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Sinnayya D, Krishnan A, Rahman WM, Lott PP, Iqbal T. Penetrating orbital injury caused by automobile airbag cover. Clin Exp Optom 2023:1-4. [PMID: 37879330 DOI: 10.1080/08164622.2023.2252460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/22/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Dheveya Sinnayya
- Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Arvindra Krishnan
- Department of Ophthalmology, Hospital Tuanku Ja'afar, Seremban, Malaysia
| | - Wan Mhwa Rahman
- Department of Ophthalmology, Hospital Tuanku Ja'afar, Seremban, Malaysia
| | - Penny Pw Lott
- Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Tajunisah Iqbal
- Universiti Malaya Eye Research Centre, Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Iannucci V, Manni P, Alisi L, Mecarelli G, Lambiase A, Bruscolini A. Bilateral Angle Recession and Chronic Post-Traumatic Glaucoma: A Review of the Literature and a Case Report. Life (Basel) 2023; 13:1814. [PMID: 37763218 PMCID: PMC10532958 DOI: 10.3390/life13091814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Ocular trauma affects millions of people worldwide and is a leading cause of secondary glaucoma. Angle recession is the main cause of post-traumatic glaucoma after blunt eye trauma, and it is usually unilateral. The aim of this paper is to investigate the possible causes of angle recession with a bilateral presentation. Airbag activation during traffic accidents is a likely cause to be ruled out, along with repeated head or eye trauma, due to contact sports or a history of physical abuse. These aspects can aid in early detection, appropriate management, and improved outcomes for patients with ocular trauma. Finally, we report the case of a 75-year-old Caucasian man who developed a bilateral angle recession after an airbag impact, with advanced glaucoma in the right eye and ocular hypertension in the left eye. To our knowledge, this is the first case in the literature of chronic post-traumatic glaucoma probably caused by an airbag.
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Affiliation(s)
| | | | | | | | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy; (V.I.); (P.M.); (L.A.); (G.M.)
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Hoskin AK, Philip S, Dain SJ, Mackey DA. Spectacle‐related eye injuries, spectacle‐impact performance and eye protection. Clin Exp Optom 2021; 98:203-9. [DOI: 10.1111/cxo.12283] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 12/11/2014] [Accepted: 12/13/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Annette K Hoskin
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia
| | - Swetha Philip
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia
| | - Stephen J Dain
- School of Optometry and Vision Science, University of New South Wales, Kensington, New South Wales, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Western Australia, Australia
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Djalali-Talab Y, Mazinani B, Djalali-Talab Y. Traumatic open globe injury—epidemiology, risk factors and visual outcome at the University Hospital Aachen. SPEKTRUM DER AUGENHEILKUNDE 2021. [DOI: 10.1007/s00717-020-00480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Summary
Background
Ocular trauma is still a major cause leading to enucleation. This study aims to analyze the visual outcome, epidemiology and risk factors of open globe injury (OGI) at the University Hospital Aachen, Germany.
Material and methods
A retrospective analysis of patient records involving traumatic OGI treated surgically between 2005 and 2015 was conducted. Age, gender, cause of accident, ocular trauma score, best corrected visual acuity (BCVA) at presentation and after treatment as well as location of injury were evaluated.
Results
Of 2272 eyes with trauma, 102 patients with OGI were identified, of which 65% were male and 35% were female. Women were significantly older than men (p < 0.001). The most common cause of injury was domestic syncopal episodes (47%). Work-related injuries occurred exclusively in men in 8.8%. A total of 16% had no light perception (NLP) at presentation, 69% of which improved post intervention to hand movement or better. Endophthalmitis was observed in 4% of all cases. Enucleation was needed mostly due to rupture. Location of OGI, pseudophakia and initial BCVA are risk factors for poor final BCVA. Patients’ BCVA did not improve further after three surgeries.
