Percussive massage guns have become a familiar fixture in gyms, clinics, and homes – marketed as an accessible and mobile way to soothe tired muscles and improve recovery. But a new case report highlights a less familiar risk: serious ocular injury when these devices are used near, or directly on, the eyes.
Writing in BMJ Case Reports, authors Niamh O’Connell and Ashraf Khan, from the Princess Alexandra Eye Pavilion in Edinburgh, UK, describe a man in his 20s who presented with a six-day history of floaters and occasional photopsia in his right eye. He was otherwise healthy, with no ocular history beyond low myopia, no family history of retinal disease, and no reported trauma. Initial findings were unexpectedly severe: visual acuity was 6/6 in both eyes, but indented scleral examination revealed multiple retinal tears, widespread commotio retinae, and superior temporal retinal dialysis in the right eye. The left eye also showed commotio retinae and six small horseshoe tears.
Only after further questioning did the cause become clear. The patient disclosed that, for around three months, he had been applying a high-frequency percussive massage gun both around and directly onto both eyes, weekly, for several minutes at a time. He had used the device, he said, to relieve a sensation of tiredness.
The retinal pathology was treated promptly. Retinal tears in both eyes received laser treatment, and the right superior temporal retinal dialysis was managed with barrier laser therapy. At six months, the patient remained stable, with no progression of dialysis and no cataract formation.
The authors suggest that the injury was likely caused by direct percussive force to the globe. Retinal dialysis is a rare but sight-threatening form of retinal break at the ora serrata, most often associated with significant ocular trauma. In traumatic cases, rapid compression of the eye along the anterior-posterior axis, with expansion at the equator, is thought to generate shearing forces at the vitreous base. In this case, the unusual superior temporal location of the dialysis may reflect direct application to the front of the eye, rather than a more typical blunt-trauma mechanism involving the orbital rim.
Although ocular complications from massage gun use appear rare, they are not unprecedented. Previous reports have described lens subluxation with secondary glaucoma, traumatic cataract, retinal detachment, and profound visual impairment following improper use. What makes this case notable is the combination of bilateral retinal tears and dialysis – and the preservation of vision, likely because the patient presented soon after symptoms began and treatment was initiated quickly.
The report raises broader questions about consumer safety. Percussive massage therapy remains widely available, but evidence on safe use is limited and recommendations vary across manufacturers, therapists, and users. The patient in this case had purchased the device commercially and reported being unaware of warnings against ocular use.
The authors note how this case report highlights how these popular devices hold the potential for significant retinal injury when misused. As such, clinicians may need to educate patients that massage guns are not benign when misapplied. High-frequency vibration and percussive force may be designed for muscle, but the eye is another matter entirely.
