97th DOG Annual Meeting 1999
AIRBAG-INDUCED ORBITAL CONTUSION IN A MINOR ACCIDENT
S. Gösele, K. M. Stein*, A. Peuser**, E. Miltner***, R. O. W. Burk
Introduction: With the installation of airbags, fatal injuries in severe accidents were reduced from 11.9 % to 2.8 %. But the present case shows severe ocular injuries in a minor accident, caused by inadequate geometry of airbag-deployment, early release of the airbag, and small size of the passenger sitting close to the dashboard.
Case: The 31-year-old front passenger in a Fiat Brava (1997 model) was wearing a seat belt. She suffered a blunt ocular trauma of her right eye during a collision. In the emergency room, visual acuity was light perception, intraocular pressure was 3 mmHg. There was a conjunctival dehiscence, endothelial contusion with following stromal edema and epithelial bullae, hyphema, traumatic mydriasis, and lens subluxation with following traumatic cataract. The retina developed a sclopetarian retinopathy with a chorioretinal scar. There was a pseudoptosis by hematoma of the lid, and a fracture of the lamina papyracea.
Discussion: The Fiat's approaching speed was about 36 km/h and after braking, its speed was about 31 km/h. The impact was at the left front side, the maximum deceleration being 15 - 19 km/h. The airbag-deployment was directed to the face of the side passenger. Colour traces were found on the upper rim of the airbag, apparently from the patient's eye shadow. The eye injuries had consequently been caused by the deploying airbag. Improvements by changing the geometry of deployment (e.g. tethered airbags), later release, and so-called "intelligent systems" with additional sensors are possible.
Department of Ophthalmology, Heidelberg University, Im Neuenheimer Feld 400, D-69120 Heidelberg;
*Institute of Legal Medicine, Heidelberg University; **Engineers' Office Wiedmann Neckarsulm;
*** Institute of Forensic Medicine, Ulm University