Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

Wang, Shih Hao; Lim, Chen Chee; Teng, Yu Ti

doi:10.1159/000452652

Cited by 6 publications

(7 citation statements)

References 12 publications

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“…Despite the relatively rare occurrence of vitreoretinal complications with airbag impact, there are a wide variety of clinical presentations of this disorder, such as vitreous hemorrhage, 48 retinal tear, 18 , 20 retinal detachment, 9 choroidal rupture 15 and macular disorders. 21 , 49 Severe blunt trauma has been shown to decrease the anterior-posterior diameter of the globe by 41%.…”

Section: Discussionmentioning

confidence: 99%

“… 30 This result of ocular outer surface strain suggests that the retina or choroid might suffer the greatest damage, resulting in sight-threatening complications reported previously. 9 , 15 , 49 Deformation rate of the vitreous was very low, and the vitreous might act as a shock absorber against the deformation caused by the anterior segment due to its large volume. However, an interesting tendency was that vitreous length showed elongation in the later phase of airbag impact in our study.…”

Section: Discussionmentioning

confidence: 99%

“…However, serious and visually devastating ocular injuries caused by airbags, ranging from corneal endothelial cell loss to retinal detachment, have been reported. [4][5][6][7][8][9][10][11][12][13][14][15][16] Minor ocular injuries due to airbag impact include corneal abrasion, hyphema, vitreous hemorrhage, retinal tear, maculopathy, and localized photoreceptor damage. 8,[16][17][18][19][20][21] Moderate to serious ocular injuries include corneoscleral laceration, bullous keratopathy, lens dislocation, lens capsule rupture, choroidal rupture, retinal detachment, and open globe rupture.…”

Section: Introductionmentioning

confidence: 99%

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Finite Element Analysis of Changes in Deformation of Intraocular Segments by Airbag Impact in Eyes of Various Axial Lengths

Ueno,

Fujita,

Ikeda

et al. 2024

OPTH

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Background We studied the kinetic phenomenon of an airbag impact on eyes with different axial lengths using finite element analysis (FEA) to sequentially determine the physical and mechanical responses of intraocular segments at various airbag deployment velocities. Methods The human eye model we created was used in simulations with the FEA program PAM-GENERIS TM . The airbag was set to impact eyes with axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 20, 30, 40, 50 and 60 m/s. The deformation rate was calculated as the ratio of the length of three segments, anterior chamber, lens and vitreous, to that at the baseline from 0.2 ms to 2.0 ms after the airbag impact. Results Deformation rate of the anterior chamber was greater than that of other segments, especially in the early phase, 0.2–0.4 ms after the impact (P < 0.001), and it reached its peak, 80%, at 0.8 ms. A higher deformation rate in the anterior chamber was found in hyperopia compared with other axial length eyes in the first half period, 0.2–0.8 ms, followed by the rate in emmetropia (P < 0.001). The lens deformation rate was low, its peak ranging from 40% to 75%, and exceeded that of the anterior chamber at 1.4 ms and 1.6 ms after the impact (P < 0.01). The vitreous deformation rate was lower throughout the simulation period than that of the other segments and ranged from a negative value (elongation) in the later phase. Conclusion Airbag impact on the eyeball causes evident deformation, especially in the anterior chamber. The results obtained in this study, such as the time lag of the peak deformation between the anterior chamber and lens, suggest a clue to the pathophysiological mechanism of airbag ocular injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Finite Element Analysis of Changes in Deformation of Intraocular Segments by Airbag Impact in Eyes of Various Axial Lengths

Ueno,

Fujita,

Ikeda

et al. 2024

OPTH

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“…An airbag impact can result in severe ocular damage, significant loss of vision, and, in extreme cases, complete loss of the eye [4]. Ocular injuries caused by airbags have been widely reported in the literature [5][6][7][8][9][10][11][12][13][14][15][16], and most injuries require immediate emergency surgery and numerous follow-up surgeries.…”

