TY - JOUR
AU - Kuhn, Ferenc
AB - Determining the incidence and severity of ocular injuries and the protective vs harmful effect of air bag deployment is important. We commend Duma et al1 for raising the issue, but we found several reasons for concern. Using the National Automotive Sampling System database may represent selection bias because it is not a random sampling. Is it not possible that, given the increased interest in injuries related to air bags, disproportionately more of these cases have been selected for analysis? How can we be certain that crashes involving air bag deployment were of equal severity to those without? Is the air bag not more likely to deploy in more severe crashes? It is most unfortunate to use the new Abbreviated Injury Scale (AIS) to assess eye injury severity. The new AIS does not follow the internationally accepted ocular trauma terminology (Birmingham Eye Trauma Terminology2) and appears arbitrary. For example, what is a corneal hyphema? How can a nurse determine that posterior vitreous detachment has occurred? How can traumatic cataract, vitreous hemorrhage, macular hole, and endophthalmitis, just to name a few, be omitted? Why is uveal injury designated a level 2 injury, only to have choroidal rupture designated a level 3 injury, and why is iris laceration also a level 3 injury? Why are skin abrasions included as eye injuries? Authors of numerous studies identified variables with prognostic significance for open and closed globe injuries. Many such variables were not included in the authors' methodology, and those included are not organized in a rational manner. The authors cannot be faulted with creating the new AIS, but its use is questionable at best, and comments on its inadequacies should have been included in the discussion. Air bags, as we have indicated in 2 published reviews, 3,4 save lives and prevent injuries. We have shown3 that occupants in similar crashes have a 2.5 times higher risk of sustaining an eye injury if there is no air bag deployment. Careful reading of the article by Duma et al1 yields the same conclusion, but it is unfortunate to emphasize in the abstract that corneal abrasions are statistically significantly more common with than without air bag deployment. Although this may well be true, this injury has no long-term visual consequences. What matters is that occupants have a higher chance of staying alive and a reduced risk of sustaining vision-threatening globe trauma. The authors' study contributes to the body of knowledge concerning eye injuries and air bag deployment, and we encourage a more concerted effort between clinicians and research scientists to develop an ocular injury scale that more accurately predicts the severity of injury. We encourage our colleagues to report cases of severe ocular injury sustained in automobile accidents to the United States Eye Injury Registry, which now has online reporting (www.useironline.org). We congratulate the authors on their pioneering data about use of eyeglasses and contact lenses, but we caution against emphasizing injuries that are related to air bags but have no visual relevance— this may be counterproductive.5 References 1. Duma SMJernigan MVStitzel JD et al. The effect of frontal air bags on eye injury patterns in automobile crashes. Arch Ophthalmol. 2002;1201517- 1522PubMedGoogle ScholarCrossref 2. Kuhn FMorris RWitherspoon CDHeimann KJeffers JTreister G A standardized classification of ocular trauma terminology. Ophthalmology. 1996;103240- 243PubMedGoogle ScholarCrossref 3. Kuhn FMorris RWitherspoon C Eye injury and the air bag. Curr Opin Ophthalmol. 1995;638- 44PubMedGoogle ScholarCrossref 4. Pearlman JEong KKuhn FPieramici D Air bags and eye injuries: epidemiology, spectrum of injury, and analysis of risk factors. Surv Ophthalmol. 2001;46234- 242PubMedGoogle ScholarCrossref 5. Kuhn FMorris RWitherspoon CByrne JBrown S Air bag: friend or foe? Arch Ophthalmol. 1993;1111333- 1334PubMedGoogle ScholarCrossref
TI - Frontal Air Bags and Eye Injury Patterns in Automobile Crashes
JF - Archives of Ophthalmology
DO - 10.1001/archopht.121.12.1807
DA - 2003-12-01
UR - https://www.deepdyve.com/lp/american-medical-association/frontal-air-bags-and-eye-injury-patterns-in-automobile-crashes-ce8rclaQmC
SP - 1807
EP - 1808
VL - 121
IS - 12
DP - DeepDyve
ER -