Blunt trauma of the aging eye: injury mechanisms and increasing lens stiffness.

OBJECTIVE To investigate possible injury mechanisms in the eyes of elderly individuals and the effects of lens stiffness on model outputs indicative of injury as a function of age. METHODS Three separate frontal impact scenarios, a foam particle (30 m/s), steering wheel (15 m/s), and air bag (67 m/s), were simulated with a validated finite-element model to determine the effects of changing lens stiffness on the eye when subjected to blunt trauma. The lens stiffness of the model was increased with increasing age using stiffness values determined from the literature for 3 age groups. RESULTS The computational eye model demonstrated increasing peak stress in the posterior portion of the ciliary body and decreasing peak stress in the posterior portion of the zonules with increasing lens stiffness for the 2 most severe impact types, the air bag and steering wheel. Peak deformation of the lens decreased with increasing lens stiffness. CONCLUSIONS On the basis of the computational modeling analysis, the risk of eye injury increases with age; as a result, the eyes of elderly patients may be more susceptible to ciliary body-related eye injuries in traumatic-impact situations. Clinical Relevance These data support the contention that trauma-induced damage to the lens, ciliary body, and zonules may be related to increased stiffness of the lens. The data indicate that all people, especially elderly individuals, should use safety systems while driving an automobile and sit as far from the air bag as is comfortable. Those in sports or work environments requiring protective lenses should wear them. Designers of air bags and automobile companies should continue to work to reduce the potential that the air bag will contact the eye.