PURPOSE: Although sports participation among pediatric patients benefits overall development, the risks of ocular trauma are often overlooked. This retrospective cohort study investigated sports groups to determine which caused the greatest ocular trauma and initial presenting visual acuity (VA) impairment. PATIENTS AND METHODS: 1,290 pediatric ocular traumas in two Indianapolis tertiary care centers over a 10-year period were collected and stratified based on sport category, injury type, age, and need for surgical intervention. Chi-square analysis and Fisher exact testing were used to determine each variable's significance. RESULTS: Ocular injuries were most commonly attributed to baseball (38.5%), basketball (16.9%), and soccer (14.9%). The most common ocular diagnoses were contusions (82.4%) and hyphemia (8.1%). Orbital fractures were the most common diagnosis requiring surgery (54.5%) with baseball as the most common cause (67.0%) of these fractures. Analysis of significant visually impairing traumas indicated that golf and archery were the most detrimental in initial presenting VA followed by football and baseball. Lastly, children aged 0-11 years old (p = <
0.01) most commonly had injuries attributable to baseball (p = <
0.01) whereas older children aged 12-18 more commonly had injuries attributable to soccer (p= 0.04) and football (p=0.04). CONCLUSION: With our study illustrating that archery and golf were the most detrimental on initial presenting VA while baseball was the most common cause of impactful injuries, particularly among children aged 3-11 years, safety guidelines should include mandatory eye protection to decrease the risk of sport-related ocular injury.