Motorcycle-Associated Ocular Injuries: A Narrative Review
Road traffic accidents lead to millions of injuries and arethe leading cause of death in 5-29 year-olds globally. Among road trafficaccidents, those associated with motorcycles carry a particularly high risk ofinjury and death. The number of motorcycle fatalities is also increasing. Theissue of motorcycle injury and deaths also disproportionately affects low- andmiddle-income countries, with countries with lower GDP per capita having anincreased prevalence of motorcycle-related deaths compared to car-relateddeaths.
The literature identifying and characterizing limb and headinjuries associated with motorcycle crashes is well established, with closedfractures of the limbs and traumatic brain injuries identified as common injurytypes. However, motorcycle-related injuries involving the eye and orbit are notwell characterized. One way to possibly lower the risk of ocular injuries isthrough the use of protective equipment such as visors, goggles, andwindscreens. However, the use of protective equipment may not be widespread.The most recent report on the subject demonstrated that in 73% of motorcycleaccidents, the rider wore no eye protection, implying that foreign bodies orthe effect of wind caused impaired vision that consequently delayed thedetection of possible hazards. In addition, there is a possible elevated riskof direct ocular injuries resulting from the crashes themselves
To better understand the injury types and descriptivecharacteristics of patients experiencing motorcycle-associated eye injuries, Kimet al sought to review the literature on the subject.
The research team utilized the following databases: PubMed,EMBASE, and Web of Science to query for English articles from peer-reviewedjournals that provided some patient data regarding eye injury due to motorcycleor moped accidents or usage.
A total of 65 studies were included in qualitativesynthesis. Of these studies, 40 (61.5%) were case reports, 20 retrospectivecase series (30.8%), and five (7.69%) were observational prospective studies.Among the 25 retrospective and prospective studies, 12 (48.0%) of these studiesprimarily focused on motorcycle-associated injuries. These 65 studies describeda wide variety of motorcycle-associated eye injuries, including but not limitedto orbital fractures and associated sequelae, foreign bodies, vitreoretinaltrauma, neuro-ophthalmic trauma, corneal injuries, open globe injuries,lacerations, and globe avulsions.
From the results of this review, motorcycle eye injuries canat times lead to permanent loss of visual acuity and, in severe cases,blindness. However, the role of eye protection, such as helmet visors andgoggles, in preventing eye injuries is poorly characterized in the medicalliterature. Eye protection presumably serves two functions: firstly, to reducethe risk of motorcycle accidents by preventing vision obstruction caused byforeign objects and wind; secondly, to reduce or even possibly prevent eyeinjuries in the event of a motorcycle accident.
The current state of the literature indicates that knowledgeregarding the ocular manifestations of motorcycle accidents is limited tomostly case reports and few retrospective cohort studies focused specificallyon motorcycle-associated eye injuries. However, it is evident that the types ofmotorcycle-associated eye injuries are legion and predominantly seen in adultmales, potentially leading to severe injuries and loss of vision and blindness.Future research needs to be conducted in order to better characterize theepidemiology of certain types of motorcycle-associated eye injuries (ie foreignbody injuries) and to better understand the roles of eye protection in reducingeye injuries, both through its prevention of visual interruptions that causecrashes and through the attenuation of eye injury severity in the event of anaccident.
Source: Kim et al; Clinical Ophthalmology 2022:16 https://doi.org/10.2147/OPTH.S387034
