Current knowledge of traumatic ocular injury is still limited as most studies have focused on the ocular injuries that happened at the anterior part of the eye, whereas the damage to the optic nerve known as traumatic optic neuropathy (TON) is poorly understood. The goal of this study is to understand the mechanism of the TON following the primary blast through a fluid–structure interaction model. An axisymmetric three-dimensional (3D) eye model with detailed orbital components was developed to capture the dynamics of the eye under the blast wave. Our numerical results demonstrated a transient pressure elevation in both vitreous and cerebrospinal fluid (CSF). A high strain rate over 100 s−1 was observed throughout the optic nerve during the blast with the most vulnerable part located at the intracanalicular region. The optic nerve deforming at such a high strain rate may account for the axonal damage and vision loss in patients subjected to the primary blast. The results from this work would enhance the understanding of indirect TON and provide guidance in the design of protective eyewear against such injury.
References
1.
Blanch
, R.
, Bindra
, M.
, Jacks
, A.
, and Scott
, R. A.
, 2011
, “Ophthalmic Injuries in British Armed Forces in Iraq and Afghanistan
,” Eye
, 25
(2
), p. 218
.2.
Ari
, A. B.
, 2006
, “Eye Injuries on the Battlefields of Iraq and Afghanistan: Public Health Implications
,” Optom.-J. Am. Optom. Assoc.
, 77
(7
), pp. 329
–339
.3.
Weichel
, E. D.
, Colyer
, M. H.
, Ludlow
, S. E.
, Bower
, K. S.
, and Eiseman
, A. S.
, 2008
, “Combat Ocular Trauma Visual Outcomes During Operations Iraqi and Enduring Freedom
,” Ophthalmology
, 115
(12
), pp. 2235
–2245
.4.
Harris
, J. N.
, and Miller
, N. R.
, 2017
, “Traumatic Optic Neuropathy
,” Emergencies of the Orbit and Adnexa
, Springer
, Berlin, pp. 113
–137
.5.
Levin
, L. A.
, Beck
, R. W.
, Joseph
, M. P.
, Seiff
, S.
, and Kraker
, R.
, and International Optic Nerve Trauma Study Group
, 1999
, “The Treatment of Traumatic Optic Neuropathy: The International Optic Nerve Trauma Study
,” Ophthalmology
, 106
(7
), pp. 1268
–1277
.6.
Scott
, R. A.
, Blanch
, R. J.
, and Morgan-Warren
, P. J.
, 2015
, “Aspects of Ocular War Injuries
,” Trauma
, 17
(2
), pp. 83
–92
.7.
Esposito
, L.
, Clemente
, C.
, Bonora
, N.
, and Rossi
, T.
, 2015
, “Modelling Human Eye Under Blast Loading
,” Comput. Methods Biomech. Biomed. Eng.
, 18
(2
), pp. 107
–115
.8.
Liu
, X.
, Wang
, L.
, Wang
, C.
, Fan
, J.
, Liu
, S.
, and Fan
, Y.
, 2015
, “Prediction of Globe Rupture Caused by Primary Blast: A Finite Element Analysis
,” Comput. Methods Biomech. Biomed. Eng.
, 18
(9
), pp. 1024
–1029
.9.
Watson
, R.
, Gray
, W.
, Sponsel
, W. E.
, Lund
, B. J.
, Glickman
, R. D.
, Groth
, S. L.
, and Reilly
, M. A.
, 2015
, “Simulations of Porcine Eye Exposure to Primary Blast Insult
,” Transl. Vision Sci. Technol.
, 4
(4
), p. 8
.10.
Bhardwaj
, R.
, Ziegler
, K.
, Seo
, J. H.
, Ramesh
, K.
, and Nguyen
, T. D.
, 2014
, “A Computational Model of Blast Loading on the Human Eye
,” Biomech. Model. Mechanobiol.
, 13
(1
), pp. 123
–140
.11.
Notghi
, B.
, Bhardwaj
, R.
