Outdoor “risk sports” may cause traumatic eye injuries such as retinal hemorrhages, according to findings published in Journal Francais d’Ophtalmologie.
Researchers presented a literature review and clinical case study detailing ocular trauma occurring secondary to bodily injury after sports such as bungee jumping. The study explains that, due to the heights from which participants of this sport fall (60 to 120 meters), injuries such as contusions, burns, eye hemorrhages, peroneal nerve paralysis, and tetraplegia have been known to occur. Additionally, due to increased intrathoracic and ocular hydrostatic pressure, eye injuries similar to Purtscher’s retinal traumatic angiopathy and Valsalva’s retinopathy have been noted in previous literature. Evidence-based explanations for the increase in intrathoracic pressure include air retention and excessive abdominal muscle tension, as well as the sudden deceleration and blood flow to the head due to rope tension.
In addition to retinal hemorrhage, the researchers explain that previous studies have identified periorbital hematomas, chemosis, hyposphagma, oculomotor paralysis, and nystagmus as ocular injuries resulting from bungee jumping. The literature review also found descriptions of internal limiting membrane hemorrhages, subhyaloid hemorrhages, and vitreous hemorrhages. Foveal involvement of injuries described may be accompanied by macular edema and cotton wool exudates, the report adds.
As far as visual acuity (VA), prior research has noted changes ranging from “slightly diminished” to “severely affected,” with slow but high rates of recovery in patients with such lesions.
The present study detailed the case of a 23-year-old female patient who, upon experiencing a sudden loss of bilateral vision, went to the emergency room. The case notes that the patient had gone jogging 2 days earlier, but had no medications or family history of interest. Exams of motility, pupillary reflexes, color vision, alterations in the anterior pole, and intraocular pressure (IOP) were normal, with the only finding being scattered superficial hemorrhages in the posterior pole of both eyes. She was tested for VA at the time of the incident as well as at a 1-year follow-up.
“…she presented a [VA] without correction of count fingers at 2 meters in the right eye and 8/10 in the left eye, without improvement with the pinhole … 1 year after the episode, she was re-evaluated with a corrected [VA] of 8/10 in the right eye and 10/10 in the left eye and fundus with small changes in the macular pigment epithelium,” the study explains. “OCT showed chorioretinal atrophy in the macular area with no change in foveal thickness.”
The researchers conclude that it is important to understand the eye injuries secondary to the practice of bungee jumping to make early diagnoses to reduce future ocular damage.
Pérez-Rueda A, Castro-Luna G. Traumatic retinal hemorrhages after bungee jumping: A case report and review of the literature. J Fr Ophthalmol. Published online April 5, 2021. doi:10.1016/j.jfo.2020.10.006