Orbital Trauma Caused by Bicycle Hand Brakes

John D. Ng, Troy D. Payner, David E.E. Holck, Ronald T. Martin, William T. Nunery

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)60-63
Number of pages4
JournalOphthalmic plastic and reconstructive surgery
Issue number1
StatePublished - Jan 2004

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology


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