Air bags and ocular injuries.
OBJECTIVE
This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed.


METHODS
Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries.


RESULTS
Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury.


CONCLUSIONS
Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm.
Stein
J D
JD
Department of Ophthalmology, Jefferson Medical College, Thomas Jefferson University, USA.
Jaeger
E A
EA
Jeffers
J B
JB
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017278:Air Bags / Q000009:adverse effects* / Q000592:standards; D000869:Anterior Eye Segment / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D002829:Choroid / Q000293:injuries*; D015807:Eye Injuries, Penetrating / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006988:Hyphema / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012160:Retina / Q000293:injuries*; D012166:Retinal Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012167:Retinal Perforations / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014792:Visual Acuity; D014822:Vitreous Body / Q000293:injuries*; D014823:Vitreous Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control