Firecracker-related ocular injury: A retrospective study of clinical outcomes in North India

Abstract Background: Firecracker-related ocular injuries are a common but preventable cause of visual impairment, particularly during festivals such as Deepawali in India. These injuries often affect young individuals and bystanders, leading to significant ocular morbidity. This study aims to analyze the demographic profile, injury patterns, visual outcomes, and risk factors associated with firecracker-induced ocular trauma in North India. Materials and Methods: A retrospective review was conducted on 150 patients with firecracker-related ocular trauma who presented to a tertiary care center in Uttar Pradesh during the festive seasons of 2022–2023. Comprehensive ophthalmic examination and imaging were performed. Injuries were classified based on the Birmingham Eye Trauma Terminology System (BETTS). Management included medical and surgical interventions as per the severity. Data regarding age, gender, type of firecracker, visual acuity, and type of injury were systematically analyzed. Results: Among 150 patients, 117 (78%) were males and 33 (22%) females (M:F = 3.5:1). The most affected age group was 11–20 years (39%), followed by children below 10 years (21%). Of the 155 eyes involved, 87 (56.2%) were right eyes, 58 (37.4%) left, and 10 (6.4%) bilateral. At presentation, 60 eyes (38.7%) had a visual acuity better than 20/40, while 7 eyes (4.5%) had no light perception. Common injury types included contusions (62%), superficial foreign bodies (21.4%), penetrating injuries (5.1%), and globe ruptures (2.5%). The most frequent sources of injury were bombs (30.6%) and bottle rockets (24.6%). Notably, approximately one-third of the injuries occurred in bystanders. Conclusion: Firecracker-related ocular injuries predominantly affect young males and often result in significant visual impairment, including permanent blindness. Lack of protective measures, inadequate public awareness, and the involvement of bystanders contribute to the burden. Stringent safety regulations, public education campaigns, and responsible use of fireworks are crucial to prevent such life-altering injuries.