(A) and (B) show the key penetrating the left orbit (image taken at the time of presentation to our emergency department); (C) CT showing upward displacement of the globe. The key has penetrated the inferior wall of the orbit. The muscles, the optic nerve, and the globe are not affected; and (D) the foreign body. Scale in cm.

In June, 2008, a 15-year-old boy presented to our emergency department with a key penetrating his left orbit ( figure A, B ). He had been playing a game of football while wearing his key on a necklace. When our patient went to head the ball, his key flew upwards against gravity, got in the way of the flight path of the approaching football, and penetrated his left eye socket. CT showed that the key had lodged deep within the orbit, but fortunately it did not injure the globe ( figure C ). Our patient had surgery to loosen and remove the key ( webvideo ), which had become lodged in the inferior wall of the orbit ( figure D ). He was also given prophylactic broad-spectrum antibiotics. Our patient recovered well after surgery and had no visual sequelae. He was in violation of Federation Internationale de Football Association (International Federation of Association Football [FIFA]) rules by wearing a necklace with a key during the game.