Spectrum of ocular injuries and visual outcome following firework injury to the eye

• Published in: Journal of emergencies, trauma and shock Vol. 13; no. 1; pp. 39 - 44
• Main Authors: Kurien, Neethu, Peter, Jayanthi, Jacob, Pushpa
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.01.2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Cataracts; Contusions; Cornea; Developing countries; Edema; eye injury; Festivals; fireworks; Injuries; LDCs; Medical research; Morbidity; Original; Patients; preventative measures; Socioeconomic factors; Surgery; Trauma; visual outcome; India; Eye injury; fireworks; visual outcome; preventative measures
• ISSN: 0974-2700; 0974-519X
• DOI: 10.4103/JETS.JETS_62_18

Background: Ocular injury due to fireworks requires urgent ophthalmic assessment and management to preserve vision. Methods: Spectrum of injury, type of intervention, visual outcome, and reasons for visual loss were assessed in consecutive patients presenting over 2 years with firework-related eye injury. The final visual outcome was recorded as best-corrected visual acuity. Results: In the 96 patients (75 males) enrolled, 122 eyes were involved. Twenty-six patients had bilateral eye injury. The median (interquartile) age was 14 (8, 28.5) years. Injuries occurred during Diwali festival (59.4%) and funeral processions (20.8%); over half (53.8%) were bystanders. Injury was due to negligence (78%), device malfunction (12.5%), and attempts to reignite (5.2%) or recover failed device (4.2%). Presenting symptoms were redness (100%), pain (97%), watering (86%), and reduced vision (77%). Facial laceration, contusion, or hematoma occurred in 13 patients. The most frequent adnexal and ocular surface injuries were lid burns (57.3%), edema (44.2%), charred eyelashes (24.6%), and laceration (13.9%). Open-globe injury occurred in 8 eyes. Common anterior segment injuries were corneal epithelial defect (51.6%) and hyphema (20.5%). Posterior segment injuries included commotio retinae (13.1%) and Berlin's edema (7.4%). Surgical treatment was required in 15 eyes; 107 (88%) were managed conservatively. At study completion, of the 99 eyes evaluated, 21 had reduced visual acuity (<6/6) including 7 with monocular blindness. Factors associated with poor vision were open-globe injury (P < 0.001) and poor initial visual acuity (P = 0.05). Conclusions: Open-globe injury and poor visual acuity at presentation predict the final visual outcome. Monocular blindness following firecracker injury is common.