Analysis of ocular trauma due to firecracker injury in oculoplasty clinic at a tertiary care hospital of North India

Abstract

Purpose: To evaluate the spectrum of ocular injuries, clinical and demographic profile and management patterns following firecracker injury during three days of festive season of ‘Deepavali’. Materials and Methods: A hospital-based, retrospective study of 19 patients, who sustained ocular injuries following firecracker injury during three days of festive season of Deepavali from 28/10/19 to 30/10/19 visiting emergency department of SMIH, Dehradun. All the patients were attended in collaboration with on call ophthalmologists and plastic surgery burn unit team. Vision assessment was done using Snellen’s chart. Slit lamp examination including anterior segment evaluation and fundus examination was done in cases possible. USG B-scan and X-Ray orbit were done in cases required. Patients with severe injuries were advised admission and managed either conservatively or surgically. Surgical intervention included corneo-scleral tear repair and evisceration. Rest of the patients were treated on outpatient basis. Results: The firecrackers causing ocular injuries include Bomb in 37% cases, Flowerpot in 31.5%, Rocket in 21% and Sparkles in 10.5% cases. The spectrum of ocular involvement included periocular burns in 100% cases, corneal abrasion in 74%, corneal perforation and hyphema in 16%, lid and conjunctival laceration and globe rupture in 11%, and iridodialysis and vitreous hemorrhage in 5% cases. The devastating visual outcomes were seen in 10% cases. 89.5% cases underwent medico-legal consultation. Conclusion: Firecracker injury leads to physical and mental trauma to the patients. Adult supervision is very crucial while igniting firecrackers. Appropriate triage management and coordinated treatment was critical to ensure best possible patient outcome. Enforcement of legislations, health education and public awareness are essential in preventing this hazard to ocular health in country. Keywords: Ocular trauma, Firecracker injury, Medicolegal.