Penetrating ocular injuries secondary to motor vehicle accidents

Penetrating ocular trauma is second only to cataracts as the most common cause of visual impairment in the United States; motor vehicle accidents are an important cause of injuries (ocular and non-ocular).

The files of 293 consecutive patients treated for a penetrating ocular injury over a 5-year period (1986 to 1991) were reviewed, and 10 (3.4%) were associated with a motor vehicle accident.

Median age was 27.5 years and median initial visual acuity was 20/200 (range, 20/30 to light perception). A sharp glass fragment penetrating the eye was the mechanism of injury in seven cases. A seatbelt was worn by only one patient. Six patients had a corneoscleral laceration, and two patients each had corneal and scleral lacerations. Primary repair of the laceration was solely performed in eight patients. Vitreous surgery was required in two cases, one with retained intraocular foreign bodies and one with a retinal detachment. The median follow-up period was 5 months, and 8 of 9 retinas remained attached at final follow-up. One patient died of unrelated causes. Final median visual acuity was 20/25 (range, 20/20 to hand motions).

Among patients in a large series of penetrating ocular injuries, the percentage of injuries due to motor vehicle accidents is low. The anterior segment is predominantly involved, and the final visual prognosis is favorable. Compulsory seatbelt legislation may reduce the frequency and morbidity of these accidents in the United States.