Conclusion
Traumatic OGI still poses a challenge in terms of treatment planning and prognostic outcome. A rise in elderly patients with multimorbidity represents a secondary obstacle to treatment. Patients with initial NLP can be treated with moderate success. Nevertheless, risk factors and ocular trauma score are unable to provide definitive therapy decisions. OGI should be assessed case by case, taking risk factors for OGI into account. Treating physicians should consider the ethical and economic reasons with regard to whether a high number of surgeries with possible comorbidities is justified.
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Ruslin M, Brucoli M, Boffano P, Benech A, Dediol E, Uglešić V, Kovačič Ž, Vesnaver A, Konstantinović VS, Petrović M, Stephens J, Kanzaria A, Bhatti N, Holmes S, Pechalova PF, Bakardjiev AG, Malanchuk VA, Kopchak AV, Galteland P, Mjøen E, Skjelbred P, Bertin H, Corre P, Løes S, Lekven N, Laverick S, Gordon P, Tamme T, Akermann S, Karagozoglu KH, Kommers SC, de Visscher JG, Forouzanfar T. Motor vehicle accidents–related maxillofacial injuries: a multicentre and prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:199-204. [DOI: 10.1016/j.oooo.2018.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/17/2018] [Accepted: 12/04/2018] [Indexed: 11/30/2022]
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6
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Porter AJ, Hayes R, Lee L, O'Hagan S. Driver's side curtain air bag-related globe rupture. BMJ Case Rep 2018; 2018:bcr-2017-224152. [PMID: 29866677 DOI: 10.1136/bcr-2017-224152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 35-year-old man presented after a high-speed motor vehicle accident and the driver's side curtain air bag causing blunt force trauma rupturing his right globe. The tangential force of the air bag resulted in an unusual arcuate horseshoe-shaped rupture through the lateral rectus insertion, causing avulsion of the muscle and tearing the sclera, with the apices of the tear extending anteriorly towards the limbus. Repair of the globe rupture was undertaken, and secondary vitrectomy revealed that the scleral tear had not involved the retina abutting the ora serrata. Silicone oil tamponade was used to fill the globe and the postoperative best corrected vision was 6/9. This is the first reported case of a ruptured globe caused by a side curtain air bag, resulting in a uniquely shaped arcuate scleral wound combined with lateral rectus avulsion, not associated with rhegmatogenous retinal damage, and is the first air bag-related globe rupture with scleral involvement to report a final best-corrected visual acuity better than 6/60.
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Affiliation(s)
- Ashley J Porter
- Ophthalmology Department, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia.,School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Rylan Hayes
- Ophthalmology Department, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia.,School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Lawrence Lee
- School of Medicine, University of Queensland, Herston, Queensland, Australia.,City Eye Centre, Spring Hill, Queensland, Australia
| | - Stephen O'Hagan
- Ophthalmology Department, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia.,Cairns Eye and Laser Centre, Edge Hill, Queensland, Australia
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Koisaari T, Leivo T, Sahraravand A, Haavisto AK, Sulander P, Tervo TMT. Airbag deployment-related eye injuries. TRAFFIC INJURY PREVENTION 2017; 18:493-499. [PMID: 28055229 DOI: 10.1080/15389588.2016.1271945] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 12/08/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We studied the correlation between airbag deployment and eye injuries using 2 different data sets. METHODS The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009-2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012. RESULTS In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33-10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59-3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants. CONCLUSIONS Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.
