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Periocular burns due to firecracker injuries: (a) in a 16-yr-old male with infected wound involving right upper eyelid with blunt injury to the globe; (b) in a 14-yr-old male with superficial facial burns; (c) in a 13-yr-old female with tattooing of facial skin; (d) in a 5-yr-old female child with eyelid and facial burns.
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Purpose:
To identify the patterns of ocular injury and to determine ocular morbidity resulting from the use of firecrackers.
Methods:
A prospective observational study of all patients presenting with ocular trauma consequent to fireworks usage in a tertiary eye care center in South India over a one-month period around the autumn festival of Diwa...
Context in source publication
Context 1
... is a prospective study of patients presenting to a tertiary eye care hospital in Southern India during the festival of Diwali. The purpose of this study was to assess the ocular morbidities attributable to fireworks by type and severity of injury, nature of intervention, and final visual outcome. The aim of this study was to create public awareness about the dangers of fireworks. This is a prospective observational case series. All patients with history of fireworks-related injuries, who attended the emergency eye care services of a tertiary eye care hospital in South India during the month of the Diwali festival, were included in this study. Details of injuries were recorded, whether requir- ing hospital admission for ocular surgery or conser- vative management. Data collected included age, gender, laterality (right, left, or both eyes), type of fireworks and behavior (user or bystander), visual acuity at presentation, diagnosis, management, and final best-corrected visual acuity (BCVA) at the last follow-up. All patients underwent a comprehen- sive ophthalmic examination. B-scan Ultrasonogram (USG) was done if the posterior segment was not well- visualized. Computerized Tomography (CT) scan was requested wherever needed to rule out retained intraocular or intra-orbital foreign body and/or sus- pected orbito-facial fractures. Ocular injuries were classified according to the Birmingham Eye Trauma Terminology System (BETTS). Periocular injuries were classified as abra- sion, laceration, thermal injury (burns), chemical injury, and others (e.g. fractures). Patients with open-globe injury needed admission and immediate surgical intervention, whereas those with periocular injuries were treated on an outpatient basis. A total of 49 patients were seen during the month of the Diwali festival. Out of them, 40 (81%) were males and nine (19%) were females. The age range was 2 to 50 years with an average age of 17 years. Thirteen patients were in the age range of 5–10 years (Table 1). In 18 patients, the right eye was affected; in 23, the left. Eight patients had bilateral involvement. Bombs and other sound-emanating devices were the most common fireworks causing injury among those who could recall the type of the firecracker causing injury. Out of 49 patients, 24 were bystanders and 25 ignited the fireworks themselves. Three (6.12%) patients had only periocular injury (Figure 1). Thirteen (26.53%) had an open-globe injury while 33 (67.34%) had closed-globe injury (Figure 2). Amongst the 24 bystanders, 16 (66.66%) patients had closed- globe injury while 7(29.16%) had open-globe injury and one patient had periocular injury. Six patients had undergone primary treatment elsewhere and were referred to us for further management. The characteristics of injury at presentation are outlined in Table 2. The immediate emergency care in case of burns was according to standard protocol. Thorough wash was given with normal saline along with removal of soot particles and debris after ruling out open-globe injury. The corneal status and extent of limbal ische- mia were assessed. According to the severity, patients were started on copious lubricants, topical antibiotics, and steroid combination eye drops and cycloplegics. One patient required glue with bandage contact lens along with amniotic membrane transplant and tenoplasty. Out of 49 patients, 22 (44.89%) patients underwent surgical intervention at our institute; 26 (53%) were managed conservatively, and one patient was advised evisceration but declined surgery. Five patients had grave ocular injury with no possibility of salvaging the vision. Four of them underwent evisceration. The remaining patient had been operated for corneo- scleral tear elsewhere, and presented to us with corneal infiltrates, exudates in anterior chamber, and intraocular foreign bodies. He was also advised evisceration but declined the same. Out of 22 patients admitted, all except three had visual acuity of counting fingers close to the face or worse. Five patients underwent surgery for repair of open-globe injury. Eight patients had to undergo more than one surgery. Nine patients needed vitreo-retinal surgical interventions. Two patients underwent glaucoma surgery, of which one was operated for Ahmed glaucoma valve after trabeculectomy with Mitomycin C failed to control the intra- ocular pressure. Six patients underwent cataract removal with posterior chamber intra