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G.B. Baveja, S.A. Newman; Ophthalmic Injuries Associated With ATV Accidents . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5032.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: We describe the etiology, demographics, visual exam findings, spectrum of ophthalmic injuries and outcomes associated with ATV accidents. Methods: 19 ATV riders sustaining ophthalmic injuries were studied retrospectively. Trauma registry records were screened for ATV accidents for all patients triaged at the UVA hospital from Jan, 1994 to Oct, 2004. 19 had detailed eye clinic records and were therefore selected. Radiology reports were cross referenced to confirm injuries noted in outpatient charts. Results: The average age of patients sustaining ophthalmic injures was 22.4 ranging from 5 to 38. 89% of patients were male. All were Caucasian. Only 1 patient (5 yrs old) was a passenger. Helmet status was documented in 14 cases. 11 were reported as neglecting to use a helmet, and 3 were reported to have worn helmets. The accident mechanism was documented in 17 cases. There were 6 collisions, 9 rollovers, 1 ejection and 1 handlebar impact. There was 1 fatality. 4 patients were discharged directly from the ER whereas 15 (79%) were admitted for further management. The average LOS including inpatient rehabilitation among those admitted was 12.2 days. The spectrum of eye injuries included 1 CN III palsy, 2 lid lacerations, 2 traumatic optic neuropathies, 2 open globes, 2 exposure keratopathies, 3 CN VII palsies, and 27 eyes with 1 or more orbital fractures. 7 patients had further brain injuries. 11 patients (58%) underwent 1 or more surgical interventions including repairs of orbital fractures, CSF leaks, lid lacerations and open globes. Additional surgeries included enucleations, craniectomy, craniotomy, and gold weight implants. 2 patients were treated with IV steroid therapy for traumatic optic neuropathy. Final visual outcome could not be assessed in 14 of the 38 eyes secondary to lack of follow up/death. Among these 14, 10 eyes measured 3 pt acuity via the near card on initial exam. The remaining 4 had no initial recorded measurements. 24 of 38 eyes had both initial and final encounter visual acuity measurements. Of those, vision improved in 5, remained the same in 18, and worsened in 1. Among the 24 eyes with recorded final visual acuities, 16 were better than 20/40, 2 were between 20/40 and 20/50, and 4 were worse than 20/400. Conclusions: Serious ophthalmic injuries occur during ATV accidents often requiring surgical intervention. Our study emphasizes a broader spectrum of eye injuries than previously reported. Demographic factors associated with eye injuries in our study group include male gender, lack of helmet, vehicle driver, and Caucasian race. Eye injuries were found in a greater percentage of patients involved in ATV accidents than in motorcycle or motor vehicle accidents.
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