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Case Series: Open Globe Injuries From Garage Door Springs

Key findings

  • This case series describes seven people who attempted to repair a garage door, without knowledge of the serious risk, and suffered devastating open globe injuries (six lacerating injuries, one zone III globe rupture)
  • Five patients developed a retinal detachment and six presented with or developed a relative afferent pupillary defect
  • For all but one patient, final visual acuity was hand motions or worse; two did not recover any vision

A garage door is the heaviest mechanical device in most homes, weighing up to 400 pounds. It has been underappreciated as a potential mechanism of open globe injury.

Between 2008 and 2022, Mass Eye and Ear physicians saw seven patients who sustained severe eye injuries when a garage door spring dislodged at high velocity. Elizabeth J. Rossin, MD, PhD, a vitreoretinal surgeon in the hospital's Retina Service, and colleagues describe these injuries and their outcomes in Ophthalmic Surgery, Lasers and Imaging: Retina.

Characteristics of the Cases

All of the injured individuals were attempting to fix a jammed garage door with no experience in doing so. All injuries were severe and resulted in significant loss of vision:

  • Six of the seven injuries involved zone III
  • All but one patient had a lacerating injury, probably because the spring had a sharp edge after breaking or dislodging; the other had a zone III globe rupture
  • Five patients developed a retinal detachment that required extensive subsequent surgeries
  • In six patients, a relative afferent pupillary defect (RAPD) was detected on presentation or after globe repair
  • For all but one patient, final visual acuity was hand motions or worse (length of follow-up 1.5 months to 7.7 years)
  • Two patients did not recover any vision; one of them required enucleation for a painful blind eye


When garage doors close, energy is stored in a spring that is under compression. The energy is released as the door opens, and when misdirected, it has been known to cause fatal injury. Garage doors have a life span of six to 10 years, and experts recommend yearly safety inspections.

The open globe injuries in this case series were severe and resulted in very poor outcomes. Of note, the authors estimate that the likelihood of a severe open globe injury, if hit by a garage spring, is 50% based on their exhaustive chart review. The main takeaway here is the importance of getting professional assistance when attempting to repair a garage door.

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