HEENT:

• Superficial abrasions to the right periorbital area with mild upper-eyelid edema
• Textured honeycomb pattern overlying 80 percent of the right cornea visible on direct visualization and more prominent with fluorescein staining under ultraviolet light
• Pupils equal, round, and reactive to light, 3 mm in size
• Bilateral visual fields intact to confrontation

Visual Acuity: Right eye 20/100, left eye 20/20

Intraocular Pressure: Right eye 12 mm Hg, left eye 18 mm Hg

Corneal pH: Right eye 7, Left eye 7

Airbag trauma

While the use of airbags has long been associated with a reduction in MVC mortality, the incidence of ocular-related airbag trauma has been well described in ophthalmologic literature [1-6]. Airbag-related injuries include alkali burns, lens dislocation, corneal abrasions, traumatic cataracts, globe rupture, and others.

Most modern airbags are equipped with a nylon bag that deploys upon vehicle impact and can cause significant facial injury. This is the likely cause of the textured honeycombed corneal abrasion in our patient described above. Airbag-related eye injuries have been found to be exceedingly rare when the vehicle occupant survives the incident and a restraint system was used appropriately [7].

The patient was treated with erythromycin ointment and moxifloxacin eye drops and discharged home with directions for a prompt outpatient ophthalmology follow-up.

Take-Home Points

• In trauma patients with eye complaints following an MVC with airbag deployment, a high index of suspicion should be maintained, and a thorough ocular examination conducted.
• Remember to check the corneal pH as alkali-related ocular injuries are potentially blinding and represent a true ophthalmologic emergency.

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