, Bailoor
, S.
, Thompson
, K. A.
, Weaver
, A. A.
, Stitzel
, J. D.
, and Nguyen
, T. D.
, 2017
, “Biomechanical Evaluations of Ocular Injury Risk for Blast Loading
,” ASME J. Biomech. Eng.
, 139
(8
), p. 081010
.12.
Weaver
, A. A.
, Stitzel
, S. M.
, and Stitzel
, J. D.
, 2017
, “Injury Risk Prediction From Computational Simulations of Ocular Blast Loading
,” Biomech. Model. Mechanobiol.
, 16
(2
), pp. 463
–477
.13.
Karimi
, A.
, Razaghi
, R.
, Navidbakhsh
, M.
, Sera
, T.
, and Kudo
, S.
, 2016
, “Computing the Stresses and Deformations of the Human Eye Components Due to a High Explosive Detonation Using Fluid–Structure Interaction Model
,” Injury
, 47
(5
), pp. 1042
–1050
.14.
Hua
, Y.
, Tong
, J.
, Ghate
, D.
, Kedar
, S.
, and Gu
, L.
, 2017
, “Intracranial Pressure Influences the Behavior of the Optic Nerve Head
,” ASME J. Biomech. Eng.
, 139
(3
), p. 031003
.15.
Duma
, S. M.
, Bisplinghoff
, J. A.
, Senge
, D. M.
, McNally
, C.
, and Alphonse
, V. D.
, 2012
, “Evaluating the Risk of Eye Injuries: Intraocular Pressure During High Speed Projectile Impacts
,” Curr. Eye Res.
, 37
(1
), pp. 43
–49
.16.
Alphonse
, V. D.
, 2015
, “The Biomechanical Response of the Eye, Face, and Orbit to Primary Blast Overpressure
,” Doctoral dissertation, Virginia Tech, Blacksburg, VA.17.
Olsen
, T. W.
, Aaberg
, S. Y.
, Geroski
, D. H.
, and Edelhauser
, H. F.
, 1998
, “Human Sclera: Thickness and Surface Area
,” Am. J. Ophthalmol.
, 125
(2
), pp. 237
–241
.18.
Norman
, R. E.
, Flanagan
, J. G.
, Rausch
, S. M.
, Sigal
, I. A.
, Tertinegg
, I.
, Eilaghi
, A.
, Portnoy
, S.
, Sled
, J. G.
, and Ethier
, C. R.
, 2010
, “Dimensions of the Human Sclera: Thickness Measurement and Regional Changes With Axial Length
,” Exp. Eye Res.
, 90
(2
), pp. 277
–284
.19.
Sigal
, I. A.
, Flanagan
, J. G.
, Tertinegg
, I.
, and Ethier
, C. R.
, 2004
, “Finite Element Modeling of Optic Nerve Head Biomechanics
,” Invest. Ophthalmol. Visual Sci.
, 45
(12
), pp. 4378
–4387
.20.
Jonas
, J.
, Mardin
, C. Y.
, Schlötzer-Schrehardt
, U.
, and Naumann
, G.
, 1991
, “Morphometry of the Human Lamina Cribrosa Surface
,” Invest. Ophthalmol. Visual Sci.
, 32
(2
), pp. 401
–405
.https://iovs.arvojournals.org/arvo/content_public/journal/iovs/933159/401.pdf21.
Duke-Elder
, S.
, 1961
, System of Ophthalmology: The Anatomy of the Visual System
, Henry Kimpton
, St. Louis, MO.22.
Xie
, X.
, Zhang
, X.
, Fu
, J.
, Wang
, H.
, Jonas
, J. B.
, Peng
, X.
, Tian
, G.
, Xian
, J.
, Ritch
, R.
, and Li
, L.
, 2013
, “Noninvasive Intracranial Pressure Estimation by Orbital Subarachnoid Space Measurement: The Beijing Intracranial and Intraocular Pressure (iCOP) Study
,” Crit. Care
, 17
(4
), p. 1
.23.
