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Dawn A Sim, Specialist Registrar in Ophthalmology Moorfields Eye Hospital, 162 City Road, London EC1V2PD
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I read with interest that Loosemore et al1 found no evidence for a strong association between amateur boxing and chronic traumatic brain injury. Conversely, chronic injury does occur with ocular structures, which like the brain, has a limited ability to renew itself. Eyes face blunt impact directly,and can sustain severe lesions resultant from boxing. These can range from minor anatomical aberrations to severe, visual threatening lesions. Examples include lid lacerations and avulsions, tearing of the sphincter pupillae, peripheral iris or ciliary body, traumatic uveitis, cataract, hyphaema, secondary glaucoma from angle recession, retinal tears and detachments, visual field defects secondary to injuries to the visual pathways. Significant differences have been found between boxers and controls for the number of ocular injuries.2,3 Furthermore, there are significant correlations between the total number of bouts and the total number of losses, and the presence of retinal tears.3 Boxers can have up to ten times the incidence of serious ocular lesions.4 It is important to note that most publications recommend regular evaluations by an ophthalmologist, with emphasis on examination of the peripheral fundus. 1. Loosemore MP, Knowles CH, Whyte GP. Amateur boxing and risk of chronic traumatic brain injury: systematic review of observational studies. BMJ 2007 doi: 10.1136/bmj.39342.690220.55 2. Wedrich A, Velikay M, Binder S, Radax U, Stolba U, Datlinger P. Ocular findings in asymptomatic amateur boxers. Retina 1993;13(2):114-9. 3. Giovinazzo VJ, Yannuzzi LA, Sorenson JA, Delrowe DJ, Cambell EA. The ocular complications of boxing. Ophthalmology 1987 Jun;94(6):587-96 4. P F Vinger commentary on, M Bianco, A S Vaiano, F Colella, F Coccimiglio, M Moscetti, V Palmieri, F Focosi, P Zeppilli. Ocular complications of boxing. Br J Sports Med 2005;39:70–74. Competing interests: None declared |
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Simon M. Kemp, Sports Coach PO10 7TX
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Between 1990 - 1994 it was my pleasure and privilege to coach the England Universities' Amateur Boxing squad. The team I took up to Scotland for an International match in November 1993 contained two Medical Students and was Captained by Alex Mehta MA (Oxon) who was then reading for a PhD in Environmental Law at Oriel College, Oxford University. The British Medical Association has argued that young people under the "Age of Consent" should not be allowed to Box because they may be too young to understand the risks involved in participation in this tough combat sport. Presumably the BMA would accept that someone studying Medicine at Cambridge or Oxford was old enough, and sufficiently well informed, to understand the risks involved in Boxing? Dr. Alex Mehta, winner of four Oxford University Boxing "Blues", is now a successful Barrister-at-Law. Hard to reconcile that record of intellectual achievement with the BMA's claims that "Boxing is bad for the brain." Competing interests: Qualified Amateur Boxing Association Coach |