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Affiliation(s)
- Tapio Koisaari
- a Finnish Motor Insurers' Centre , Road Safety Unit , Helsinki , Finland
- b Finnish Crash Data Institute OTI , Helsinki , Finland
- c Aalto University , Department of Engineering Design and Production , Aalto, Espoo , Finland
| | - Tiina Leivo
- d Department of Ophthalmology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Ahmad Sahraravand
- d Department of Ophthalmology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Anna-Kaisa Haavisto
- d Department of Ophthalmology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
| | - Pekka Sulander
- a Finnish Motor Insurers' Centre , Road Safety Unit , Helsinki , Finland
| | - Timo M T Tervo
- d Department of Ophthalmology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland
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Sahraravand A, Haavisto AK, Holopainen JM, Leivo T. Ocular traumas in working age adults in Finland - Helsinki Ocular Trauma Study. Acta Ophthalmol 2017; 95:288-294. [PMID: 27935236 DOI: 10.1111/aos.13313] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 10/02/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE To describe epidemiology, causes, treatments and outcomes of ocular injuries in adults aged 17 to 60 in southern Finland. METHODS All new ocular trauma patients admitted to the Helsinki University Eye Hospital (HUEH), during 1 year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months. RESULTS The incidence for ocular injury was 88/100 000/year. From 831 trauma patients, 80% were men, 34% were work-related injuries, and 11% were assaults. Most of the injuries were minor traumas (54%). Contusions (22.5%) and chemical injuries and burns (13%) were common. Fractures (5%), lid wounds (3%), open globe injuries (OGI, 2%) and optic nerve injuries (0.5%) were rare. The main causes of ocular injury were superficial foreign bodies (33%), chemicals (13%), body parts (13%) and sports equipment (10%). The most dangerous objects were needles, stones, pellet guns, tools and guns. No patient with OGI used protective eyewear. All OGI and most of contusions needed a lifelong follow-up. Permanent impairment (73 patients, 9%) was caused most often by body parts, sports equipment and work tools. CONCLUSION A typical ocular trauma patient was a man aged 31-45 with a minor trauma caused by a foreign body at work and a final visual acuity of 20/20. Most common serious injuries were contusion, OGI or fracture at home or at work and were caused by a body part, sport equipment or work tool. Factors causing common and serious eye injuries provide the targets for protective measures.
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Affiliation(s)
- Ahmad Sahraravand
- Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Anna-Kaisa Haavisto
- Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Juha M. Holopainen
- Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Tiina Leivo
- Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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Abbott J, Shah P. The epidemiology and etiology of pediatric ocular trauma. Surv Ophthalmol 2014; 58:476-85. [PMID: 23969021 DOI: 10.1016/j.survophthal.2012.10.007] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Revised: 10/11/2012] [Accepted: 10/16/2012] [Indexed: 11/25/2022]
Abstract
Eighteen million people worldwide have uniocular blindness from traumatic injury. Injuries occur disproportionally commonly in childhood. Every year a quarter of a million children present with serious ocular trauma. For the vast majority the injury is preventable. We review the international literature that identifies high-risk circumstances.
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Affiliation(s)
- Joseph Abbott
- Moorfields Eye Hospital, University College London Partners, London, UK.
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10
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Almahmoud T, Barss P. Vehicle occupant restraint systems impact on eye injuries: a review. Surv Ophthalmol 2013; 59:334-44. [PMID: 24359757 DOI: 10.1016/j.survophthal.2013.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 08/19/2013] [Accepted: 08/20/2013] [Indexed: 11/30/2022]
Abstract
Vehicle occupant trauma to the eyes and associated facial structures has evolved rapidly in conjunction with safety-oriented vehicle design, including restraint systems. Trends vary worldwide with culture, personal factors, vehicle safety equipment, and the traffic environment-including physical, legislative, and enforcement. Wearing safety belts is essential to occupant protection. Airbags were designed as a supplement to protect the head from hard surfaces in frontal crashes, not as a primary countermeasure. Even where vehicle fleets are new with high airbag prevalence, but safety culture and knowledge of restraints is less than robust, injury attributable to not wearing seatbelts is frequent, especially in countries where high-powered vehicles are prevalent. Upper bodies of rapidly forward-moving unrestrained occupants collide with rearward-accelerating airbags. Airbag deployment produces injuries such as corneal abrasions, alkali burns, and the effects of globe compression.
