The NHL vs. Everyone Else (Part 3): The Eyes Have It

When a puck or a stick meets an eye, bad things happen (see: Malhotra, Manny; Berard, Brian).  The current debate is whether visors should be made mandatory in the NHL, and whether they actually do anything.  The fact of the matter is that you can find research on almost any subject to support either side of an argument.  Ready? Go:

Visors cause more injuries!

“Oh, so visors are dangerous!”

No, not necessarily.  This was a study done in the ECHL that compared injuries in players with visors to players with no facial protection.  The study found that lacerations to the forehead and cheek were more severe in players with visors, but contusions due to collisions were more severe with no facial protection.  The researchers concluded that since high sticking caused the most facial injuries, and sticks could slip under a visor, that visors may not provide adequate protection.  Here’s the problem: Were the visors properly fitted?  How many players do you see with a loose chin strap and their helmet tilted back?  A visor only works if it is properly worn – low enough that it covers the eyes and the lower edge of the nose.  Could something still slip under it?  Yes, probably.  Is it less likely?  Obviously.  The point is that you can’t go from “Players in visors have lacerations of greater severity” to “Visors are dangerous/not helpful”.  That’s not a leap that makes sense.

Now for the other side of the argument:

Visors prevent injuries!

“Oh, so visors keep you from getting hurt!”

This study looked at NHL injuries in 2001-02, and concluded that visor use resulted in decreased eye and non-concussion head injuries, but did not affect concussion rates (I think I’ll file that last point under “Duh, really?”).

Here’s another.  This study looked at injuries in elite amateur hockey players and compared injuries in players with full facial protection, visors, and no facial protection.  Since full facial protection isn’t something the NHL will be seeing any time soon (other than what you’ll see occasionally on players healing certain facial injuries), I’ll just note that all injuries were reduced with full protection.  The study found that overall facial injury was twice as likely with no facial protection, and eye injury was 4.7 times greater.  Interestingly, the study also found that players using full and partial facial protection did not have an increase in neck injury or concussion (because I know someone was going to try to make that argument).

So there is definitely evidence that visors are protective, and one study that says players who wear them have more severe lacerations (but doesn’t reliably establish a causative link).  My conclusion: Wear a visor, save an eye.  Let’s face it – a laceration is something you can repair relatively easily – especially compared to a detached retina or a ruptured eyeball.  Every complaint about fogging or scratching or not looking cool seems petty when the alternative is losing an eye and a career.

Also, this guy has figured out how to permanently anti-fog glass and plastic surfaces.

Next time: I’ll take a look at the variety of eye injuries hockey players can get, and explain the treatments for them.  Advance warning – eye injuries are not for the squeamish.

– Jo

About Jo Innes
Who am I? I'm a paramedic turned ER doc with truly sub-par rec league hockey skills. And I have absolutely no problem sharing my opinion with you. You're welcome.

5 Responses to The NHL vs. Everyone Else (Part 3): The Eyes Have It

  1. Peter says:

    This brings to mind a question of mind, but I want to be careful to say beforehand that it is not intended as an argument against visors. But the question: Do you think visors make players less careful (or more reckless) with their sticks?

    It may be simply a coincidence, but with one of the injuries you mentioned, Marian Hossa had a visor, while Bryan Berard did not. Was Hossa, subconsciously, less careful with his stick because the possibility of a serious eye injury seemed less likely because he wears a visor?

    Makes me wonder if the current opt-in model is the worst possible situation: Either make everyone wear a visor, or tell no one to wear a visor, but don’t have some people wear one while others don’t.

    • Jo Innes says:

      I think this is a very valid question, and it’s one you hear a lot. You’d have to do an analysis breaking down injury by cause (collision, fall, puck, stick, etc) and then throw out everything but high sticks (to maintain the premise that facial protection makes you less careful with your stick). Then you’d have to subdivide the high-stickers by use of facial protection versus no protection.
      I’m inclined to say that you wouldn’t see a difference. That’s purely an opinion call, but I base it on the fact that there are so many players now (a vast majority) who grew up playing in systems requiring facial protection (NCAA, IIHF, high school, Canadian collegiate, everything below junior, etc). I honestly don’t think that every single league that mandates protection is populated by a bunch of high-sticking animals.
      Honestly, I think the ‘visors make you careless’ argument is a lot like saying seat belts make you careless. They prevent injuries. I don’t necessarily think they encourage bad behaviour.
      There’s a push in the NCAA now to get away from the cage and step back to a visor, and one of the arguments is that the cage is dangerous, creating blind spots, leading to paralyzing injuries from hits. Untrue, and disproven in one of the studies I cited. The other argument is the “more protection makes you more careless/aggressive” argument. The simple truth is that there’s extensive evidence in the NCAA and elsewhere that when you increase the level of protection, you decrease injuries.
      Let’s assume increased protection does lend itself to more careless or aggressive play. Does that outweigh the benefits of fewer injuries, and less playing time lost (also correlated with more facial protection)? I’d have to say no. I think the evidence that facial protection decreases injury is too good.
      My solution: Grandfather the visor in. It worked for helmets, and now they’re a non-issue.

  2. radioblaster says:

    Jo, i know nothing about injuries, medicine, sports injuries or even stuff about staying healthy. but i love hockey. and your blog is fantastic! a pleasure to have it in my RSS reader.

    so thanks for the great posts!

  3. Pingback: Eye injuries: From “No big deal” to “HOLY S*%T” Part 2 « Puck, that hurts!

  4. Pingback: Can technology help hockey players deal with concussions? | Hockey Gear HQ - news, reviews & deals

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