@article{ref1,
title="Orbital trauma caused by bicycle hand brakes",
journal="Ophthalmic plastic and reconstructive surgery",
year="2004",
author="Ng, John D. and Payner, Troy D. and Holck, David E. E. and Martin, Ronald T. and Nunery, William T.",
volume="20",
number="1",
pages="60-63",
abstract="PURPOSE: This report aims to increase awareness of an unusual mechanism of orbital injury sustained by bicycle riders. METHODS: In this retrospective small case series, we describe two cases of orbital injury caused by upper eyelid penetration. A 5-year-old boy (patient 1) and a 6-year-old boy (patient 2) presented to our service within a 2-week period. Both had been injured by similarly styled, handlebar-mounted bicycle hand brake levers. Patient 1 had an orbital roof fracture and penetrating brain injury and underwent repair of a left upper eyelid laceration, craniotomy for pseudoencephalocele, and ptosis repair. Patient 2 had orbital hemorrhage and underwent repair of left upper eyelid laceration. RESULTS: In both cases, a handlebar-mounted bicycle hand brake lever perforated the left eyelid when the rider fell onto it. Neither patient was wearing protective headwear or eyewear. Two months after surgery, patient 1 had 20/25 visual acuity OU and excellent cosmetic appearance. Patient 2 had baseline amblyopic vision 2 days after surgery but moved from town and was lost to follow-up. CONCLUSIONS: Orbit injuries from bicycle brake levers are rare, and helmets or protective eyewear probably would not have prevented these injuries. However, a change in the design and/or mounting location of handlebar-mounted brake levers might help prevent further injuries of this type.",
language="",
issn="0740-9303",
doi="10.1097/01.IOP.0000103007.29795.71",
url="http://dx.doi.org/10.1097/01.IOP.0000103007.29795.71"
}