Ocular injury is quite common. Approximately two million people in the United States are annually estimated to experience an eye injury requiring treatment1, and the rate of emergency-department-treated eye injury has been estimated to be 3.15 per 1000 population2. Traumatic eye injuries are one of the most common causes of monocular blindness in the United States, with more than 40,000 new cases of impaired vision reported every year3. As injury rates are highest among people in their 20 s and 30 s, the socioeconomic impact and lost productivity in the workplace are significant; eye injuries account for more than 140,000 disabling work injuries every year, with direct and indirect costs estimated at over $4 billion4.
Motor Vehicle Accidents
Motor vehicle accidents (MVAs) are the leading cause of post-traumatic stress disorder (PTSD) in the general population. 1 Each year, there are an estimated six million MVAs in the United States, resulting in over 2.5 million injuries. 2 According to a National Institute of Mental Health (NIMH) study, 39.2% of MVA survivors develop PTSD.
Airbags have reduced the amount of serious brain injuries and deaths from motor vehicle accidents. This is a good thing, but airbags can also cause injuries, especially to the eye.
In order for an airbag to work it must open explosively, before the severe whiplash jerks the head forward. The airbag frequently comes into direct contact with the eyes- there is not even enough time to blink and glasses may or may not afford protection. In fact glasses can shatter with the impact of the air bag and further damage the eye.
Injuries can be vision threatening immediately or even years later.
The immediate findings with a MVA can be readily aparaent with penetrating trauma or more subtle with or without an air bag deployment are redness, pain, and decreased vision. The direct force of the bag can damage the delicate structures of the eyelid, eye and orbit. There can be damage the front surfaces of the eye, in particular the cornea and conjunctiva. Corneal abrasions are common and need to be evaluated. The impact can result in bleeding in the front of eye (called a hyphema) or the back of the eye (called a vitreous hemorrhage). These are serious injuries and need immediate evaluation and treatment. Of even greater concern- airbag blunt force can cause silent retinal tears which can later lead to retinal detachment and loss of vision. With significant trauma, there can be damage to the drainage canal of the eye called angle recession that cannot be detected on a routine exam and can silently lead to blindness even years later.
Even a detailed examination by a competent eye doctor can miss subtle signs of trauma. A detailed examination with an OCT (Optical Coherence Tomographer) can detect subtle retinal or optic nerve damage. The examination directly images the nerve tissue in the eye called the optic nerve and retina. With blunt trauma, there can be disruption of the normally orderly retinal layers resulting in early or late loss of vision or even blindness.