Motor Vehicle Accident Eye Injury Expert
Vision complaints after a motor vehicle collision fall into two very different groups: direct injuries to the eye and orbit from airbags, glass, steering wheels and dashboards, and indirect effects on vision from head injury, whiplash and the visual pathways. Marc H. Shomer, MD, PhD, QME evaluates both, with the objective tools that separate structural damage from symptoms that have another explanation.
Direct injuries to the eye and orbit
- Airbag injuries. Deployment can cause corneal abrasion, hyphema, iris damage, lens dislocation, retinal tears and, in the most severe cases, globe rupture. The chemical residue from deployment can also produce a mild alkali keratitis. The severity depends on occupant position, seat distance and whether eyeglasses were worn.
- Glass and blunt impact. Windshield and side-window fragments cause lid lacerations, corneal lacerations and penetrating injury; steering wheel and dashboard impact causes the blunt injuries described at Blunt Eye Trauma.
- Orbital fractures. A blowout fracture of the orbital floor or medial wall can trap the extraocular muscles and cause persistent double vision, numbness of the cheek and a sunken eye. Whether and when to repair it, and whether diplopia was addressed, are frequent standard-of-care questions.
- Traumatic optic neuropathy. Blunt force to the brow or head can injure the optic nerve without any visible damage to the eye, producing profound loss on one side with a relative afferent pupillary defect as the objective sign. See Optic Nerve Injury.
Vision after head injury
Blurred vision, light sensitivity, reading difficulty and double vision are common after concussion and can persist for months. Some have measurable causes: a cranial nerve palsy, a convergence insufficiency, a visual field defect from injury to the visual pathways in the brain. Others are real symptoms without a structural correlate. Distinguishing the two is the core of the evaluation and is done with the same objective tests used in any vision claim: pupillary responses, optical coherence tomography (OCT), automated perimetry and, where indicated, electrophysiology. See Neuro-Ophthalmology Expert Witness.
The pre-accident record is the case. Optometry files, the most recent eyeglass prescription and Department of Motor Vehicles vision screening often establish the baseline against which any claimed loss is measured. They should be requested before they are purged.
Causation questions that recur
- Was a retinal detachment diagnosed weeks after the collision caused by it, or by the patient’s high myopia and age? The presence of a tear pattern consistent with trauma, the timing and the fellow eye all bear on the answer. See Retinal Detachment.
- Did the collision cause the cataract, or accelerate one that was already forming? Traumatic cataracts have characteristic patterns that an examination can identify.
- Is a claimed field loss consistent with the imaging of the nerve and retina, or does the field show the constriction pattern seen in non-organic loss? See Evaluating Vision Loss Claims.
Damages and prognosis
Visual impairment is quantified from best-corrected acuity, visual fields and diplopia using the AMA Guides framework. Prognosis depends on the tissue injured: a corneal abrasion heals completely, an orbital fracture repaired promptly usually resolves the double vision, and optic nerve damage generally does not recover. Future care ranges from a single follow-up visit to lifelong glaucoma treatment after angle recession. See Ophthalmic Prognosis and Visual Disability Evaluation.
What attorneys should gather
The crash report and photographs; emergency department and trauma records including any CT of the orbits and head; all ophthalmology, optometry and neurology records before and after the collision; imaging in native format; and the current eyeglass prescription. The general checklist is at Attorney Checklist for Eye Injury Cases.
Frequently Asked Questions
Can an airbag cause permanent eye damage?
Yes, though most airbag eye injuries are superficial and heal. Serious injuries include hyphema, lens dislocation, retinal tears and, rarely, globe rupture. Eyeglasses worn at deployment can shatter and add laceration injuries.
Why does my client see double after a car accident?
Common causes are an orbital fracture trapping an eye muscle, a cranial nerve palsy from head injury, or a convergence problem after concussion. Each has characteristic examination findings, and the treatment and prognosis differ, so the cause needs to be identified rather than assumed.
Can a collision cause a retinal detachment weeks later?
It can. Trauma can create a retinal tear that leads to detachment days or weeks afterward. The question in each case is whether the findings support a traumatic tear or a detachment from age, high myopia or lattice degeneration, and the examination record at the time of injury is usually decisive.
How is vision loss after a car accident measured for damages?
From best-corrected visual acuity, visual field testing and any double vision, rated under the AMA Guides framework, with the reliability of each test checked and the results correlated with structural imaging.
Authorities Cited
Primary sources referenced on this page. Links open the official text on the publishing agency’s site.
Educational information only. This page provides general information for attorneys and other medical-legal professionals. It is not medical or legal advice, does not address any particular case, and does not create a physician-patient, attorney-client, or expert-client relationship. Opinions in any matter are formed only after review of the specific records, examination findings, and applicable literature. Past engagements do not guarantee any result.
Board-certified ophthalmologist; Adjunct Associate Professor of Ophthalmology, Keck School of Medicine of USC; active California Qualified Medical Evaluator. Full biography · Curriculum vitae
Published September 16, 2026 · Last substantive review September 16, 2026 · Medical reviewer: Marc H. Shomer, MD, PhD, QME
Request a Conflict Check and Case Review
Submit the matter for conflict screening. Please do not send medical records or protected health information until conflicts are cleared and secure transfer instructions are provided.