Motor Vehicle–Associated Traumatic Ocular Injuries Secondary to External Rear-Facing Sideview Mirrors

Abstract

IMPORTANCE Rear-facing sideview mirrors are a potentially reducible source of ocular morbidity following motor vehicle crashes.OBJECTIVE To report cases highlighting shattered glass from sideview mirrors as a potential cause of ocular trauma in motor vehicle crashes.DESIGN, SETTING, AND PARTICIPANTS Case series of 3 patients who presented to Grady Memorial Hospital, a level 1 trauma center and tertiary hospital, between May 5, 2017, and July 10, 2017, with ocular trauma as a result of shattered glass from sideview mirrors during motor vehicle crashes. A review of the literature was also conducted. Data were analyzed between July 2017 and August 2017. INTERVENTIONS OR EXPOSURES Operation for exploration and repair of open globe in all 3 cases. MAIN OUTCOMES AND MEASURES Visual prognosis and ocular morbidity postoperatively.RESULTS All patients were white men in the age range of 26 to 43 years. This was a retrospective review of 3 of 208 patients who presented to Grady Memorial Hospital after motor vehicle crashes from May 5, 2017, to July 10, 2017. From the time of presentation of the 3 reported patients from Grady Memorial Hospital, all 3 had 2 surgeries inclusive of the initial open globe repair. Patients with this mechanism of injury experienced ocular morbidity, with all 3 cases resulting in uveal prolapse and 2 of 3 resulting in retinal detachments. Among the 3 patients, visual acuities after the second surgery within the first year were hand motion, 20/100, and 20/150.CONCLUSIONS AND RELEVANCE Sideview mirrors can be a cause of serious ocular injuries in motor vehicle crashes. These 3 reported cases, combined with cases previously reported, suggest that this mechanism of ocular injury does occur. Further studies seem warranted to investigate the frequency of these findings and whether any design modifications may help reduce the frequency.

Penetrating ocular injury from motor vehicle rear-view side-mirror

“…Rear-view side-mirror induced penetrating and non-penetrating ocular injuries have also been documented in the U.S. A recent retrospective review published in 2019 reported 3 cases of similar globe injuries from a single U.S. institution within just a 3-month time period. 9 All three patients suffered from large corneal and/or scleral lacerations accompanied with significant intraocular damage. Another earlier retrospective review reported 41 patients with ocular or periocular injuries due to rear-view side-mirrors including eyelid/brow lacerations, corneal abrasions, corneal/scleral lacerations, and globe contusion.…”

“… 7 Our case, like the previously discussed case reports, are clear incidents of injury due to isolated damage to the rear-view side-mirror without associated damage to the windshields, side windows or interior rearview mirrors. 6 , 7 , 8 , 9 …”

Evaluating Ciliary Body Damage Induced by Blunt Low Speed Impact Using Finite Element Simulation

“…The severe eye injuries, such as rupture of globes and retinal detachments, that were caused by blast force or shocks. [2][3][4][5][6][7][8] Most common oculus traumas were related to vehicle crashes [9][10][11][12][13] and sport accidents, [14][15][16][17][18] which mainly focused on rupture injuries of globes and retinal. The contusion ocular injuries often lead to the moderate vision impairment, especially for young patients.…”