Citation

Ng JD, Payner TD, Holck DE, Martin RT, Nunery WT. Ophthal. Plast. Reconstr. Surg. 2004; 20(1): 60-63.

Affiliation

Casey Eye Institute, Portland, Oregon, U.S.A. ngj@ohsu.edu

Copyright

(Copyright © 2004, American Society of Ophthalmic Plastic and Reconstructive Surgery, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/01.IOP.0000103007.29795.71

PMID

14752313

Abstract

PURPOSE: This report aims to increase awareness of an unusual mechanism of orbital injury sustained by bicycle riders. METHODS: In this retrospective small case series, we describe two cases of orbital injury caused by upper eyelid penetration. A 5-year-old boy (patient 1) and a 6-year-old boy (patient 2) presented to our service within a 2-week period. Both had been injured by similarly styled, handlebar-mounted bicycle hand brake levers. Patient 1 had an orbital roof fracture and penetrating brain injury and underwent repair of a left upper eyelid laceration, craniotomy for pseudoencephalocele, and ptosis repair. Patient 2 had orbital hemorrhage and underwent repair of left upper eyelid laceration. RESULTS: In both cases, a handlebar-mounted bicycle hand brake lever perforated the left eyelid when the rider fell onto it. Neither patient was wearing protective headwear or eyewear. Two months after surgery, patient 1 had 20/25 visual acuity OU and excellent cosmetic appearance. Patient 2 had baseline amblyopic vision 2 days after surgery but moved from town and was lost to follow-up. CONCLUSIONS: Orbit injuries from bicycle brake levers are rare, and helmets or protective eyewear probably would not have prevented these injuries. However, a change in the design and/or mounting location of handlebar-mounted brake levers might help prevent further injuries of this type.