Ocular contusion caused by elastic cords: a retrospective analysis using the Erlangen Ocular Contusion Registry

Elastic cords are common tools to secure luggage to the roof of motor vehicles or the carrier of bicycles. In comparison with other variants of ocular contusion, patients with elastic cord injuries appear to suffer more severe ocular damage.

The charts of 398 consecutive patients of the Erlangen Ocular Contusion Registry who had been hospitalized for ocular contusion over a 10-year period were retrospectively reviewed. The acute clinical findings of 23 patients with elastic cord injury were compared with 375 patients with other contusions. Open globe injuries were excluded.

A total of 5.8% of the patients were injured by elastic cords; their mean age was 36.6 +/- 17.0 years (range 8-66; median 34 years). The following morphological changes were documented in elastic cord injuries versus other ocular contusions: hyphema 100% versus 75%; angle recession 92% versus 72%; iridodialysis 17% versus 9%; traumatic cataract 14% versus 10%; lens dislocation 38% versus 13%; choroidal rupture 19% versus 6%; peripheral Berlin's oedema 57% versus 35%; and central Berlin's oedema 29% versus 12%. The difference of the incidence was significant for lens dislocation (P < 0.01), choroidal rupture (P = 0.024), and central (P = 0.029) and peripheral Berlin's oedema (P = 0.043). The final visual outcome was lower in patients with elastic cords injuries (P = 0.008).

Elastic cord injuries induce more severe ocular damage than most other contusions. The elastic cords producing industry is called on to develop safer luggage fixation systems and warn against the potential harmful consequences of injury to the eye.