Abstract
Purpose:
Although golf-related ocular injuries are infrequent, they are of significant concern due to their high rate of devastating outcomes. Many studies have analyzed ocular golf injuries, but most had fewer than 10 subjects, the largest having only 13 subjects. This study is a meta-analysis of 10 studies analyzing ocular golf injuries in 68 subjects.
Methods:
40 articles, identified by PubMed search, were screened for eligibility, resulting in 10 studies, yielding 68 subjects. Included articles described all ocular golf injuries that occurred during a specific time period at an institution. Articles only analyzing injuries due to golf ball dissection were excluded since that mechanism of injury no longer occurs. Eight factors were analyzed: age, gender, place of injury, mechanism of injury, use of protective eyewear, resulting open globe injury, resulting enucleation, and visual changes post-injury. Significance was determined by 2-tailed t-test and Fisher’s exact test.
Results:
71% of ocular golf injuries occurred in adults, 72% in males. 61% were due to golf balls, 37% to golf clubs, and 1.7% to a foreign body (p<0.02). No subjects wore protective eyewear. 45% of injuries resulted in a ruptured globe (p<0.05) and 37% in enucleation (p<0.01). Mean initial and post-treatment logMAR vision was 1.11 and 0.556, respectively, with mean improvement >5 lines in those with better than light perception vision post-injury (p<0.05). 81% of golf club injuries occurred in those <20 years old (p=0.001). Golf balls accounted for 23% of ocular golf injuries in children and 87% of ocular golf injuries in adults. Ruptured globe occurred in 68% of golf ball injuries (p<0.02) and 24% of golf club injuries (p<0.02). Enucleation resulted from 53% of golf ball injuries and 20% of golf club injuries. Average logMAR visual improvement from golf ball injury was -0.85 and from golf club injury was -0.23 (p<0.05). Subjects wearing sunglasses or glasses had higher rates of globe rupture (75% and 100%, respectively) than those not wearing glasses (33%).
Conclusions:
Ocular golf injuries tend to be devastating: 45% resulted in ruptured globe and 37% in enucleation. We believe that increased use of protective polycarbonate eyewear among golfers would help prevent these injuries. Children should also be supervised more carefully when playing golf, as 77% of injuries to children were due to golf clubs (compared to 13% in adults).
Keywords: 742 trauma •
462 clinical (human) or epidemiologic studies: outcomes/complications •
754 visual acuity