Profile and Management Outcomes of Fireworks-Related Eye Injuries in Saudi Arabia: A 16-Year Retrospective Study

Abstract

Background: Fireworks are a culturally significant part of celebrations in many parts of the world but can lead to blinding injuries. Objective: To decipher the profile and management outcomes of fireworks-related eye injuries at a tertiary eye hospital in central Saudi Arabia. Methods: This was a retrospective review of cases with fireworks-related eye injuries managed at our institution between 2003 and 2019. Demographic information, clinical features at presentation, mode of management, and visual outcome were evaluated at the last follow-up. Results: A total of 155 eyes of 150 patients with a median age of 10 years [127 male (84.7%) and 69 (46%) right eyes, 76 (50.7%) left eyes, and 5 patients with bilateral injury] were enrolled for the study. Among the injured individuals, 59 (39.3%) were bystanders and 91 (60.7%) had ignited the fireworks. The fireworks included bangers (53; 35.3%), rockets in bottle (42; 28%), firecrackers (41; 27.3%). Closed globe injury (CGI) was the most common type of eye injury (100; 64.5% eyes) while Open globe injury (OGI) was noted in (55; 35.5% eyes). Management used for treatment included penetrating injury repair (55; 35.5%), lens removal/lens implant (51; 32.9%). Corrected distance visual acuity obtained after 6 months was 20/20 to 20/60 (74; 47.7%), 20/70 to 20/200 in (31; 20%), <20/200 to 20/400 in (9; 5.8%) and <20/400 in (41; 26.5%) eyes. Treatment was able to restore vision and salvage blindness in 50 (32.3%) eyes. Conclusion: Mainly males were found to suffer from fireworks-related eye injuries and the main fireworks responsible for them were bangers. Visual disability remained in one-third of the treated patients.

Occurrence and outcome of firework-related ocular injuries in Switzerland: A descriptive retrospective study

“…Furthermore, 62% of our patients were under the age of 30 years, which compares well to the 67% reported by Wisse et al [ 3 ]. The rate of bystander involvement varied in other countries from 39% in Saudi Arabia [ 15 ], 40–53% in the Netherlands [ 5 , 16 ], 56% in Germany [ 17 ], up to 64% in the United Kingdom [ 18 ], whereas in our study 51% of those injured were bystanders. However, missing information concerning the role played in the firework accident for 34% of our patients might represent a potential bias.…”

Explosive eye injuries: characteristics, traumatic mechanisms, and prognostic factors for poor visual outcomes

“…Generally, injuries caused by explosion involve significantly more binocular trauma (29.96% in the present study; 3.33–72.91% in previous reports [ 4 – 8 , 12 , 13 ]) compared with those related to ordinary causes (0–2.13%) [ 14 – 17 ]. The number of eyes involved seems to be related to the type and power of the explosives, for example, 3.33–16.32% for firework-related injuries [ 6 , 12 ] and 72.91% for injuries related to explosive military ammunition [ 13 ]. This explosive difference also leads to different types of MEI.…”

“…An explosive blast has sudden and devastating effects and usually causes great casualties [ 1 ]. Explosion-related eye injuries are a common cause of morbidities for survivors, whether the injury occurred during wartime, a disaster, or an explosion-related accident during peacetime [ 2 – 6 ]. Explosions rapidly generate impact waves with dramatic power, producing instantaneous peeling, implosion, and hemodynamic effects, and pressure differences (called primary or level I explosion injuries); fragments with high kinetic energy (leading to secondary or level II injuries); huge airflow capable of overturning the human body (leading to level III injuries); and hyperthermic or high-pressure chemical reaction (leading to level IV injuries) [ 4 , 5 , 7 ].…”

Fireworks ocular injury in Saudi children: profile and management outcomes

“…Studies showed that that countries with stricter laws had 87% fewer ocular injuries than those with relaxed rules about the private use of fireworks 25 . Children are more likely than adults to sustain fireworks-related eye injuries 26 . Strict regulations concerning the use of fireworks are needed for a significant protective impact on the children since minors sustain a profound proportion of fireworks-inflicted severe injuries 26 .…”

“…Children are more likely than adults to sustain fireworks-related eye injuries 26 . Strict regulations concerning the use of fireworks are needed for a significant protective impact on the children since minors sustain a profound proportion of fireworks-inflicted severe injuries 26 . Minors are undoubtedly placed at a greater risk for severe ocular trauma.…”