Lawnmower-Related Eye Injuries in the U.S., 2004 to 2023

Nicholas R Stange; Charles A Jennissen

doi:10.1016/j.ajo.2025.04.038

Lawnmower-Related Eye Injuries in the U.S., 2004 to 2023

Am J Ophthalmol. 2025 May 9:277:7-16. doi: 10.1016/j.ajo.2025.04.038. Online ahead of print.

Authors

Nicholas R Stange¹, Charles A Jennissen²

Affiliations

¹ From the School of Medicine (N.R.S.), Saint Louis University, St. Louis, Missouri, USA; College for Public Health and Social Justice (N.R.S.), Saint Louis University, St. Louis, Missouri, USA. Electronic address: nicholas.stange.research@gmail.com.
² Department of Emergency Medicine (C.A.J.), University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA; Stead Family Children's Hospital Department of Pediatrics (C.A.J.), University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA.

PMID: 40349815
DOI: 10.1016/j.ajo.2025.04.038

Abstract

Objective: To determine the epidemiology, mechanisms, and trends of lawnmower-related eye injuries in the U.S., focusing on national estimates, injury types, and high-risk populations.

Design: A retrospective trend study.

Participants: Individuals presenting to National Electronic Injury Surveillance System (NEISS) emergency departments.

Methods: Lawnmower-related eye injuries from 2004 to 2023 were identified using the NEISS. The database narratives were coded to classify the mechanism of injury and other variables. Periorbital injuries were not included. Descriptive and comparative analyses (chi-square and Fisher's exact test) were performed of national estimates derived using statistical weights.

Main outcome measures: Injury mechanisms, demographics, diagnoses, and trends over time.

Results: An estimated 120,613 lawnmower-related eye injuries occurred in the U.S. from 2004 to 2023 (N = 2467 NEISS cases). Those injured were 82% males, 95% adults, and 82% non-Hispanic Whites. Ninety-nine percent of injuries occurred at home. Most injuries (77%) were from projectiles (predominately grass, dirt, and rocks), 12% nonprojectile injuries during mowing, 8% maintenance/repair-related, and 2% from chemical exposures (primarily gasoline). Common diagnoses included eye abrasions/contusions (55%) and foreign bodies (27%). Severe injuries included retinal detachment, iris sphincter tear, corneal erosion, lens dislocation, and open globes. Only 2% of projectile injuries were documented in narratives as using eye protection, including eyeglasses. The average annual estimate for lawnmower-related eye injuries was 33% lower when comparing 2018-2023 to 2004-2017 (4502 vs 6686, P < .001). Injuries decreased more in males than in females (35% vs 23%, P < .001), and in adults aged 18 to 65 (35%) as compared to youth <18 yrs (26%) and adults >65 yrs (23%), P < .001. Whereas injuries decreased in non-Hispanic White individuals (41%), they increased in Black individuals (18%) and other racial/ethnic groups, including Hispanic (42%), P < .001. Youth <18 years were a higher proportion of bystander (50%) vs operator (5%) injuries, P < .001. Bystanders, as compared to operators, had higher rates of severe injuries requiring hospital admission, P = .002.

Conclusions: Lawnmower-related eye injuries remain a serious risk, especially from projectiles. Interventions designed to increase the use of safety glasses both while operating mowers and when performing maintenance/repair, such as sharpening blades, and prevent bystander presence, especially children, are needed to significantly reduce risk of injury.