Just like genitalia, the eye accounts for 1% of all surfing injuries. 14% of all surfing injuries is caused by the nose of the board (see our FFF).
This week we review a 2004 case report that illustrates the 1:70000 chance of getting an eye injury caused by the nose of a surfboard.
A 35 year old experienced surfer who was “dumped” by a large tubular wave that unexpectedly closed down on him. The nose of the surfboard hit him in the left superior orbital region and the force of the impact shattered the fiberglass coating of his board.
He was unable to open his left upper eyelid and thought he could feel a hard lump above his left globe. His visual acuity was not impaired, and external eye movements were full. There was a laceration across the upper eyelid sulcus, with marked edema and hematoma of the eyelids. The laceration was sutured under local anesthesia, and no further investigations were carried out.
Two weeks later, there was still little return of function of the left upper eyelid, and the patient was referred to an ophthalmologist. A CT scan showed a large, dense foreign body with multiple small particles embedded immediately below the superior orbital rim.
The patient was then referred to an oculoplastic surgeon, who explored the orbit. Multiple pieces of fiberglass were found to be embedded along the trajectory tract. Altogether, approximately 50 pieces ranging from individual fibers to a large, curved piece measuring 21×14 mm were extracted.
Recovery was uneventful, and 1 month after surgery, the left upper eyelid was 1 mm ptotic compared with the right in primary gaze. There was no lagophthalmos, but in downgaze, medial tethering to the orbital roof in the area of fat loss was evident.
Fiberglass is composed of silicon dioxide with various metals and elements. The fabric is made from molten glass forced through a sieve, spun in threads, and woven in sheets. There should be a high index of suspicion of retained foreign bodies in high-energy surfboard orbital trauma, especially if board fragmentation has occurred.
What’s your opinion surfboard nose protective foam covers?
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