Balaratnasingam
, C.
, Morgan
, W. H.
, Johnstone
, V.
, Pandav
, S. S.
, Cringle
, S. J.
, and Yu
, D.-Y.
, 2009
, “Histomorphometric Measurements in Human and Dog Optic Nerve and an Estimation of Optic Nerve Pressure Gradients in Human
,” Exp. Eye Res.
, 89
(5
), pp. 618
–628
.24.
Jonas
, J. B.
, Jonas
, S. B.
, Jonas
, R. A.
, Holbach
, L.
, and Panda-Jonas
, S.
, 2011
, “Histology of the Parapapillary Region in High Myopia
,” Am. J. Ophthalmol.
, 152
(6
), pp. 1021
–1029
.25.
Lang
, J.
, 2012
, Clinical Anatomy of the Head: Neurocranium Orbit Craniocervical Regions
, Springer Science & Business Media
, Berlin.26.
Shroff
, A.
, 2011
, An Eye on Numbers: A Ready Reckoner in Ophthalmology
, Postscript Media Pvt. Ltd
., Mumbai, India.27.
Hwang
, S. H.
, Park
, C. S.
, Cho
, J. H.
, Kim
, S. W.
, Kim
, B. G.
, and Kang
, J. M.
, 2013
, “Anatomical Analysis of Intraorbital Structures Regarding Sinus Surgery Using Multiplanar Reconstruction of Computed Tomography Scans
,” Clin. Exp. Otorhinolaryngol.
, 6
(1
), p. 23
.28.
Habal
, M. B.
, Maniscalco
, J. E.
, and Rhoton
, A. L.
, Jr, 1977
, “Microsurgical Anatomy of the Optic Canal: Correlates to Optic Nerve Exposure
,” J. Surg. Res.
, 22
(5
), pp. 527
–533
.29.
Steinsapir
, K. D.
, and Goldberg
, R. A.
, 1994
, “Traumatic Optic Neuropathy
,” Surv. Ophthalmol.
, 38
(6
), pp. 487
–518
.30.
Schultz
, D. S.
, Lotz
, J. C.
, Lee
, S. M.
, Trinidad
, M. L.
, and Stewart
, J. M.
, 2008
, “Structural Factors That Mediate Scleral Stiffness
,” Invest. Ophthalmol. Visual Sci.
, 49
(10
), pp. 4232
–4236
.31.
Jones
, I.
, Warner
, M.
, and Stevens
, J.
, 1992
, “Mathematical Modelling of the Elastic Properties of Retina: A Determination of Young's Modulus
,” Eye
, 6
(6
), pp. 556
–559
.32.
Patin
, D. J.
, Eckstein
, E. C.
, Harum
, K.
, and Pallares
, V. S.
, 1993
, “Anatomic and Biomechanical Properties of Human Lumbar Dura Mater
,” Anesth. Analg.
, 76
(3
), pp. 535
–540
.33.
Zhang
, L.
, Yang
, K. H.
, and King
, A. I.
, 2001
, “Comparison of Brain Responses Between Frontal and Lateral Impacts by Finite Element Modeling
,” J. Neurotrauma
, 18
(1
), pp. 21
–30
.34.
Liu
, M.
, Liu
, G.
, and Lam
, K.
, 2002
, “Investigations Into Water Mitigation Using a Meshless Particle Method
,” Shock Waves
, 12
(3
), pp. 181
–195
.35.
Itoh
, S.
, Hamashima
, H.
, Murata
, K.
, and Kato
, Y.
, 2002
, “Determination of JWL Parameters From Underwater Explosion Test
,” 12th International Detonation Symposium
, San Diego, CA, Aug. 11–16, pp. 281–285.36.
Görig
, C.
, Varghese
, T.
, Stiles
, T.
, van den Broek
, J.
, Zagzebski
, J. A.
, and Murphy
, C. J.
