An uncommon mechanism of airbag-related ocular injury

There have been several reviews of airbag‑related eye injuries. Regarding the action of airbags themselves the mechanisms responsible for these injuries have been classified into three types: impact force on the eyes or objects between the occupant and the airbag vented hot nitrogen gas and surface abrasions. We report a patient who suffered severe corneal injury in a car crash while driving at low speed without wearing a seat belt. In this case the action of the airbag was not among the well‑known mechanisms. A 23‑year‑old man lost control of his automobile while accelerating from a stop signal and crashed into a guardrail at approximately 30 km/h while not wearing a seat belt. He was aware of his surroundings but because he felt sleepy he could not support his body in the driving position at the time of the sudden crash. His head moved along the surface of the airbag and his left eye impacted the end of the column shift lever. His half‑rim eyeglasses were broken in the collision. A long continuous oblique penetrating corneal injury iris prolapse and laceration of the upper and lower eyelids occurred. The corneal and skin lacerations were closed with sutures and the iris prolapse was repaired. His final visual acuity was 20/20 although corneal opacity remained and the pupil was deformed slightly. With regard to the action of the airbag itself the deployed airbag led to the subject's movement. This mechanism of injury has not been reported previously.