players. Our study demonstrates that
MPE confers a reduced total head and
face injury rate of 32% and a reduced
eye/orbital injury rate of 80%. In addition, HS field hockey players participating in states with no MPE had
a greater than sixfold increased risk of
delayed return to activity from injury
compared with players from MPE
states. A noteworthy finding was that
14% (1 in 7) eye/orbital injuries sustained in the no-MPE group resulted in
time loss .21 days.
Injury rates for all eye/orbital, head/
face, and concussive injuries were
lower in the MPE group compared with
the no-MPE group; however, only total
head and face injury rates (including
eye/orbital and concussions) between
the 2 groups achieved statistical significance. Nonetheless, this result lends
additional evidence to previous study
findings that, for female athletes, as
the amount of required protective
equipment increases, injury rates decrease.17 Because injury rates for
head/face and concussive injuries
were lower in the MPE group versus
the no-MPE group, our findings indicate that protective eyewear affords
direct and indirect protection to other
head/facial areas from stick and ball
contact that would otherwise be sustained in the absence of eye/orbital
protection.
Our data indicate that injuries to eye
orbits, eye globes, eyebrows, and eyelids were completely eliminated in the
MPE group. These findings are concordant with a recent study by Lincoln
et al18 in female HS lacrosse players,
which also demonstrated a virtual
elimination of the aforementioned eye/
orbital injuries after mandated use of
ARTICLE
TABLE 3 Injury Mechanisms for Eye, Head, and Facial Injuries
Injury Mechanism
Contact with ball
Contact with stick
Contact with player
Contact with ground
Contact with goal
Missing data
Total
% of Total
Injuries
36.3
30.7
19.3
3.8
0.5
9.4
100
MPE
No MPE
No. of
Injuries
% of MPE
Injuries
No. of
Injuries
% of No-MPE
Injuries
11
11
6
3
0
0
31
35.5
35.5
19.3
9.7
0
0
100
66
54
35
5
1
20
181
36.5
29.8
19.3
2.8
0.6
11.0
100
eyewear. The single eye injury recorded
in our study’s MPE group was a superficial corneal abrasion that resulted in
the athlete’s return to activity in 3 to 6
days.
Regarding player-player contact injuries, the percentage of injuries
caused by this mechanism was the
same in both the MPE and no-MPE
groups (19.3%). Opponents of protective eyewear mandates have cited
concern that protective eyewear
obscures peripheral vision and can
lead to more aggressive play, consequently increasing the incidence of
player-player contact injuries. Our
study failed to demonstrate this association.
No catastrophic injuries were recorded
during our 2-season study period. In the
United States, the National Center for
Catastrophic Sports Injury Research
has compiled data regarding HS direct
catastrophic injuries (direct being defined as “injuries resulting directly
from participation in the skills of the
sport”) since 1982.19 The overall incidence of nonfatal direct catastrophic
injuries in female HS field hockey
players during this time period is 0.19
per 100 000 participants: the second
highest of any female HS sport compiled by the National Center for Catastrophic Sports Injury Research. This
equates to 1 such injury per 526 316
participants. Because time-based exposure metrics (eg, injuries per 1000 AEs)
have replaced player-based exposures
(eg, injuries per 100 000 participants) in
injury surveillance studies, it would be
difficult to calculate how many seasons of injury data would have to
be collected to capture 1 catastrophic
injury. Assuming that the HS field
hockey season has remained fairly
consistent between 1982 and 2010
in regard to the number of player
exposures (practices and competitions) over the course of a given
season, and knowing that 63 000
female athletes currently participate
each year in HS field hockey, it is
possible to speculate that, given
an injury incidence rate of 0.19 per
100 000 participants, 1 catastrophic
injury occurs in HS field hockey every
8.3 seasons.
Our study provides important epidemiological data regarding concussion
rates in HS field hockey, a sport often
excluded from large, national epidemiological studies because of lower
participation rates compared with
girls’ sports such as soccer, basketball, and volleyball. The overall concussion rate for both MPE and no-MPE
groups was 0.28 injuries per 1000
AEs. Although it is often difficult to
compare concussion injury rates
across studies and time periods because of variables such as improved
awareness, recognition, and diagnostic evaluation, previous studies of
HS female athletes have shown the
following concussion rates (per 1000
AEs): 0.36 injuries (soccer), 0.21
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injuries (basketball), 0.10 to 0.21
injuries (lacrosse), 0.07 injuries
(softball), and 0.05 injuries (volleyball).20–22
With the inclusion of our data, field
hockey currently has the second-highest
concussion rate among female HS
sports for which concussion injury
data are recorded. Moreover, because the concussion rates for MPE
and no-MPE groups were similar
(0.27 and 0.28 per 1000 AEs, respectively), these results indicate that
the addition of protective eyewear
did not result in more player-player
contact injuries, challenging a commonly held perception in contact/
collision sports that increased protective equipment yields increased
injury rates, known as a “gladiator
effect.”23
There were several limitations to our
study. Given the established state
mandates for protective eyewear that
were in existence during the 2009–
2010 and 2010–2011 seasons, we
were unable to conduct a randomized study because enrollment in
MPE and no-MPE groups was predetermined.