, 2006
, “Evaluation of Acoustic Wave Propagation Velocities in the Ocular Lens and Vitreous Tissues of Pigs, Dogs, and Rabbits
,” Am. J. Vet. Res.
, 67
(2
), pp. 288
–295
.37.
Suri
, S.
, and Banerjee
, R.
, 2006
, “Biophysical Evaluation of Vitreous Humor, Its Constituents, and Substitutes
,” Trends Biomater. Artif. Organs
, 20
(1), pp. 72
–77
.http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.557.4954&rep=rep1&type=pdf38.
Bloomfield
, I.
, Johnston
, I.
, and Bilston
, L.
, 1998
, “Effects of Proteins, Blood Cells and Glucose on the Viscosity of Cerebrospinal Fluid
,” Pediatr. Neurosurg.
, 28
(5
), pp. 246
–251
.39.
Hua
, Y.
, Akula
, P. K.
, Gu
, L.
, Berg
, J.
, and Nelson
, C. A.
, 2014
, “Experimental and Numerical Investigation of the Mechanism of Blast Wave Transmission Through a Surrogate Head
,” ASME J. Comput. Nonlinear Dyn.
, 9
(3
), p. 031010
.40.
Hua
, Y.
, Wang
, Y.
, and Gu
, L.
, 2017
, “Primary Blast Waves Induced Brain Dynamics Influenced by Head Orientations
,” Biomed. Eng. Lett.
, 7
(3
), pp. 253
–259
.41.
Kline
, L. B.
, Morawetz
, R. B.
, and Swaid
, S. N.
, 1984
, “Indirect Injury of the Optic Nerve
,” Neurosurgery
, 14
(6
), pp. 756
–764
.42.
Kennedy
, E. A.
, Voorhies
, K. D.
, Herring
, I. P.
, Rath
, A. L.
, and Duma
, S. M.
, 2004
, “Prediction of Severe Eye Injuries in Automobile Accidents: Static and Dynamic Rupture Pressure of the Eye
,” Annu. Proc. Assoc. Adv. Automot. Med.
, 48, pp. 165
–179
.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217427/43.
Tao
, W.
, Dvoriantchikova
, G.
, Brian
, C. T.
, Pappas
, S.
, Chou
, T.-H.
, Tapia
, M.
, Porciatti
, V.
, Ivanov
, D.
, David
, T. T.
, and Pelaez
, D.
, 2017
, “A Novel Mouse Model of Traumatic Optic Neuropathy Using External Ultrasound Energy to Achieve Focal, Indirect Optic Nerve Injury
,” Sci. Rep.
, 7
(1
), p. 11779
.44.
Stitzel
, J. D.
, Duma
, S. M.
, Cormier
, J. M.
, and Herring
, I. P.
, 2002
, “A Nonlinear Finite Element Model of the Eye With Experimental Validation for the Prediction of Globe Rupture
,” SAE
Paper No. 2002-22-0005.45.
Wang
, F.
, Lee
, H. P.
, and Lu
, C.
, 2007
, “Biomechanical Effect of Segmental Scleral Buckling Surgery
,” Curr. Eye Res.
, 32
(2
), pp. 133
–142
.46.
Qiu
, G.
, Henke
, S.
, and Grabe
, J.
, 2011
, “Application of a Coupled Eulerian–Lagrangian Approach on Geomechanical Problems Involving Large Deformations
,” Comput. Geotech.
, 38
(1
), pp. 30
–39
.47.
Crompton
, M. R.
, 1970
, “Visual Lesions in Closed Head Injury
,” Brain
, 93
(4
), pp. 785
–792
.48.
Rajiniganth
, M.
, Gupta
, A. K.
, Gupta
, A.
, and Bapuraj
, J. R.
, 2003
, “Traumatic Optic Neuropathy: Visual Outcome Following Combined Therapy Protocol
,” Arch. Otolaryngol., Head Neck Surg.
, 129
(11
), pp. 1203
–1206
.49.