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Affiliation(s)
- Tahra Almahmoud
- Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Peter Barss
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada; Interior Health Authority of British Columbia, Salmon Arm, British Columbia, Canada
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Weaver AA, Loftis KL, Duma SM, Stitzel JD. Biomechanical modeling of eye trauma for different orbit anthropometries. J Biomech 2011; 44:1296-303. [DOI: 10.1016/j.jbiomech.2011.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 12/21/2010] [Accepted: 01/09/2011] [Indexed: 10/18/2022]
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12
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Criado AL, López PB, Alonso AG. Permanent visual loss secondary to airbag deployment. Acta Ophthalmol 2010; 88:e341. [PMID: 19878116 DOI: 10.1111/j.1755-3768.2009.01741.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sinclair SA, Smith GA, Xiang H. Eyeglasses-Related Injuries Treated in U.S. Emergency Departments in 2002–2003. Ophthalmic Epidemiol 2009; 13:23-30. [PMID: 16510343 DOI: 10.1080/09286580500346645] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE An estimated 60% of Americans wear prescription eyeglasses. Despite the fact that eyeglasses pose a threat for injury, there is little research presenting national statistics of eyeglasses-related injuries. METHODS The National Electronic Injury Surveillance System was used to analyze eyeglasses-related injuries treated in U.S. emergency departments (EDs) in 2002-2003. Eyeglasses-related injury cases were identified by the consumer product codes for eyeglasses and sunglasses and each case's narrative description was reviewed to identify the mechanism of injury. Cases (n = 642) were weighted to produce national estimates of eyeglasses-related injuries. Mechanism of injury, body region injured, injury diagnosis, and outcome of ED visit were analyzed by gender and age. RESULTS An estimated 27,152 (95% confidence interval [CI]: 21,627-32,677) eyeglasses-related injuries were treated in U.S. EDs in 2002-2003. Overall, males and females were equally likely to sustain eyeglasses-related injuries (53.5% vs. 46.5%), but this distribution varied by age group. A significantly higher percentage of eyeglasses-related injuries due to falls occurred among persons aged 65 years or more (89.5%, 95% CI: 83.5-93.5), whereas sports-related injuries were more common among persons aged 0-17 years (36.6%, 95% CI: 26.1-48.6). Eyeball injuries were significantly more prominent among persons aged 18-64 years. Overall, 3.8% (95% CI: 2.3-6.3) of eyeglasses-related injuries resulted in hospital admission. CONCLUSIONS Eyeglasses-related injuries in the U.S. demonstrate age- and gender-specific characteristics. Safer eyeglasses design and the use of protective eyewear during sports activities and other activities with a high risk of ocular trauma will help prevent future eyeglasses-related injuries.
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Affiliation(s)
- Sara A Sinclair
- College of Medicine & Public Health, The Ohio State University, OH 43205, USA
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In Vivo Observation of Rigid Gas-Permeable Contact Lens Fragments Embedded in Cornea. Eye Contact Lens 2009; 35:105-7. [DOI: 10.1097/icl.0b013e318194e72e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rao SK, Greenberg PB, Filippopoulos T, Scott IU, Katsoulakis NP, Enzer YR. Potential Impact of Seatbelt Use on the Spectrum of Ocular Injuries and Visual Acuity Outcomes after Motor Vehicle Accidents with Airbag Deployment. Ophthalmology 2008; 115:573-576.e1. [PMID: 17765310 DOI: 10.1016/j.ophtha.2007.05.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2007] [Revised: 05/29/2007] [Accepted: 05/30/2007] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate the association between seatbelt use and (1) the spectrum of ocular injuries and (2) visual acuity outcomes after motor vehicle accidents (MVAs) with airbag deployment. DESIGN Single-center retrospective observational case series. PARTICIPANTS Forty-seven patients involved in MVAs with airbag deployment. METHODS Medical record review of all patients evaluated after an MVA with airbag deployment between January, 1997, and August, 2005, at a single level 1 trauma center. MAIN OUTCOME MEASURES Type of ocular injury and visual acuity at 3 months after an MVA. RESULTS Seventy-one percent of patients who did not wear seatbelts experienced type III ocular injuries compared with 31% who wore seatbelts (P<0.0002). Posterior segment injuries occurred only in patients who did not wear seatbelts. At the 3-month follow-up, 76% of patients who did not wear seatbelts achieved a visual acuity of 20/40 or better compared with 96% of patients who wore seatbelts (P>0.10); a visual acuity worse than 20/200 was measured in 14% and 0% of patients in the 2 groups, respectively (P<0.03). CONCLUSIONS In the current study, the use of seatbelts was associated with less severe ocular injuries and better visual outcomes.
