Firework-Related Injuries and Ocular Trauma

Firework-related injuries remain a significant cause of preventable morbidity worldwide, with ocular trauma among the most severe outcomes. Explosive forces, thermal burns and flying debris can inflict damage ranging from superficial corneal abrasions and chemical injuries to full-thickness globe ruptures. Traumatic cataract, lens subluxation, secondary glaucoma, vitreous haemorrhage and optic nerve damage further compound the risk of permanent visual impairment. Young males and bystanders are disproportionately affected, particularly during cultural and national festivals. The acute management of such injuries demands rapid assessment, advanced microsurgical intervention and careful postoperative rehabilitation. Despite improvements in surgical techniques and fragment removal, up to one third of patients may retain profound visual loss. Legislative measures, public education campaigns and the use of protective eyewear have demonstrated efficacy in reducing incidence and improving safety, yet disparities in regulation and enforcement contribute to a persistently high global burden.

Research from Nature Portfolio

A comprehensive retrospective study of paediatric ocular trauma over a 16-year period assessed 115 children presenting with firework-induced eye injuries. Nearly half of the victims were bystanders, and common devices implicated included bangers, bottle rockets and firecrackers. Clinical presentations spanned corneal abrasions, traumatic cataract formation, penetrating injuries and limbal stem cell deficiency. Surgical management encompassed primary globe repair, lens extraction with intraocular lens implantation and removal of intraocular foreign bodies. Six-month follow-up revealed that although many patients achieved functional vision, approximately one third continued to experience severe impairment, emphasising the need for targeted prevention strategies and optimised care pathways for paediatric populations.

Firework-Related Injuries and Ocular Trauma publication trend

The graph below shows the total number of articles in firework-related injuries and ocular trauma across all publications each year (not limited to Nature Index journals).

Technical terms

Best-corrected visual acuity (BCVA): The highest level of visual acuity achievable with optimal corrective lenses.

Globe rupture: A full-thickness breach of the eye’s outer coats (cornea or sclera) resulting from blunt or penetrating trauma.

Corneal abrasion: A superficial scratch or defect of the corneal epithelium, often causing pain, tearing and light sensitivity.

Pars plana vitrectomy: A microsurgical procedure performed through the pars plana to remove vitreous gel and access the posterior segment.

Limbal stem cell deficiency: A condition in which loss of corneal epithelial stem cells at the limbus leads to poor epithelial regeneration and opacity.

References

1. Fireworks ocular injury in Saudi children: profile and management outcomes. Scientific Reports (2022).
2. Occurrence and outcome of firework-related ocular injuries in Switzerland: A descriptive retrospective study. BMC Ophthalmology (2022).
3. Changing Trends in Firework‐Related Eye Injuries in Southern China: A 5‐Year Retrospective Study of 468 Cases. Journal of Ophthalmology (2020).