Additionally, while our power analysis
indicated 80% power for detecting
differences in injury rates between
MPE and no-MPE groups with respect
to total injuries, differences between
MPE and no-MPE groups with respect
to specific injury subcategories did
not attain statistical significance because of small event rates in the MPE
group, although rates were all lower
among athletes having eyewear protection and several analyses demonstrated trends toward statistical
significance.
Additionally, only schools with ATs were
eligible to participate. Consequently,
our results may not be generalizable to
all schools in the United States. Another
potential limitation was that injuries
were categorized by principal body part
(eg, head/face, eye/orbit, and nose). It
1073
is possible that some inaccurate identification of injury location may have
occurred given the close proximity of
these facial structures. However, this is
more likely to have resulted in underrepresentation rather than overrepresentation of eye/orbital injuries in
the databases because eye/orbital
injuries were included only if ATs commented on this specific area of injury
in their data collection or comments
section. Finally, our injury and exposure data did capture HS male field
hockey players, although the overall
participation rates of male players
were ,1% of the population for which
data were collected. Nonetheless, the
study results are not exclusively representative of female HS field hockey
players.
Despite these limitations, our study
compiled data from 2 large regional and
national injury surveillance databases
before the implementation of a national
protective eyewear mandate in HS girls’
field hockey, resulting in the largest
prospective national study examining
the effectiveness of MPE in reducing
head, eye/orbital, concussive, and facial injuries performed to date.
CONCLUSIONS
Among HS field hockey players, playing in a state with no MPE results in
a statistically significant higher incidence of head and face injuries
compared with playing in a state with
MPE. The addition of protective eyewear did not result in a higher incidence of concussions or other
player-player contact injuries, challenging an unfounded perception in
contact/collision sports that increased protective equipment yields
increased injury rates. Our study
supports future efforts to evaluate the
effectiveness of protective eyewear in
HS field hockey players in reducing
eye injury rates before and after
implementation of a national protective eyewear mandate, as well as
performance of clinical studies in
collegiate and national team field
hockey players to determine whether
the risk of eye injuries for these additional 5000 female athletes is reduced by the provision of protective
eyewear for all field hockey–related
activity.
ACKNOWLEDGMENTS
We thank the ATs who assisted in data
collection in this study and Vito
Perriello, MD, for his lifelong contributions to the fields of pediatrics,
sports medicine, and injury prevention before his unexpected passing
in 2009.
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(Continued from first page)
Address correspondence to Peter Kriz, MD, 2 Dudley St, Suite 200, Providence, RI 02905. E-mail: [email protected]
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2012 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: Funded in part by Prevent Blindness America (PBA) grant 701-5215 and the Centers for Disease Control and Prevention grant R49/CE001172-01. The
authors also acknowledge the generous research funding contributions of the National Operating Committee on Standards for Athletic Equipment. The content of
this report is solely the responsibility of the authors and does not necessarily reflect the official views of Prevent Blindness America or the Centers for Disease
Control and Prevention.
PEDIATRICS Volume 130, Number 6, December 2012
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Effectiveness of Protective Eyewear in Reducing Eye Injuries Among High
School Field Hockey Players
Peter K. Kriz, R. Dawn Comstock, R. David Zurakowski, Jon L. Almquist, Christy L.
Collins and Pierre A. d'Hemecourt
Pediatrics; originally published online November 12, 2012;
DOI: 10.1542/peds.2012-1492
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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly
publication, it has been published continuously since 1948. PEDIATRICS is owned, published,
and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk
Grove Village, Illinois, 60007. Copyright © 2012 by the American Academy of Pediatrics. All
rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
Downloaded from by guest on July 12, 2017
Effectiveness of Protective Eyewear in Reducing Eye Injuries Among High
School Field Hockey Players
Peter K. Kriz, R. Dawn Comstock, R. David Zurakowski, Jon L. Almquist, Christy L.
Collins and Pierre A. d'Hemecourt
Pediatrics; originally published online November 12, 2012;
DOI: 10.1542/peds.2012-1492
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
/content/early/2012/11/06/peds.2012-1492
PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly
publication, it has been published continuously since 1948. PEDIATRICS is owned,
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 2012 by the American Academy
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
Downloaded from by guest on July 12, 2017