Descemet's membrane detachment attributed to the mechanical forces of airbag deployment

Abstract

A patient who developed a Descemet's membrane detachment 3 weeks following airbag deployment is reported. A hydrogel contact lens wearer (extended wear) presented to her primary eye care provider with a painful red eye that had been treated with pressure patching the previous day at a hospital emergency room. Examination revealed full thickness corneal edema localized in the temporal region of the left eye, a corneal infiltrate with an overlying epithelial defect, and an anterior chamber reaction with marked temporal injection. The patient was referred to a corneal specialist after the cornea failed to respond to anti-microbial treatment. Probing of the history revealed that the patient had recently sustained an automobile accident in which the front air bags had deployed. Confocal microscopy revealed that Descemet's membrane was detached, presumably secondary to the mechanical forces of airbag deployment. The patient recovered normal vision after 3 weeks of topical therapy and ultimately returned to successful contact lens wear. Although Descemet's membrane detachment is an uncommon complication of airbag deployment, it is important to exclude this possibility because delayed diagnosis and treatment may compromise the corneal endothelium, predispose the cornea to chronic edema, and result in permanent vision loss. An awareness of the spectrum of injuries resulting from airbag deployment should facilitate early diagnosis and treatment, particularly in situations where the etiology of the presenting eye condition is not readily apparent.