Section: Introductionmentioning

confidence: 99%

Finite element analysis of changes in tensile strain and deformation by airbag impact in eyes of various axial lengths

et al. 2022

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Purpose Airbags have substantially reduced mortality and morbidity, while ocular injuries caused by airbags have been reported. We applied a three-dimensional finite element analysis (FEA) model we have established for evaluation of the deformation of an intact eyeball of various axial lengths induced by an airbag impact at various impact velocities. Methods A model human eye we have created was used in simulations with an FEA program, PAM-GENERIS™ (Nihon ESI, Tokyo, Japan). The airbag was set to impact eyes with various axial lengths of 21.85 mm (hyperopia), 23.85 mm (emmetropia) and 25.85 mm (myopia), at initial velocities of 30, 40, 50 and 60 m/s. Changes in the shape of the eye and the strain induced were calculated. Deformation of the eye in a cross-sectional view was displayed sequentially in slow motion. Results We found that considerable damage, such as corneal or scleral lacerations, was observed especially at higher impact velocities, such as 50 or 60 m/s, in eyes with any axial length. Deformation was most evident in the anterior segment. The decrease rate of axial length was greatest in the hyperopic eye, followed by the myopic eye, and the emmetropic eye. Conclusions It was shown that hyperopic eyes are most susceptible to deformation by an airbag impact in this simulation. The considerable deformation by an airbag impact on the eye during a traffic accident shown in this study might indicate the necessity of ocular protection to avoid permanent eye damage.

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“…2 Although airbags significantly suppress passengers' injuries, still in recent years, several cases of variety of eye injuries have been documented due to airbag deployment. [3][4][5][6] In an epidemiological study, Pearlman et al 7 reported that between 1991 and 2000, there were a total of 263 incidents of airbag-related eye injuries in 101 patients that could cause a variety of eye injuries. From an anatomical perspective, the type of eye injury with the highest incidence was corneal injuries, which accounted for 21.6% of all eye injuries.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical simulation of eye-airbag impacts during vehicle accidents

Shirzadi

Zohoor

Naserkhaki

2018

Proc Inst Mech Eng H

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Airbags are safety devices in vehicles effectively suppressing passengers' injuries during accidents. Although there are still many cases of eye injuries reported due to eye-airbag impacts in recent years. Biomechanical approaches are now feasible and can considerably help experts to investigate the issue without ethical concerns. The eye-airbag impact-induced stresses/strains in various components of the eye were found to investigate the risk of injury in different conditions (impact velocity and airbag pressure). Three-dimensional geometry of the eyeball, fat and bony socket as well as the airbag were developed and meshed to develop a finite element model. Nonlinear material properties of the vitreous body and sclera were found through the in vitro tests on ovine samples and for the other components were taken from the literature. The eye collided the airbag due to the velocity field in the dynamic explicit step in Abaqus. Results of compression tests showed a nonlinear curve for vitreous body with average ultimate stress of 22 (18-25) kPa. Tensile behavior of sclera was viscoelastic nonlinear with ultimate stresses changing from 2.51 (2.3-2.7) to 4.3 (4-4.6) MPa when loading strain rate increased from 10 to 600 mm/min. Sclera, ciliary body, cornea and lens were the eye components with highest stresses (maximum stress reached up to 9.3 MPa). Cornea, retina and choroid experienced the highest strains with the maximum up to 14.1%. According to the previously reported injury criteria for cornea, it was at high risk of injury considering both stress and strains. Reduced pressure of the airbag was beneficial decreased stress of all components. Comprehensive investigations in this area can disclose biomechanical behavior of the eye during eye-airbag impact. Effective guidelines can be drawn for airbag design for instance the airbag pressure which reduces risk of eye injury.

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Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report

Cited by 6 publications

References 12 publications

Finite Element Analysis of Changes in Deformation of Intraocular Segments by Airbag Impact in Eyes of Various Axial Lengths

Finite Element Analysis of Changes in Deformation of Intraocular Segments by Airbag Impact in Eyes of Various Axial Lengths

Finite element analysis of changes in tensile strain and deformation by airbag impact in eyes of various axial lengths

Biomechanical simulation of eye-airbag impacts during vehicle accidents

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