Traumatic retinal angiopathy and seat belts: pathogenesis of whiplash injury

Three cases of traumatic retinal angiopathy associated with whiplash injury are presented. The pathogenesis of the fundal appearances is discussed. Local microcirculatory disturbances are postulated as the cause of the retinopathy as opposed to the systemic disturbance associated with Purtscher's retinopathy. This condition may be underdiagnosed as there may be few abnormal signs on funduscopy. Fluorescein angiography may be very helpful. The incidence may be increasing as a result of legislation concerning the wearing of seat belts, and the condition has medico-legal significance. Increasing awareness may increase diagnosis.