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Affiliation(s)
- Sunil K Rao
- Division of Ophthalmology, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island, USA
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Abstract
A 59-year-old woman self presented to the emergency department with a painful right eye following a motor vehicle accident. She had reduced visual acuity and the eye had an alkaline pH with complete corneal uptake of fluorescein. Diagnosis of corneal abrasion and alkali burn to her right eye secondary to inflation of a driver's automobile airbag was made. The eye was irrigated with normal saline. Such injuries, although rare, can easily be identified within the emergency department by the history of exposure, evidence of facial injuries or burns, and an alkaline pH in the inferior cul-de-sac of the eye. Early detection and management with ophthalmology review is therefore imperative to prevent irreversible visual impairment.
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Affiliation(s)
- Angela Scarlett
- Christchurch Public Hospital, Private Bag 4710, Christchurch, New Zealand 8000.
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Rother T, Riechelmann H, Gronau S. [Secondarily accelerated foreign bodies as a source of danger from airbag deployment]. HNO 2007; 54:967-70. [PMID: 16341817 DOI: 10.1007/s00106-005-1353-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of airbag systems in motor vehicle construction has led to a significant reduction in both the frequency and intensity of injuries during traffic accidents. However, recent reports have shown numerous cases in which it is assumed that the airbag was the major cause of serious injury. CASE REPORT In a collision with a wild boar, both airbags in the automobile deployed. The driver suffered facial abrasion and belt contusion to the left shoulder. The passenger held a glass bottle in her hands during the impact that, secondarily accelerated through the airbag, hit both eyes and the bridge of her nose. On clinical admission, the patient showed fractures of the nasal bridge, of both medial orbital walls on both sides and a massive periocular haematoma which required direct examination under narcosis. Both eyes showed an orbital contusion, a large area of corneal abrasion, traumatic mydriasis with sphincter tears such as bilateral 90% hyphema. During surveillance, a progressive reduction in visual acuity occurred. After posterior chamber vitrectomy with epiretinal peeling and posterior chamber lens implantation in the left eye, visual acuity was 0.05 in the left eye and 0.01 in the right. CONCLUSIONS A considerable danger emanates from objects which are situated between head and airbag in the moment of airbag deployment. This requires public education and, in addition, airbag systems which are adapted to the drivers height and weight, as well as to objects in its immediate vicinity.
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Montard R. [Ocular injuries in mild facial trauma]. REVUE DE STOMATOLOGIE ET DE CHIRURGIE MAXILLO-FACIALE 2006; 107:264-72. [PMID: 17003761 DOI: 10.1016/s0035-1768(06)77048-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Ocular contusions are common and cause significant morbidity. The mechanism of ocular contusion is a decrease in the length of the anterioposterior axis whereas the transversal axis increases. Epidemiology data shows that young men are most injured in relation with sports, aggression, work, or car or work accidents. Injury to the ocular surface (conjunctiva and cornea) is minor. The iris is very frail, usually leading to hyphema which can progress to glaucoma. A cataract can appear after a contusion but usually years after the trauma. Final visual acuity can be compromised by retinal contusion or retinal detachment (due to a retinal dehiscence or post-traumatic dialysis). The worst outcome is optic neuropathy. The most difficult task is to predict visual acuity after the initial ocular lesion.
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Affiliation(s)
- R Montard
- Service d'Ophtalmologie, CHU Jean Minjoz, Besançon, France.
