Eye injuries because of firecrackers are among the most common injuries to the eye. Firecracker injuries can cause a foreign body to enter the eye, cause cuts, bruises and inside burns. Firework injuries occur when people use them at home without using proper safety precautions. Damage caused to the eye because of firecrackers can result in chemical, thermal and mechanical injury. Most firecrackers are composed of metallic fuel, a mixture of oxidizer and flash powder. If confined, they produce a loud noise. Metallic particles, for example, aluminium are also found in firecrackers that appear radio-opaque on CT scans.
Firecracker injuries to the eye are generally treated with copious irrigation of the eye soon after the detection of injury. Any remaining particles should be removed immediately because they can cause tissue necrosis.
A similar such case was presented to the emergency department with a 44-year-old with pain and decreased vision in both eyes because of lighting a firecracker. The patient presented with symptoms of reduced visual acuity of 20/80 in the left eye and was unable to perceive light in the right eye. The patient was diagnosed with globe rupture in the right eye. In addition to this, multiple foreign bodies were seen embedded at the superficial and deep levels in the corneal stroma on slit-lamp examination of the left eye.
Axial CT scans of both the eyes revealed multiple intraocular foreign bodies. The foreign bodies generally result because of high velocity injuries, for example, those caused by industrial accidents, gunshots and firecrackers. For this reason, it is important to wear protective eye wear when being exposed to firecrackers.
Treatment plan
The foreign bodies were removed from the cornea and the patient was given lubricating eye drops and topical antibiotic agents. Visual acuity in the left eye was seen to improve by 20/40 over the next 3 months. However, the right eye remained nonfunctional despite primary surgical repair. The state is often referred to as phthisis bulbi which is an end stage disease characterized by shrinking of the eye.
References
Gupta, P. C., & Ram, J. (2017). Eye injury from a firecracker. New England journal of medicine, 376(26), 2579-2579.