Five-year study of ocular injuries due to fireworks in India

Abstract

To study the demographic profile, cause, type and severity of ocular injuries, their complications and final visual outcome following fireworks around the time of Deepawali in India. Case records of patients who presented with firework-related injuries during 2005-2009 at the time of Deepawali were reviewed. Data with respect to demographic profile of patients, cause and time of injury, time of presentation and types of intervention were analyzed. Visual acuity at presentation and final follow-up, anterior and posterior segment findings, and any diagnostic and surgical interventions carried out were noted. One hundred and one patients presented with firework-related ocular injuries, of which 77.5 % were male. The mean age was 17.60 ± 11.9 years, with 54 % being ≤14 years of age. The mean time of presentation was 8.9 h. Seventeen patients had open globe injury (OGI) and 84 had closed globe injury (CGI). Fountains were the most common cause of CGI and bullet bombs were the most common cause of OGI. Mean log MAR visual acuity at presentation was 0.64 and 1.22 and at last follow-up was 0.09 and 0.58 for CGI and OGI, respectively (p < 0.05). Patients with CGI had a better visual outcome. Three patients with OGI developed permanent blindness. Factors associated with poor visual outcome included poor initial visual acuity, OGI, intraocular foreign body (IOFB), retinal detachment and development of endophthalmitis. Firework injuries were seen mostly in males and children. Poor visual outcome was associated with poor initial visual acuity, OGI, IOFB, retinal detachment and development of endophthalmitis, while most patients with CGI regained good vision.

Ocular injuries from fireworks: the 11-year experience of a US level I trauma center

“…1,8,18,26 Similar international studies have addressed these issues, but the regulation of specific firework devices outside the United States is variable, making extrapolation of the data to the US population difficult. 5,6,8,9,11,12,27 Most of the ocular injuries in this study occurred within 48 h of 4 July (US Independence Day) and New Year's Eve, together accounting for 64% of all ocular injuries over 11 years. Eye trauma occurred in 31% of the patients with general firework trauma, which is slightly higher than the previously reported rate of 17-22%.…”

“…23 Despite their legality, they remain extremely dangerous and are frequently associated with significant morbidity and even mortality. 1,[4][5][6][7]11,12,24 The most commonly injured body parts are hands, eyes, head, and face. 1,4 Not surprisingly, ophthalmologists are frequently involved in the care of these patients because of the high rates of ocular injury.…”

“…1,4 Not surprisingly, ophthalmologists are frequently involved in the care of these patients because of the high rates of ocular injury. [5][6][7][8]12,13,18,25 This study represents one of the most comprehensive data sets to date describing ocular injuries from fireworks in the United States, and serves to update findings last published over 10 years ago in this country. 8,18,26 Previous studies have focused on the incidence of ocular trauma from fireworks in the United States, but have neglected reporting of outcomes, morbidity, and extent of vision loss.…”

“…1,5 Similar to prior studies, the majority of firework-related ocular injuries affected young males, an average age of 24 years, and a significant proportion (35%) of all ocular injuries occurred in children. 1,[5][6][7][8][9][11][12][13][14]18,24,28 The ocular injuries varied in presentation and severity. A significant proportion of these injuries resulted in permanent vision loss, with the mean Snellen visual acuity of~20/1000 at presentation.…”

“…[4][5][6]10 Current precise data regarding the types of injuries and outcomes of patients affected by eye injuries from fireworks are lacking in the United States, but has been reported in other countries. 2,[5][6][7][8][11][12][13][14][15][16][17][18] The purpose of this study is to better characterize the clinical features, outcomes, and management patterns of ocular trauma from fireworks in the United States through the creation of the most comprehensive data set published to date. We performed a retrospective chart review of 327 patients presenting to our level I trauma center over an 11-year period.…”