Motor Vehicle Crash-associated Eye Injuries Presenting to U.S. Emergency Departments

Grayson W. Armstrong, BA; Allison J. Chen, BA; James G. Linakis, MD, PhD; Michael J. Mello, MD, MPH; Paul B. Greenberg, MD


Western J Emerg Med. 2014;15(6):693-700. 

In This Article


From 2001 to 2008, an estimated 221,091,934 (95% confidence interval [CI] 192,415,800–249,768,068) ED visits due to non-fatal injury occurred in the U.S., of which 21,499,257 (CI 17,729,204–25,269,310), or 9.7%, were due to MVCs (Table 2). An estimated 75,028 (CI 62,103–87,953) cases, representing 0.3% of MVC ED visits, involved an injury to the eyeball. Motor vehicle crash patients presented to EDs at an estimated rate of 730.2 cases per 10,000 people (CI 602.2–858.3/10,000), while MVC-associated eye injuries presented to EDs at an estimated rate of 2.5 cases per 10,000 people (CI 2.1–3.0/10,000). Males presented to EDs more often with MVC eye injuries (59.6%; CI 56.2%–63.0%).

The estimated annual incidence of MVC-associated eye injuries presenting to EDs are presented in the figure. The annual estimated rate of MVC-associated eye injuries varied substantially from year to year, though a distinct decreasing trend was observed. A 20% decrease was also seen in the nationally estimated number of ED visits from all MVC injuries over the eight-year period (a reduction from 100.3/10,000 people to 79.8/10,000 people).


Rates of eye injuries due to motor vehicle crashes treated in United States emergency departments.
*National estimates derived utilizing NEISS-AIP weighted frequencies. Rate of injury calculated using national population estimates from US Bureau of the Census, January, 2005. Trendline created using Microsoft Excel's 'Add Trendline…' linear regression function.

The age breakdown of ED-treated MVC-associated eye injury patients is detailed in Table 3. The estimated rate of MVC eye injuries peaked in the 15- to 19-year-old age group (5.8/10,000; CI 4.3–6.0/10,000) and then decreased with increasing age (not presented in table). Children less than five years of age had the lowest estimated rate of MVC eye injuries (0.8/10,000; CI 0.4–1.2/10,000).

Table 4 details the estimated rate of ED presentation of MVC-associated eye injuries per licensed driver in the U.S. The rate of eye injury was highest in the 16 to 24 age group (3.7/10,000 licensed drivers; CI 2.6–4.8/10,000) and decreased with increasing age; in the 65 to 74 age group, however, the number of eye injuries reported was too low to provide stable estimates.

We list race and ethnicity data for MVC-associated eye injury cases in Table 5. They are presented as percentages of ED cases where race and ethnicities were known and recorded in the NEISS-AIP. The white non-Hispanic population had the greatest estimated incidence of eye injuries during our study period (59.6%; CI 45.8%–73.4%). Taking U.S. race and ethnicity population estimates into account and excluding the 'other non-Hispanic' category, the estimated rate of MVC eye injury was highest among African Americans (4.5/10,000; CI 2.0–7.1/10,000) and was lowest for Asian non-Hispanics (0.9/10,000; CI −0.3 to 2.0/10,000).

Further MVC victim- and crash-characteristics (diagnosis, disposition, occupant status) are presented in Table 6. The most common diagnoses were contusion/abrasion (61.5%; CI 56.5–66.4%), foreign body (19.7%; CI 15.5–23.9%), and hemorrhage (4.1%; CI 2.6–5.6%). The majority of patients were treated and released from the ED (94.9%; CI 92.8–97.0%). Drivers suffered the majority of MVC eye injuries (62.2% excluding unknown; CI 58.3%–66.1%) as compared to passengers.

The rates of elderly MVC eye injuries were decreased across all diagnostic categories except for 'hemorrhage,' though the number of eye injuries reported per diagnosis in each age category was often too low to provide stable estimates (data not presented).