This study sought to examine the initial presentation of sports-related ocular injury in youths presenting to a US tertiary eye centre. This was a retrospective study of cases with a one-year follow-up period. Over a five-year period of 2010-15, 3965 visits were recorded to a single centre emergency department consistent with youth ocular trauma. Seven hundred and fifty-six were found to be sports-related. Many had repeat visits, so the sample actually consisted of 223 patients (19.1% of all youth trauma visits within the specified time period). Injuries were most common in boys (78.9%) with a mean age of 16.2 years. Most were in late adolescence (n=95) followed by early adolescence (76), young adults (44) and late paediatrics (eight). Common diagnoses included hyphema (n=161) and commotia retinae (52) with blunt trauma. Soccer caused the highest number of injuries (n=52), then baseball (38) and basketball (26) which accounted for 52% of all injuries. Thirty-three patients needed surgical repair for laceration, retinal pathology, and orbital fractures. All were unilateral injuries. The average number of follow-up visits was 4.95 over a period of mean 82.9 days. Few used protective eyewear but not all were asked about this. The limitations of this study are that this was a tertiary eye care centre, and the referrals may have been more likely to be severe. Also, there were variable follow-up periods and limited visual acuity measurements. Socioeconomic data was not collected. The authors recommend the use of protective eye wear, particularly in contact group sports.