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Case reports: Orbital trauma caused by bicycle hand brakes
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Orbital injuries caused by bicycle hand brakes are rare, and protective eyewear may not be useful in preventing them, according to a report describing two similar cases.
John Ng, MD, and colleagues at the Casey Eye Institute in Portland, Ore., described two pediatric ocular injuries involving eyelid penetration sustained while the patients were riding bicycles.
One patient, a 5-year-old boy, presented with an orbital roof fracture and penetrating brain injury. He underwent repair of the left upper eyelid laceration, craniotomy for pseudoencephalocele and ptosis repair. A second patient, a 6-year-old boy, presented with orbital hemorrhage. He underwent repair of the left upper eyelid laceration.
Both patients had been impaled by brake levers of similar styles on their bicycles’ handlebars. In both cases, a handlebar-mounted bicycle hand brake perforated the left eyelid when the rider fell onto it after losing control. Neither patient was wearing protective head or eyewear.
“Helmets or protective eyewear probably would not have prevented these injuries,” the authors of the report said.
Two months after surgery, the 5-year-old patient had 20/25 visual acuity and excellent cosmetic appearance. The 6-year-old patient had baseline amblyopic vision 2 days after surgery but was lost to follow-up.
The case studies are published in the January issue of Ophthalmic Plastic and Reconstructive Surgery.