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Donovan N Calder, Ivor crandon, Jennifer calder, Nicole Meeks-aiken; A case series of automobile wing (side) mirror ocular injuries. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6061.
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Traffic-related injuries are estimated to become the fifth leading cause of the global burden of diseases by 2020. A 2008 showed that although responsible for 3.3% of all emergency department eye injury visits, traffic-related injuries were responsible for 19.1% of these visits that required hospitalization. The motor vehicle industry has been responsive to the safety needs of drivers and passengers, however studies related to wing mirror related ocular injuries are few. This is the largest case series to date that assesses the severity of wing mirror related ocular injuries.
From January 1996 to December 2005 patients were recruited from two ophthalmology clinics and a trauma registry. Demographic, driving history, vehicle-specific, and clinical data were collected. An ocular injury was any disruption in the integrity of the eye or surrounding orbital structures. Eyebrow or eye lid lacerations or corneal abrasions were considered minor injuries, all other injuries were considered to be major and were classified according to the Birmingham Eye Trauma Terminology System (BETTS). Visual acuity (VA) at presentation and outcome was based on Recommendations of the WHO Consultation on “Development of Standards for Characterization of Vision Loss and Visual Functioning" for monocular vision. All patients underwent slit lamp examination and were treated with as appropriate. Data were analyzed using SAS 9.4
39 patients had 41 eye injuries (Table 1). Seven of 39 (17.9%) patients had minor injuries. The remaining 32/39 (82.0%) patients had at least one major eye injury which was classified using BETTS (Figure). In persons experiencing minor vs. major injuries there was a statistically significant difference in the mean ages at which driver’s licence was obtained (p=0.0184) and the accident occurred (p=0.0177), and years of driving experience (0.0314). The VA at presentation was associated with that at outcome (p=<0.0001). Only 38% of persons who were categorized as blind at presentation had improved VA at outcome.
While wing mirror-related ocular injuries are rare, we show that many cause permanent blindness. Great strides have been made in improving automobile safety, however few standards exist for wing mirrors and even these need review. We propose a larger study to assess the risk factors for wing mirror-related ocular injuries and to develop an international automotive standard.
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