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JAMA Ophthalmology Clinical Challenge
October 2014

Ocular Trauma and Airbag Deployment

Author Affiliations
  • 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, Florida
JAMA Ophthalmol. 2014;132(10):1245-1246. doi:10.1001/jamaophthalmol.2014.2790

A 60-year-old woman without any remarkable ocular or medical history presented to the emergency department 2 days after a motor vehicle crash with the chief concern of a “shadow” over her right eye. The patient reported loss of consciousness and face trauma secondary to airbag deployment. Visual acuity measured 20/200 OD and 20/40 OS. No afferent pupillary defect was noted. In the right eye, external examination revealed ecchymosis and periorbital edema. The anterior segment was within normal limits. Examination of the posterior segment in the right eye demonstrated whitening of the macula with a central red spot consistent with posterior pole commotio retinae. Flame-shaped hemorrhages and cotton-wool spots were noted (Figure 1A). Optical coherence tomography (OCT) revealed subfoveal debris (Figure 1B). The patient was observed with serial examinations. At the 10-week follow-up appointment, the patient reported that she was “miserable” because of vision loss; Snellen best-corrected visual acuity was 20/30 OD. Posterior segment examination was within normal limits.

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