Ocular trauma from fireworks during Diwali festival

Abstract

Background: Fireworks are an important part of festivals in India, especially Diwali. The use of these fireworks often result in ocular trauma
with a loss of vision. The aim of this study was to determine the pattern of eye injuries from fireworks during the Diwali festival and the visual
outcome at a tertiary eye hospital in south India.

Materials and Methods: The cases of ocular trauma from fireworks over a 3-year period were retrospectively reviewed. Information regarding patient’s age, gender, laterality, the type of firework, whether user or bystander, bestcorrected visual acuity (BCVA) at presentation, the details of injuries, diagnosis, management, and BCVA at last follow-up visit were documented and analyzed using Epi Info 7.1.5.0 software.

Results: A total of 114 eyes of 110 patients were analyzed. The study population comprised 89 (81%) males and 21 (19%) females, with a male-to-female ratio of 4.2:1. The median age was 14.0 years, with 61 (56%) patients aged <18 years. One hundred (88%) eyes had closed globe injury (CGI), whereas 14 (12%) eyes had open globe injury (OGI). Thirty-five
(35%) eyes with CGI and 8 (57%) eyes with OGI had a BCVA of <3/60 at presentation. This improved with management with only 12 (12%) eyes with CGI and two (14%) eyes with CGI and 2 (14%) eyes with OGI having a  BCVA of<3/60 at the last follow-up visit. These differences in visual acuity were not statistically significant with P-values >0.5. Twenty-two (19%) eyes developed long-term complications such as glaucoma, retinal detachment, and phthisis bulbi.

Conclusion: Ocular trauma from fireworks commonly affects young boys and often results in serious, preventable, vision-threatening complications. The enforcement of existing legislation, health education, and public  awareness are essential if the current trend in India is to be reversed.

Keywords: Diwali, fireworks, ocular trauma