World tennis No.1 Novak Djokovic has been trounced in the third round of the Italian Open in just 67 minutes – just two days after the Serbian was left in agony after being hit on the head by a fan’s water bottle.

Djokovic looked far from his best in the “concerning” defeat on Sunday, and blamed Friday’s incident for his 6-2 6-3 loss to Chile’s Alejandro Tabilo.

“That has really impacted me a lot. After that, I got medical care, been through half-an-hour, an hour of nausea, dizziness and blood,” Djokovic said, adding that he would go for scans later.

“I managed to sleep OK, I had headaches. The next day, or yesterday, was pretty fine, so I thought it’s OK. Maybe it is OK, maybe it’s not.

“The way I felt on the court today was just completely like a different player entered into my shoes. Just no rhythm, no tempo, no balance whatsoever on any shot. It’s a bit concerning.”

The accident happened when a fan’s water bottle fell out of his backpack while he was leaning over railings at centre court to get an autograph following Djokovic’s second-round win.

The world No.1 was left slumped on the ground after being hit in the back of the head. He was eventually led from the arena by security staff.

The incident initially sparked outrage amid fears it might have been deliberate. But then tournament organisers sent a short statement and video showing it appeared the bottle accidentally slipped from the fan’s bag.

“His [Djokovic’s] condition is not a cause for concern,” they said.

Djokovic also reacted later with a joke, posting footage of his arrival at Rome’s Foro Italico tennis centre wearing a bike helmet.

“Today I came prepared,” he captioned the footage.

He has won the Rome tournament six times, his last in 2022.

But he was clearly far from his normal self on Sunday as Tabilo broke the top seed four times on centre court while not conceding a single break point.

The victory made the 26-year-old Tabilo – who won a Challenger Tour tournament two weeks ago – the first Chilean in 17 years to beat a world No.1 since Fernando Gonzalez beat Roger Federer at the ATP Finals in 2007.

“It’s incredible. I came on court just looking around and soaking it all in, trying to process everything. I’m trying to wake up right now,” world No.32 Tabilo said.

The result also means Djokovic – who made a double fault on match point – has failed to reach a single final in 2024 and has played only six matches on clay in the build-up to the French Open.

The Serbian had reached the semi-finals of the Monte Carlo Masters but a premature exit in Rome could hamper his preparations for Roland Garros, where the year’s second grand slam begins on May 26.

Asked about his French Open chances, Djokovic said: “Everything needs to be better for me to have at least a chance to win it.”

Djokovic followed Rafael Nadal to an early exit after the record 10-time Rome champion lost his third-round match to Hubert Hurkacz 6-1 6-3 on Saturday.

It left the Spaniard admitting he was in two minds even whether to compete at the French Open.

-with AAP