Road Traffic Accidents and Ocular Trauma: Experience
at Tripoli Eye Hospital, Libya
M El Shtewi, MD, M N Shishko, MD, and G K Purohit, MD
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Road traffic accidents (RTA) are
common occurrences every day. With the ever increasing number of various road
transport vehicles, and the increasing number of new drivers, traffic accidents
keep on increasing, causing mild to severe human injury, including injuries to
the eyes.
Eye injuries, often resulting in
some visual loss, create enormous costs both to the victim and to society. There
is great need for more active interest in the prevention of eye injuries. It is
necessary to accumulate relevant data of damage caused by road traffic
accidents (RTA) and, also, to evaluate the present situation in Libya.
The Casualty Service of the Tripoli
Eye Hospital, which receives trauma cases, is open day and night. Many cases of
eye injuries are sent from the Trauma Centre, Central Hospital, Tripoli.
Ocular involvement in road traffic
accidents may involve the eyelids, lacrimal canaliculi, orbital wall,
conjunctiva, cornea, sclera and the extra-ocular muscles. There may be prolapse
of uveal tissue, vitreous loss, traumatic cataract, retinal detachment,
vitreous haemorrhage, choroidal rupture, optic nerve avulsion or a ruptured
globe.
This two year study, from 1 October
1993 until 30 September 1995, reports the ocular trauma caused by road traffic
accidents in patients attending or referred to the Tripoli Eye Hospital.
Nature of the Injury
Most of the accidents were due to collision of one car with
another vehicle, often in head-on impact overtaking on one-way routes, or at
road traffic crossings. At times the injury was caused by a careless driver
injuring a pedestrian.
Glass-splinters from the windscreen caused cut wounds to the
face, eyelids, conjunctiva and corneas. Rupture of the globe occurred. In some
cases the injuries were limited to the external eye only with superficial
abrasion to the cornea. In some instances, for example, pieces of glass and the
frame of the spectacles pierced the eye causing a perforating injury. In a few
instances the steering wheel and dashboard were struck by the forehead, face
and the eye causing severe blunt trauma. Rarely, a fracture of the orbital
margin resulted. Intraocular foreign bodies or extraocular foreign bodies
impacted in the soft tissues of the eyes or adnexae. It was not possible to
distinguish whether the glass fragments were from windscreen glass or spectacle
glass.
Recommendations for the
Prevention of Ocular and Orbital Injuries in Road Traffic Accidents
- Passengers sitting in the front seats more commonly sustain ocular trauma.
- The use of safety seat belts must be made compulsory.
- All road vehicles must have laminated glass windscreens.
- The practice of sitting younger children on the lap of a parent on one of the front seats should not be allowed.
- There is urgent need for education of the public through the use of news media and television programmes.
- The requirement of wearing seat belts
- Observation of the rules of the road
- Punishment for reckless driving and dangerous overtaking
- The use of unbreakable plastic spectacles should be encouraged.
- Road markings, guiding traffic and drivers, need to be re-painted more frequently. Paint should be fluorescent so as to be clearly visible during darkness.
References
1. Negrel A-D, Thylefors B. The global impact of eye
injuries. Ophthalmic Epidemiology. 1998;5:143–69. [PubMed]
2. Cole MD, Clearkin L, Dabbs T, Smerdon D. The seat belt
law and after. Br J Ophthalmol. 1987;71:436–40. [PMC free article] [PubMed]
For more
information:- Some of our clients have suffered this kind of
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