Biomechanical modeling of eye trauma for different orbit anthropometries.

In military, automotive, and sporting safety, there is concern over eye protection and the effects of facial anthropometry differences on risk of eye injury. The objective of this study is to investigate differences in orbital geometry and analyze their effect on eye impact injury. Clinical measurements of the orbital aperture, brow protrusion angle, eye protrusion, and the eye location within the orbit were used to develop a matrix of simulations. A finite element (FE) model of the orbit was developed from a computed tomography (CT) scan of an average male and transformed to model 27 different anthropometries. Impacts were modeled using an eye model incorporating lagrangian-eulerian fluid flow for the eye, representing a full eye for evaluation of omnidirectional impact and interaction with the orbit. Computational simulations of a Little League (CD25) baseball impact at 30.1m/s were conducted to assess the effect of orbit anthropometry on eye injury metrics. Parameters measured include stress and strain in the corneoscleral shell, internal dynamic eye pressure, and contact forces between the orbit, eye, and baseball. The location of peak stresses and strains was also assessed. Main effects and interaction effects identified in the statistical analysis illustrate the complex relationship between the anthropometric variation and eye response. The results of the study showed that the eye is more protected from impact with smaller orbital apertures, more brow protrusion, and less eye protrusion, provided that the orbital aperture is large enough to deter contact of the eye with the orbit.

[1]  N. Davies,et al.  Age-related changes in the normal sagittal relationship between globe and orbit. , 2007, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[2]  K. Tsubota,et al.  Corneal endothelial cell loss induced by air bags. , 1993, Ophthalmology.

[3]  D R Ballal,et al.  Ocular and orbital trauma from water balloon slingshots. A clinical, epidemiologic, and experimental study. , 1997, Ophthalmology.

[4]  Joel D Stitzel,et al.  A nonlinear finite element model of the eye with experimental validation for the prediction of globe rupture. , 2002, Stapp car crash journal.

[5]  L. Parver,et al.  Eye Trauma: The Neglected Disorder , 1986 .

[6]  Kraig S Bower,et al.  Perforating globe injuries during operation Iraqi Freedom. , 2008, Ophthalmology.

[7]  Katherine Desiree Voorhies,et al.  Static and Dynamic Stress/Strain Properties for Human and Porcine Eyes , 2003 .

[8]  C D Witherspoon,et al.  Epidemiology of motor vehicle crash-related serious eye injuries. , 1994, Accident; analysis and prevention.

[9]  J. Sipperley,et al.  Ocular injuries from paintball pellets. , 1999, Ophthalmology.

[10]  H Patino Baseball hardness as a risk factor for eye injuries , 1999 .

[11]  I. C. Howard,et al.  A Computational study of the passive mechanisms of eye restraint during head impact trauma , 2005, Computer methods in biomechanics and biomedical engineering.

[12]  H B Pryor,et al.  Objective measurement of interpupillary distance. , 1969, Pediatrics.

[13]  J. Kingham,et al.  Ocular and ocular adnexal injuries treated by United States military ophthalmologists during Operations Desert Shield and Desert Storm. , 1993, Ophthalmology.

[14]  K Müller-Jensen,et al.  [Eye injuries by safety glass (windshield)]. , 1969, Hefte zur Unfallheilkunde.

[15]  J Weatherill,et al.  Sport-related eye trauma: a survey of the presentation of eye injuries to a casualty clinic and the use of protective eye-wear. , 1995, Eye.

[16]  S. Steidl,et al.  Penetrating eye injury in war. , 1999, Military medicine.

[17]  R. Enzenauer,et al.  Ocular injuries and diseases at a combat support hospital in support of Operations Desert Shield and Desert Storm. , 1993, Archives of ophthalmology.

[18]  David J. Porta,et al.  Airbag-Induced Eye Injuries: A Report of 25 Cases , 1996 .

[19]  R. Barretto,et al.  Orbital Measurement in Black and White Populations , 1999, The Laryngoscope.

[20]  Richard D Stutzman,et al.  Severe eye injuries in the war in Iraq, 2003-2005. , 2008, Ophthalmology.

[21]  Joel D Stitzel,et al.  The effects of depowered airbags on eye injuries in frontal automobile crashes. , 2005, The American journal of emergency medicine.

