An Unusual Case of an Open Globe due to Airbag Injury and Scleral Lens Use

A 30-year-old woman who wears scleral contact lenses for keratoconus was brought to the emergency room after a motor vehicle collision where a deployed airbag hit her left eye. The patient was taken to the operating room for globe exploration and found to have two large scleral lacerations (one superiorly and one temporally) with significant uveal prolapse. After primary repair, she developed a retinal detachment with proliferative vitreoretinopathy, vitreous hemorrhage and a full hyphema. She underwent a vitrectomy, retinal detachment repair and penetrating keratoplasty corneal transplant. We believe the extent of her trauma is due to a unique mechanism of injury in which the scleral lens acted like a punch, creating two scleral lacerations, and expulsing the ciliary body. To our knowledge, this is the first report of scleral lens induced open globe trauma.