Visual outcome after fireworks injuries

BACKGROUND: The epidemiology and prognosis of fireworks-related injuries treated at a tertiary eye care center in less developed nations remain unknown. METHODS: We conducted a prospective observational study that enrolled all consecutive eyes with fireworks-related ocular injury visiting our trauma clinic during a 1-year period. Eyes were graded by ocular trauma classification and followed for 6 months at least. Best corrected visual acuity (BCVA) at 6 months was considered the final visual outcome. Data were analyzed. RESULTS: Twenty-five (96%) of a total of 26 patients enrolled during study period were male patients and 13 (50%) were younger than 15 years. The type of fireworks involved was a bottle rocket in 38.5%. Factors significantly associated with better final visual outcome were better BCVA at presentation (p = 0.041), absence of bottle rocket injury (p = 0.028), closed globe injury (p = 0.028), absence of relative afferent pupillary defect (p = 0.019), absence of intraocular foreign body (p = 0.026), and absence of endophthalmitis (p = 0.006). Besides poor visual outcome, bottle rocket injuries were more frequently associated with facial lacerations, intraocular foreign body, and endophthalmitis development. CONCLUSION: Fireworks-related ocular injuries commonly affect young male subjects of northern India. Visual outcome is better in eyes having better initial BCVA or closed globe injury and if relative afferent pupillary defect, bottle rocket injury, intraocular foreign body, and endophthalmitis are absent.