Airbags Provide a Crash Course in Eye Trauma

June 9, 2000 -- Airbags save lives, but they can be hard on the eyes -- literally. During a collision, older-model auto airbags can deploy with such force that they can cause serious injuries to the eyes or even, in rare cases, blindness, say eye trauma specialists interviewed by WebMD.

Airbags can also cause the loss of fingers or parts of limbs if the driver or passenger is resting his or her hands on the airbag cover -- usually in the center of the steering wheel or the right-hand side of the dashboard -- at the moment the bag deploys.

Despite these concerns, when airbags are used as recommended and in conjunction with seat belts, they are usually safe and still beat the alternative, says a specialist who has treated patients with eye injuries sustained in car crashes. "Who knows what would've happened? Without the airbag maybe their eye would be fine, but they'd be dead," Eugene S. Lit, MD, director of the eye trauma service at the Massachusetts Eye and Ear Infirmary in Boston, tells WebMD.

"There's no question that airbags save lives, but they certainly can be improved," says Edward E. Manche, MD, assistant professor of ophthalmology at Stanford University School of Medicine.

He says the most common eye injuries seen with airbag deployment are superficial scratches, and burns from the propellant used to inflate the bag. But in a study of these cases published in 1997, Manche and colleagues saw patients with injuries to the retina (the delicate tissue lining the inside of the eye that serves as a screen for transmitting images to the brain), bleeding within the eye, cataracts (clouding of the lens due to trauma), rupture of the eyeball itself, and even one case of a young woman who went blind from her injuries.

And in at least one case, an airbag deployed with enough force to displace a LASIK flap in the cornea of a woman who had undergone the corrective laser eye surgery more than a year earlier. As Heath L. Lemley, MD, and colleagues report in The Journal of Refractive Surgery, the 37-year-old woman had a partial dislocation of the surgical flap caused by airbag deployment during a high-speed crash 17 months after her corneal surgery.

This is very rare, and the experts see no need for alarm. "The new LASIK flaps with laser refractive surgery are very strong, and I would say that the integrity is almost the same as in an eye that hasn't had surgery," Lit tells WebMD.

Thomas C. Wolf, MD, director of refractive surgery at the Dean A. McGee Eye Institute at Oklahoma Health Sciences Center in Oklahoma City and co-author of a study on airbag-related eye damage, tells WebMD that paint balls used for recreational shooting cause more eye injuries than airbags. But he cautions that drivers and passengers should heed the advice of experts:

"The main advice I'd give is what everybody in the department of public safety always says, and that is that if you have airbags, they're only effective if you're wearing a shoulder restraint or a seat belt. So if you're in a car with airbags, keep the seat back where it's supposed to be and keep your seat belt on," Wolf tells WebMD.

Manche says that the people most at risk for injury from airbags are those of short-stature who sit close to the steering wheel: "The airbags inflate at something like 200 miles an hour, and it's an explosive event. The closer you are to the steering column, the more impact you'll receive from the inflating airbag."

Manche adds, however, that the injuries he saw in his study occurred with older, "one-size-fits-all" airbag designs. Newer-model cars have bags that deflate with less force, and some new and soon-to-be available designs include "smart" features that sense the height, weight, and relative position of the occupant, as well as the vehicle's speed, and adjust the force and speed of bag inflation accordingly.

Vital Information:

  • Although having airbags in your car is safer than not having them, when an airbag deploys, it can damage the eye in some cases.
  • To avoid potential injury, one expert recommends sitting back from the steering wheel and always wearing a seat belt.
  • Newer-model cars may have airbags that deploy with less force, making them even safer for the eyes, and "smart" airbags will soon be available in some models as well.