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19
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Affiliation(s)
- M E O'Donnell
- Department of Thoracic Surgery, Royal Victoria Hospital, Belfast BT12 6BA
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20
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&NA;. Although airbag deployment may induce injuries, the majority of these injuries are minor cutaneous lesions. DRUGS & THERAPY PERSPECTIVES 2005. [DOI: 10.2165/00042310-200521110-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Maharshak I, Bourla D, Grinbaum A, Weinberger D, Axer-Siegel R. Airbag-induced bilateral corneal graft dehiscence. Cornea 2005; 24:110-1. [PMID: 15604877 DOI: 10.1097/01.ico.0000127478.21928.2c] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report a case of bilateral corneal graft dehiscence caused by blunt trauma. METHODS Case report of bilateral simultaneous corneal graft dehiscence with expulsion of the lens and iris as a result of airbag-induced trauma. RESULTS Both corneal buttons were resutured, the prolapsed iris tissue was repositioned in the right eye, and anterior vitrectomy was performed bilaterally. Topical and systemic antibiotics, topical steroids, cycloplegic agents, and antiglaucoma drugs were initiated. Repeated B-scan ultrasound examinations demonstrated an attached retina in both eyes. Three weeks after admission, the right eye was reoperated for removal of remnant lens material and additional anterior vitrectomy. The patient was fitted with polycarbonate spectacles with an optical correction of +8 in both eyes. Visual acuity improved to 20/200 and 0.5/60 in the right and left eyes, respectively. The right corneal graft regained transparency, but the left one remained hazy. CONCLUSION Airbag deployment during motor vehicle collisions is a significant cause of ocular morbidity. The reported risk of airbag-related eye injury is 2.5% for any eye injury and 0.4% for severe eye injury. Patients undergoing corneal surgery should be counseled about the weakness of the donor-recipient interface and should consider wearing protective glasses.
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Affiliation(s)
- Idit Maharshak
- Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel.
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Duma SM, Rath AL, Jernigan MV, Stitzel JD, Herring IP. The effects of depowered airbags on eye injuries in frontal automobile crashes. Am J Emerg Med 2005; 23:13-9. [PMID: 15672331 DOI: 10.1016/j.ajem.2004.09.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The purpose of this study was to investigate eye injuries resulting from frontal automobile crashes and to determine the effects of depowered airbags. The National Automotive Sampling System database files from 1993 to 2000 were examined in a 3-part investigation of 22 236 individual crashes. Of the 2 103 308 occupants exposed to a full powered deployment, 3.7% sustained an eye injury compared to 1.7% of the 310 039 occupants exposed to a depowered airbag deployment. Occupants were at a significantly higher risk to sustain an airbag-induced eye injury when exposed to a full powered airbag compared with occupants exposed to a depowered airbag deployment ( P = .04). Approximately, 90% of the eye injuries in full powered airbag deployments were caused by the airbag, compared to only 35% of the depowered airbag eye injuries.
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Affiliation(s)
- Stefan M Duma
- Virginia Tech-Wake Forest, Mechanical Engineering, Center for Injury Biomechanics, Blacksburg, VA 24061, USA.
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Abstract
With the number of vehicles on the road increasing, the safety aspects of motoring are becoming a progressively more important consideration in health care provision and policy. Airbags are a relatively new introduction into our vehicles. Unlike other mechanisms such as seat belts, they offer protection without the need for any action on the part of the occupant. However, the necessarily violent nature of their deployment has led to the emergence of patterns of injury as a direct result. Knowledge of the potential dangers posed by these systems is useful both for emergency department physicians in order to prevent important injuries being missed, and for car manufacturers using increas ingly modern technology to design more efficient mechanisms. We undertook a review of the current literature to ascertain the spectrum of injuries that have been attributed to the use of airbags, while putting this into the wider context of their protective contribution.
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Affiliation(s)
- JRB Hutt
- Emergency Department, Charing Cross Hospital, London, UK
| | - LA Wallis
- Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa,
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