To determine the necessary medical care and permanent ocular damage of a particular type of preventable ocular trauma, an observational study of 22 patients referred to the University Hospital Nijmegen (1983-1993) with eye injuries caused by the accidental release of tightened elastic straps of the so-called "spider' design was performed. Although the traumatized eyes of the 22 patients could be saved from blindness by extensive medical and surgical treatment in the majority of cases, 13 patients (59%) had residual permanent visual impairment (visual acuity < or =6/10, or aphakia) at the end of the follow-up period. Three of them had lost the perception of light in the involved eye; one painful blind eye had to be removed. It is concluded that elastic straps with free-end metal hooks should not be used to secure luggage because of the potential risk of irreversible damage to the eye.