Feng
, K.
, Zhang
, L.
, Jin
, X.
, Chen
, C.
, Kallakuri
, S.
, Saif
, T.
, Cavanaugh
, J.
, and King
, A.
, 2016
, “Biomechanical Responses of the Brain in Swine Subject to Free-Field Blasts
,” Front. Neurol.
, 7
, p. 179. 50.
Sundaramurthy
, A.
, Alai
, A.
, Ganpule
, S.
, Holmberg
, A.
, Plougonven
, E.
, and Chandra
, N.
, 2012
, “Blast-Induced Biomechanical Loading of the Rat: An Experimental and Anatomically Accurate Computational Blast Injury Model
,” J. Neurotrauma
, 29
(13
), pp. 2352
–2364
.51.
Leonardi
, A. D. C.
, Bir
, C. A.
, Ritzel
, D. V.
, and VandeVord
, P. J.
, 2011
, “Intracranial Pressure Increases During Exposure to a Shock Wave
,” J. Neurotrauma
, 28
(1
), pp. 85
–94
.52.
Guley
, N. H.
, Rogers
, J. T.
, Del Mar
, N. A.
, Deng
, Y.
, Islam
, R. M.
, D'Surney
, L.
, Ferrell
, J.
, Deng
, B.
, Hines-Beard
, J.
, Bu
, W.
, Ren
, H.
, Elberger
, A. J.
, Marchetta
, J. G.
, Rex
, T. S.
, Honig
, M. G.
, and Reiner
, A.
, 2016
, “A Novel Closed-Head Model of Mild Traumatic Brain Injury Using Focal Primary Overpressure Blast to the Cranium in Mice
,” J. Neurotrauma
, 33
(4
), pp. 403
–422
.53.
Bricker-Anthony
, C.
, Hines-Beard
, J.
, and Rex
, T. S.
, 2014
, “Molecular Changes and Vision Loss in a Mouse Model of Closed-Globe Blast Trauma
,” Invest. Ophthalmol. Visual Sci.
, 55
(8
), pp. 4853
–4862
.54.
Sahoo
, D.
, Deck
, C.
, and Willinger
, R.
, 2016
, “Brain Injury Tolerance Limit Based on Computation of Axonal Strain
,” Accid. Anal. Prev.
, 92
, pp. 53
–70
.55.
Wright
, R. M.
, and Ramesh
, K.
, 2012
, “An Axonal Strain Injury Criterion for Traumatic Brain Injury
,” Biomech. Model. Mechanobiol.
, 11
(1–2
), pp. 245
–260
.56.
Bain
, A. C.
, and Meaney
, D. F.
, 2000
, “Tissue-Level Thresholds for Axonal Damage in an Experimental Model of Central Nervous System White Matter Injury
,” ASME J. Biomech. Eng.
, 122
(6
), pp. 615
–622
.57.
Ahmadzadeh
, H.
, Smith
, D. H.
, and Shenoy
, V. B.
, 2014
, “Viscoelasticity of Tau Proteins Leads to Strain Rate-Dependent Breaking of Microtubules During Axonal Stretch Injury: Predictions From a Mathematical Model
,” Biophys. J.
, 106
(5
), pp. 1123
–1133
.58.
Singh
, A.
, Kallakuri
, S.
, Chen
, C.
, and Cavanaugh
, J. M.
, 2009
, “Structural and Functional Changes in Nerve Roots Due to Tension at Various Strains and Strain Rates: An In-Vivo Study
,” J. Neurotrauma
, 26
(4
), pp. 627
–640
.59.
Garimella
, H. T.
, Kraft
, R. H.
, and Przekwas
, A. J.
, 2018
, “Do Blast Induced Skull Flexures Result in Axonal Deformation?
,” PLoS One
, 13
(3
), p. e0190881
.60.
Yuen
, T. J.
, Browne
, K. D.
, Iwata
, A.
, and Smith
, D. H.
