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Editor,—We report a case of penetrating eye injury caused by a golf tee. We feel that this may have been a one off event; however, the paucity of information in the literature regarding ocular golf injuries makes it difficult to comment on its significance.
CASE REPORT
A 16-year-old male was playing pitch and putt, and while teeing off he felt something go into his right eye. The eye became painful immediately and the vision blurred. He removed the object from his eye, and it turned out to be his golf tee. The club he was using was a medium lofted (seven) iron and the surface underfoot was a rubber mat. The tee was a standard plastic golf tee (Fig1).
Standard plastic golf tee responsible for the penetrating injury.
On examination of the right eye there was a 2 mm penetrating wound at the limbus inferonasally with a prolapsing knuckle of iris. He was brought to theatre where the conjunctiva was opened and the wound explored. The wound did not extend beyond the limbus and the lens did not appear to have been injured. The iris was reposited and the wound repaired with two 10-0 nylon sutures (Fig 2). The postoperative recovery was uneventful and he was discharged home 2 days later. The eye healed up well over the ensuing weeks with a rapid return of vision to 6/5.
The right eye showing the injury site 24 hours after repair (arrow).
COMMENT
In recent times golf has become an increasingly popular pastime among people from all walks of life in many developed countries.1The number of ‘teeings off’ every year in Ireland alone probably runs into several millions or even hundreds of millions. In this unit we have seen many golf injuries though these are usually from golf clubs or balls, but we have never before seen one caused by a golf tee. We could find only limited references to eye injuries among golfers in the literature. Most were part of larger series of penetrating eye injuries2 or sports injuries.3 Only one recent article specifically relates to ocular golf injuries.4 Coleet al in a series of 378 penetrating eye injuries reported that two of these occurred in golfers; however, no further details are provided.2 A study of sporting eye injuries from Sussex Eye Hospital found two eye injuries as a result of golfing accidents over an 18 month period; golf injuries were among the most severe injuries seen and caused the greatest degree of visual loss.3 This article mentions that the single worst injury seen was caused by a golf ball; the nature of the second golfing injury is not specified. A series from the USA reported nine golf related ocular injuries over a 6 year period.4 Seven of the injuries were caused by golf balls and the remainder by clubs. Six out of the nine eyes were enucleated, two as a primary procedure.
Golf related eye injuries are uncommon. The United States Eye Injury Registry stated in its 1994 report of 6500 injuries that 7% (455) were sports related.5 Of these sporting injuries 4% (18) were golf related. All the eye injuries that have been reported were caused by either golf balls or clubs, none were caused by tees.34 Using lofted irons to tee off from rubber mats may be hazardous though this may have been a unique event. It is also possible that plastic tees are somehow less safe than wooden ones. Accurate reporting would help establish the incidence of eye injuries among golfers as well as demonstrating which ones are freak events and which are repeatable and so requiring preventative measures.