# Orbital and Ophthalmologic Injuries Associated With Standing Electric Scooter Accidents: A Narrative Synthesis of Clinical Outcomes and Injury Patterns

## TL;DR

Electric scooter accidents commonly cause facial and eye injuries, with unique patterns differing from bicycle accidents, and require specific clinical attention.

## Contribution

This paper provides a narrative synthesis of clinical outcomes and injury patterns specific to orbital and ophthalmologic injuries from electric scooter accidents.

## Key findings

- Orbital fractures often involve multiple walls, with the floor and lateral wall most commonly affected.
- Vision-threatening complications like orbital compartment syndrome require urgent treatment to prevent blindness.
- Soft tissue injuries are more common than fractures, and alcohol intoxication and low helmet use increase injury severity.

## Abstract

Standing electric scooters (e-scooters) have introduced a distinct pattern of facial trauma to emergency departments worldwide. Their unique biomechanics, with riders standing upright on a narrow platform, creates a characteristic forward pitching mechanism during sudden stops that directs high-energy impacts to the anterior midface and orbital region. This differs fundamentally from bicycle accidents, where lateral falls and arm bracing are typical. This review synthesises available clinical evidence on orbital and ophthalmologic injuries from electric scooter accidents. Twelve primary studies were identified, encompassing 1,675 patients across diverse geographic settings in the clinical cohorts. Orbital fractures commonly involve multiple walls simultaneously, with the floor and lateral wall most frequently affected. Vision-threatening complications, although infrequent, are clinically significant. Orbital compartment syndrome represents a time-critical emergency requiring immediate lateral canthotomy and cantholysis to prevent irreversible vision loss. Retrobulbar haemorrhage and retinal injuries also occur, although globe rupture is rare. Soft tissue injuries, including facial lacerations and eyelid trauma, are more common than fractures. Alcohol intoxication and low helmet use emerge as key modifiable risk factors associated with increased injury severity. These findings emphasise the need for high clinical suspicion for orbital pathology in electric scooter trauma and highlight opportunities for targeted prevention strategies.