Study examines golf-related eye injuries in children

Pediatric golf injuries are rare but can be devastating to the eye and vision system, according to a report in the September issue of Archives of Ophthalmology, one of the JAMA/Archives journals. The National Society to Prevent Blindness estimates that 900,000 Americans are visually impaired due to trauma, according to background information in the article. Sports-related injuries comprise only a small percentage of those, but are often more severe and cause more vision problems than other eye injuries. About 42,000 patients are treated each year for sports-related eye injuries, a number that appears to be increasing; approximately 1.5 percent to 5.6 percent of these eye injuries from sports are golf-related.

Eric M. Hink, M.D., of the University of Colorado Denver School of Medicine, and colleagues studied 11 pediatric patients treated for golf-related eye injuries at two institutions over 15 years. The children, six boys and five girls, had an average age of 10.2 and were followed up for an average of one year.

"Ten patients (91 percent) were injured by golf clubs and one patient (9 percent) by a golf ball," the authors write. "One injury (9 percent) occurred on a golf course. At the initial examination, visual acuity was 20/20 in four eyes (36 percent), 20/25 to 20/80 in three eyes (27 percent), no light perception in three eyes (27 percent) and undeterminable in one eye (9 percent) because of altered mental status."

Injuries included orbital fracture (a break in the bones forming the eye socket) in 11 eyes (100 percent), hyphema or blood in the eye in four eyes (36 percent) and damage to the optic nerve in three eyes (27 percent). Nine of 11 patients (82 percent) required surgery. At the final follow-up visit, two eyes (18 percent) had no light perception and visual acuity was 20/70 in one eye (9 percent) and 20/20 or better in eight eyes (73 percent).

Most pediatric golf-related injuries do not appear to occur on the golf course or during supervised play, the authors note. "Most children are injured by other children wielding a golf club while at play away from the golf course," they write. "The frequency of potentially devastating ocular and head trauma has been demonstrated in our series and in our review of the literature."

"Increased public awareness may help to decrease morbidity from golf-related ophthalmic injuries to children," they conclude. "We recommend close adult supervision, adequate separation between children and protective eyewear for children learning to play golf. Furthermore and most critically, golf equipment should be stored in a secure area away from children. Children should be taught that golf equipment should never be used without supervision. The efforts of ophthalmologists to prevent eye injures in other sports, notably hockey and baseball, have been successful and should serve as models to prevent golf-related ocular injuries in the pediatric population."

Source: JAMA and Archives Journals