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, best-corrected 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.