Case Series of Ocular Injury with Firecracker During Diwali in North India

Abstract

Objectives:- The primary aim of this case series is to evaluate and report the patients presenting at a tertiary care hospital with an ocular injury sustained due to firecrackers during the occasion of the Diwali festival and to report the pattern and severity of firecrackers associated ocular injury and to what extent this affects the visual acuity of these patients.
 Methods:- This study is a tertiary care teaching hospital-based prospective study that includes 14 eyes of 12 patients who suffered firecracker-associated ocular injuries. All of them were presented to the hospital’s emergency department within one week after the Diwali festival. A detailed history of all the patients was taken and their ocular examination was done. Out of 12 patients, 7 were admitted for further surgical management, and one patient who sustained a superficial facial burn, including periorbital area, without any eye injury was admitted to the department of plastic surgery 4 patients were given conservative treatment. The injuries were classified according to the ocular trauma scoring system (OTSS).
 Results:- Out of the 12 patients presented, all were males, all of age group 6 years to 42 years (mean age group 18 years). Eight of them sustained injuries from explosive firecrackers and four sustained injuries from bottle rockets. Six of them were involved in igniting firecrackers, while 5 patients were either bystanders or passersby. Out of 11 patients, the right eye (RE) was involved in 6, the Left eye (LE) was involved in 4 and both eyes (BE) were engaged in 1 patient. Out of 12 eyes, six eyes had open globe perforating injuries involving cornea or cornea and sclera both, two eyes had mild conjunctival congestion and superficial burn over the periorbital region, one eye had conjunctival injury and one eye had a vitreous hemorrhage, one eye had traumatic retinal detachment, one eye had optic nerve avulsion. The maximum number of affected eyes falls under OTSS score II, indicating poor prognosis regarding visual acuity.
 Conclusion:- Firecrackers may cause injuries in one or both eyes which may be grievous in nature resulting in an irreversible loss of vision in either or both eyes. Hence, it is a matter of serious concern. Directives should be formulated to register the ocular injury presented to the hospitals. The public should be educated regarding the safe handling of firecrackers. Firecracker manufacturing companies should be instructed to manufacture less explosive and safer firecrackers.