, 2009
, “Sodium Channelopathy Induced by Mild Axonal Trauma Worsens Outcome After a Repeat Injury
,” J. Neurosci. Res.
, 87
(16
), pp. 3620
–3625
.61.
Tasman
, W.
, 1972
, “Peripheral Retinal Changes Following Blunt Trauma
,” Trans. Am. Ophthalmol. Soc.
, 70
, p. 190
.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310450/pdf/taos00029-0211.pdf62.
Geng
, X.
, Liu
, X.
, Wei
, W.
, Wang
, Y.
, Wang
, L.
, Chen
, K.
, Huo
, H.
, Zhu
, Y.
, and Fan
, Y.
, 2018
, “Mechanical Evaluation of Retinal Damage Associated With Blunt Craniomaxillofacial Trauma: A Simulation Analysis
,” Transl. Vision Sci. Technol.
, 7
(3
), p. 16
.63.
Salimi Jazi
, M.
, Rezaei
, A.
, Azarmi
, F.
, Ziejewski
, M.
, and Karami
, G.
, 2016
, “Computational Biomechanics of Human Brain With and Without the Inclusion of the Body Under Different Blast Orientation
,” Comput. Methods Biomech. Biomed. Eng.
, 19
(9
), pp. 1019
–1031
.64.
Bailoor
, S.
, Bhardwaj
, R.
, and Nguyen
, T. D.
, 2015
, “Effectiveness of Eye Armor During Blast Loading
,” Biomech. Model. Mechanobiol.
, 14
(6
), pp. 1227
–1237
.65.
Wang
, X.
, Rumpel
, H.
, Baskaran
, M.
, Tun
, T. A.
, Strouthidis
, N.
, Perera
, S. A.
, Nongpiur
, M. E.
, Lim
, W. E.
, Aung
, T.
, and Milea
, D.
, 2018
, “Optic Nerve Tortuosity and Globe Proptosis in Normal and Glaucoma Subjects
,” J. Glaucoma
(epub). 66.
Rossi
, T.
, Boccassini
, B.
, Esposito
, L.
, Clemente
, C.
, Iossa
, M.
, Placentino
, L.
, and Bonora
, N.
, 2012
, “Primary Blast Injury to the Eye and Orbit: Finite Element Modeling
,” Invest. Ophthalmol. Visual Sci.
, 53
(13
), pp. 8057
–8066
.67.
Hua
, Y.
, Voorhees
, A. P.
, and Sigal
, I. A.
, 2018
, “Cerebrospinal Fluid Pressure: Revisiting Factors Influencing Optic Nerve Head Biomechanics
,” Invest. Ophthalmol. Visual Sci.
, 59
(1
), pp. 154
–165
.68.
Midgett
, D. E.
, Pease
, M. E.
, Jefferys
, J. L.
, Patel
, M.
, Franck
, C.
, Quigley
, H. A.
, and Nguyen
, T. D.
, 2017
, “The Pressure-Induced Deformation Response of the Human Lamina Cribrosa: Analysis of Regional Variations
,” Acta Biomater.
, 53
, pp. 123
–139
.69.
Zhang
, L.
, Albon
, J.
, Jones
, H.
, Gouget
, C. L.
, Ethier
, C. R.
, Goh
, J. C.
, and Girard
, M. J.
, 2015
, “Collagen Microstructural Factors Influencing Optic Nerve Head Biomechanics
,” Invest. Ophthalmol. Visual Sci.
, 56
(3
), pp. 2031
–2042
.70.
Girard
, M. J.
, Dahlmann-Noor
, A.
, Rayapureddi
, S.
, Bechara
, J. A.
, Bertin
, B. M.
, Jones
, H.
, Albon
, J.
, Khaw
, P. T.
, and Ethier
, C. R.
, 2011
, “Quantitative Mapping of Scleral Fiber Orientation in Normal Rat Eyes
,” Invest. Ophthalmol. Visual Sci.
, 52
(13
), pp. 9684
–9693
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