A 21-year-old male patient was admitted to the trauma/neurosurgical intensive care unit after a seatbelted, motor vehicle collision with a tree, which involved airbag deployment. He suffered extensive injuries, including a left parietal skull fracture, basal skull fracture, intraventricular hemorrhage, epidural hematoma, and multiple open extremity fractures. He was intubated and sedated. An initial ocular examination was performed within an hour of admission. Periocular lid ecchymosis and edema were present bilaterally.