Deterioration in vision after a Motor Vehicle Accident leads to a finding of Retinal Tear or Detachment. There was no direct trauma to the eye and the question of Causation is raised.
Most Tears are spontaneous, the result of degenerative ageing of the retina. In autopsy series, more than 3% people and nearly 2% of eyes have Retinal Tears.
About a quarter of tears occur after direct injury to the eye. About a third of these result from penetrating trauma, two-thirds from non-penetrating. The sufferer is characteristically a healthy young man.
Symptomatic Retinal Tears are common degenerative events in the elderly, or the result of direct trauma to the eyes of young men
When older people suffer direct trauma to the eye, the probability a giant tear will occur is determined more by the degree of short-sightedness - increased (focal) length of the eye - than by the severity of the trauma.
Prognosis for recovery, however, depends on the severity of the underlying degenerative process (Vitreo-Retinopathy).
To establish indirect traumatic Causation of Retinal Tears in the elderly usually requires a clear contemporaneous history of attributable visual deterioration
Given their commonness in the elderly, it is inevitable retinal tears will occasionally be detected shortly after mild indirect trauma such as cervical whiplash. Whether the Motor Vehicle Accident played an essential role is a contentious issue settled by weighing circumstantial opthalmological evidence.
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