[22]  Jorge O Rodriguez,et al.  Prevention and treatment of common eye injuries in sports. , 2003, American family physician.

[23]  I L Dunsky,et al.  Normative Data for Hertel Exophthalmometry in a Normal Adult Black Population , 1992, Optometry and vision science : official publication of the American Academy of Optometry.

[24]  W R Green,et al.  Ocular explosions from periocular anesthetic injections: a clinical, histopathologic, experimental, and biophysical study. , 1999, Ophthalmology.

[25]  Eric Kennedy,et al.  The effects of the extraocular muscles on eye impact force-deflection and globe rupture response. , 2008, Journal of biomechanics.

[26]  Kraig S Bower,et al.  Combat ocular trauma visual outcomes during operations iraqi and enduring freedom. , 2008, Ophthalmology.

[27]  J. Pessa,et al.  Changes in ocular globe-to-orbital rim position with age: Implications for aesthetic blepharoplasty of the lower eyelids , 1999, Aesthetic Plastic Surgery.

[28]  Ingrid U Scott,et al.  Potential impact of seatbelt use on the spectrum of ocular injuries and visual acuity outcomes after motor vehicle accidents with airbag deployment. , 2008, Ophthalmology.

[29]  Cynthia Owsley,et al.  Rate of eye injury in the United States. , 2005, Archives of ophthalmology.

[30]  S. Duma,et al.  Evaluation of different projectiles in matched experimental eye impact simulations. , 2011, Journal of biomechanical engineering.

[31]  J R Crandall,et al.  Eye injuries from airbags with seamless module covers. , 2000, The Journal of trauma.

[32]  Thomas H Mader,et al.  Ocular war injuries of the Iraqi Insurgency,January-September 2004. , 2006, Ophthalmology.

[33]  Stefan M Duma,et al.  High-rate internal pressurization of human eyes to predict globe rupture. , 2009, Archives of ophthalmology.

[34]  Joel D Stitzel,et al.  CT based three-dimensional measurement of orbit and eye anthropometry. , 2010, Investigative ophthalmology & visual science.

[35]  E K Pivnick,et al.  Interpupillary distance in a normal black population , 1999, Clinical genetics.

[36]  Joel D Stitzel,et al.  The effect of frontal air bags on eye injury patterns in automobile crashes. , 2002, Archives of ophthalmology.

[37]  W R Green,et al.  Ocular explosion after peribulbar anesthesia: case report and experimental study. , 1997, Ophthalmology.

[38]  W R Green,et al.  Ocular explosion during cataract surgery: a clinical, histopathological, experimental, and biophysical study. , 1998, Transactions of the American Ophthalmological Society.

[39]  T. Tervo,et al.  Do motor vehicle airbags increase risk of ocular injuries in adults? , 2003, Ophthalmology.

[40]  Stefan M Duma,et al.  Prediction of severe eye injuries in automobile accidents: static and dynamic rupture pressure of the eye. , 2004, Annual proceedings. Association for the Advancement of Automotive Medicine.

[41]  L. T. Kisielewicz,et al.  Simulation model of an eyeball based on finite element analysis on a supercomputer , 1999, The British journal of ophthalmology.

[42]  F BolañosGildeMontes,et al.  Exophthalmometry in Mexican adults. , 1999 .

[43]  Risto Kontio,et al.  Orbital stress analysis--Part I: Simulation of orbital deformation following blunt injury by finite element analysis method. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[44]  G. Lueder Air bag-associated ocular trauma in children. , 2000, Ophthalmology.

[45]  J H Cassen,et al.  Ocular trauma. , 1997, Hawaii medical journal.

[46]  David Smith,et al.  The epidemiology and diagnosis of penetrating eye injuries. , 2002, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[47]  U. Desai,et al.  Incidence of ocular injuries in motor vehicle crash victims with concomitant air bag deployment. , 2002, Ophthalmology.

[48]  Douglas K Ousterhout,et al.  Curve analysis of the aging orbital aperture. , 2003, Plastic and reconstructive surgery.

[49]  L Chisholm Ocular injury due to blunt trauma. , 1969, Applied therapeutics.

[50]  P. Mulder,et al.  Topographic anatomy of the eyelids, and the effects of sex and age , 1999, The British journal of ophthalmology.