Eye Trauma from Fireworks

     The use of fireworks by non-professionals leads to a significant number of injuries each year, many of which go unreported. The "legal" status of amateur fireworks varies from state to state, but certain types of fireworks are clearly more dangerous than others. Nevertheless, even sparklers, which are often dismissed as having minimal risk, burn at 1800 degrees (hot enough to melt gold).  Sparklers accounted for 10% of reported injuries in 1997 (see chart below).

Firecracker use accounted for 32% of the injuries reported (with 42% of the injuries associated with nationally illegal firecrackers).  Sky rockets, or bottle rockets, accounted for 15% of the injuries.  These are largely eye injuries, with bottle rockets accounting for most of the 2000 eye injuries per year associated with fireworks usage.

 

Fireworks Injuries by Type of Device

The U.S. Consumer Product Safety Commission (CPSC), through the National Electronic Injury Surveillance System (NEISS), collects data on injuries associated with consumer products, including fireworks. The data indicate which consumer product was associated with a particular injury, but do not mean that the product necessarily caused the injury.

For 1997, there were an estimated 8,300 fireworks-related injuries. The breakdown, by type of device, for the estimated injuries during the peak holiday season (June 23 to July 23, 1997) is:

 

Fireworks Device

 

% of Estimated Injuries

Firecrackers1

 

32%

Sky Rockets

 

15%

Sparklers

 

10%

Fountains

 

7%

Spinners and Novelties

 

5%

Roman Candles

 

4%

Reloadable Mortars

 

3%

Public Displays

 

3%

Repeating Mines and Shells

 

1%

Homemade Devices

 

1%

Smoke Devices

 

1%

Helicopters

 

1%

Miscellaneous

 

2%

Unknown

 

15%

 

 

TOTAL

 

100%

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1. Illegal firecrackers represent 42% of all firecracker injuries.

Source: American Pyrotechnics Association - http://www.americanpyro.com/

 

Fireworks Eye Injuries

Injuries to the eye from fireworks, most commonly bottle rockets, can be devastating:

  • Approximately 2000 eye injuries occur each year from consumer fireworks use.

  • About one-third of these injuries result in permanent eye damage and one-fourth in permanent vision loss or blindness.

  • Almost one in twenty fireworks-related eye injury victims lose all useful vision or require removal of the eye.

  • Data from the United States Eye Injury Registry shows that bystanders are more often injured by fireworks than operators themselves.

  • 44 percent of the injured are children ages 19 years old and under.

  • 72 percent of the victims were male. 

Source: Prevent Blindness America - www.preventblindness.org.

Prevent Blindness America warns that there is no safe way for non-professionals to use fireworks. It is only safe to enjoy the splendor and excitement of fireworks at a professional display.

While most injuries occur with legal fireworks, some states are debating legalizing an even broader range of fireworks. Heavy lobbying by the fireworks industry, promising more tax revenue through fireworks sales, may result in an increase in fireworks-related injuries.

The single most dangerous type of firework is the bottle rocket, which flies erratically and causes bystander injury.  The bottles and cans used to launch them often explode, showering fragments of glass and metal.

From 1980-1994, fireworks accounted for 29 fires, 65 explosions and 114 deaths. The victims of these accidents ranged in ages from 4 months to 88 years old.

 

Ocular Trauma from Fireworks

Eye injuries from fireworks and especially bottle rockets can be severe, with total loss of vision possible. This following photographs represent possible external eye injuries from fireworks. Internal eye injuries can also occur, easily leading to loss of vision through blunt trauma. Retinal injury can lead to an immediate loss of vision. Cataract and glaucoma can be long term problems. Remember, children bystanders are the most frequently injured.

 

 

 

 

WARNING !

The  6 images below are graphic, and may be repulsive to some.

 

 

 

 

 

 

 

Examples of the Types of Injuries Possible with Direct Trauma from a Projectile type of Firework

Blood on Ocular Surface

 

Traumatic Eyelid Laceration

 American Academy of Ophthalmology

 

 American Academy of Ophthalmology

 

 

 

 

Torn Iris

 

Blood Layering out in Front Part of Eye (Hyphema)

 American Academy of Ophthalmology

 

 American Academy of Ophthalmology

 

 

 

 

Rupture of Cornea with Iris Prolapsing Out

 

Rupture of Cornea with Iris Prolapsing Out

 American Academy of Ophthalmology

 

 American Academy of Ophthalmology

 

 

 

 

Eye safety with fireworks

Attending a public fireworks display on the Fourth of July is a safe and patriotic way to honor out tradition of independence, our shared values, and our hopes for a healthy future. Professional displays rarely lead to injury.

If an accident does occur during a non-professional display, what can you do right away to minimize the damage to the eye.  These eight action can help save your child's sight.

 

  • Do not delay medical attention even for seemingly mild injuries. "Mildly" damaged areas can worsen and end in serious vision loss, even blindness, that might not have happened if treatment had occurred immediately.

     

  • Stay calm, do not panic; keep the child as calm as possible.

     

  • Do not rub the eye. If any eye tissue is torn, rubbing might push out the eye's contents and cause more damage. Trying to rub the eye is an automatic response to pain, but pressure will only do more harm. Take the child's hand from his or her face.

     

  • Do not attempt to rinse out the eye. This can be even more damaging than rubbing.

     

  • Shield the eye from pressure. Tape or secure the bottom of a foam cup, milk carton or similar shield against the bones surrounding the eye: brow, cheek and bridge of the nose.

     

  • Avoid giving aspirin or ibuprofen (or other non-steroidal anti-inflammatory drugs, called "N-SAIDS") to try to reduce the pain. They thin the blood and might increase bleeding. Acetaminophen is the over-the-counter drug of choice. Unfortunately, non-prescription painkillers will not be of much help. It is better to by-pass the drugstore or medicine cabinet and get to the emergency room right away.

     

  • Do not apply ointment or any medication. It is probably not sterile. Also, ointments make the eye area slippery. This could slow the doctor's examination at a time when every second counts.

     

  • Above all, do not let your child play with fireworks.  If you must attend a non-professional fireworks display, have all present wear safety goggles (which may not prevent all injuries). Regular glasses will not prevent injury, and may break or shatter if impacted by flying debris.  Again, the best option is to attend a professional fireworks display.

 American Academy of Ophthalmology