When the head impacts a soft surface, the force is widely dissipated even though the brain decelerates rapidly. More importantly it is the sudden angular deceleration of the brain and cerebral vessels that causes intracranial injury. Furthermore, when ocular damage was present, retinal, subdural optic nerve and vitreous hemorrhages were included in the list of injuries. 4 Hemorrhages were most frequently seen in the posterior fundus. 4 Subdural optic nerve hemorrhages can be attributed to indirect and direct mechanisms.
Indirect trauma is caused by local rupture of the dural-pial bridging vessels.
5 Direct trauma to the optic nerve results in compressive or contusive forces on the optic nerve vessels. 4 Damage to the retina, which includes retinal detachment, may result in profound visual loss from macular scarring, chorioretinal atrophy and optic nerve atrophy. 4 Similar findings of folds, retinoschisis and retinal hemorrhages were also reported in a study of experimental blunt, nonperforating eye trauma. As proposed by Greenwald et al, retinal folds and retinoschisis are produced from severe anteroposterior acceleration-deceleration forces. 4 These types of injuries are usually the result of direct trauma to the eye.