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Brief Report
July 18, 2019

Motor Vehicle–Associated Traumatic Ocular Injuries Secondary to External Rear-Facing Sideview Mirrors: A Report of 3 Patients

Author Affiliations
  • 1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
  • 2Department of Ophthalmology, Grady Memorial Hospital, Atlanta, Georgia
  • 3Berkeley Eye Center, Houston, Texas
JAMA Ophthalmol. 2019;137(9):1067-1071. doi:10.1001/jamaophthalmol.2019.2513
Key Points

Question  Could ocular injuries from rear-facing sideview mirrors lead to serious ocular morbidity?

Findings  In a case series of 3 patients within 3 months presenting to Grady Memorial Hospital with penetrating eye injuries from shattered side rearview mirrors, 3 patients had a mean of 1.5 surgeries, inclusive of open globe repair, and had a median postoperative visual acuity of 20/150.

Meaning  These findings show that shattered side rearview mirrors can be associated with ocular morbidity. Further studies might determine the frequency of these findings and whether any changes to design might reasonably reduce this frequency.


Importance  Rear-facing sideview mirrors are a potentially reducible source of ocular morbidity following motor vehicle crashes.

Objective  To report cases highlighting shattered glass from sideview mirrors as a potential cause of ocular trauma in motor vehicle crashes.

Design, Setting, and Participants  Case series of 3 patients who presented to Grady Memorial Hospital, a level 1 trauma center and tertiary hospital, between May 5, 2017, and July 10, 2017, with ocular trauma as a result of shattered glass from sideview mirrors during motor vehicle crashes. A review of the literature was also conducted. Data were analyzed between July 2017 and August 2017.

Interventions or Exposures  Operation for exploration and repair of open globe in all 3 cases.

Main Outcomes and Measures  Visual prognosis and ocular morbidity postoperatively.

Results  All patients were white men in the age range of 26 to 43 years. This was a retrospective review of 3 of 208 patients who presented to Grady Memorial Hospital after motor vehicle crashes from May 5, 2017, to July 10, 2017. From the time of presentation of the 3 reported patients from Grady Memorial Hospital, all 3 had 2 surgeries inclusive of the initial open globe repair. Patients with this mechanism of injury experienced ocular morbidity, with all 3 cases resulting in uveal prolapse and 2 of 3 resulting in retinal detachments. Among the 3 patients, visual acuities after the second surgery within the first year were hand motion, 20/100, and 20/150.

Conclusions and Relevance  Sideview mirrors can be a cause of serious ocular injuries in motor vehicle crashes. These 3 reported cases, combined with cases previously reported, suggest that this mechanism of ocular injury does occur. Further studies seem warranted to investigate the frequency of these findings and whether any design modifications may help reduce the frequency.