ocular lens (PC-IOL) implantation while one patient needed lensectomy with sclera fixated IOL. Best-corrected visual acuity at final follow up was 20/40 in 24 affected eyes, between 20/200–20/50 in three affected eyes, less than 20/200 to counting fingers in five affected eyes, perception of light (PL)/ hand movement (HM) in two and no PL in eight eyes (Table 3). We were unable to assess vision in five affected eyes of three patients in the pediatric age group. Nine patients (10 eyes) were lost to follow-up. Fireworks are a class of explosive pyrotechnic devices invented by the Chinese in the seventh century. China is still the largest manufacturer and exporter of fireworks in the world, India being the second largest producer. Important events such as the New Year and National Day celebrations in many countries, and festivities like Diwali in India, Spring festival in China, Wednesday Eve festival in Iran, and Aidil Fitri celebration in Malaysia, involve extensive display of fireworks. 2–5 Diwali or Deepawali, also called the ‘‘festival of lights’’, derived from the Sanskrit words deepam (lamp) and avali (row), meaning ‘‘row of lights’’, is an ancient Hindu autumn festival. The illumination of homes with lights and the skies with firecrackers is supposed to be an expression of gratitude to the gods and an indication of the joy of the people living on earth. (The other, more pragmatic, reason being that the fumes produced by the firecrackers kill a lot of insects and mosquitoes, found plentifully after the rains.) The religious significance of Diwali varies regionally, depending on the school of Hindu phil- osophy, regional myths, legends, and beliefs. It is commonly believed that the festival originated to celebrate the return of the hero Rama from exile, as described in the ancient Hindu epic Ramayana. Diwali is an official holiday in India, Nepal, Sri Lanka, Myanmar, Mauritius, Guyana, Trinidad and Tobago, Suriname, Malaysia, Singapore, and Fiji. At the retail level, about US$ 800 million (INR 5000 crores) worth of consumer firecrackers are burnt in India over the Diwali season. There has been growing concern over the negative environmental and health impact of this ritual. Air pollution and burn injuries from fireworks are the two most studied issues. 6 Apart from noise and air pollution, horrific industrial accidents have also been associated with the manu- facture of firecrackers. On 5 September 2012, 40 people were killed and more than 70 injured in the explosion at a fireworks factory in Sivakasi in South India, which is considered the ‘‘fireworks capital’’ of India. This study was a hospital-based, single-center, prospective case series of firecracker injuries documented over a month-long period around Diwali. In this study, the age range was 2 to 50 years with average age of 17 years. Amongst the 49 patients, the majority (40) were males, consistent with findings from previous studies, ...
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Fireworks are an integral aspect of national, cultural and religious festivals globally, featuring in a vast range of celebrations including Diwali in India and New Year’s Eve in the USA. We have seen a trend in eye injuries related to the use of fireworks, with millions of people, of which a large proportion comprising children, are injured annual...
Citations
... 3 Open globe injury in our study was 46.5% which was similar to another study (35.5%). 13 The possible reason for the high number of open globe injuries was that our hospital is a non-profitable tertiary eye hospital which is run by NNJS (Nepal Netra Jyoti Sangh) where most of the referred patient is treated. Most of the open globe injuries in our study occurred during the Chaat festival (64.7%), which is celebrated at a nearby river bank or pond worshipping the sun and has strict rituals. ...
... Many Indian studies have shown that more than 85 % of firecracker injuries occurred while children were not under-supervised by adults. 3,[12][13][14] Studies have shown that bystanders are more at risk of injuries because they are unaware of the fireworks approaching them and can't anticipate the danger. 3 In our study 78.8% of the patients who had ocular injuries were bystanders and not actively participating in lunching firework similar to previous study. ...
Introduction: Fireworks can cause severe ocular injuries which can be prevented if used with proper
precautions. It causes not only mechanical injuries but also thermal and chemical injuries. This
study aimed to find out the prevalence of ocular firework injuries among patients presented to the
emergency department during festival season in a tertiary eye hospital.
Methods: This is a descriptive cross-sectional study done among patients presenting in the emergency
department of a tertiary eye hospital after obtaining ethical approval from the Institutional Review
Committee. Data of patients from medical records between 26 October 2021 to 28 November 2021
and 15 October 2022 to 17 November 2022 was collected. A convenience sampling method was used.
The point estimate was calculated at a 95% Confidence Interval.
Results: Among 132 patients, the prevalence of ocular firework injuries was seen in 73 (55.30%)
(46.82-63.78, 95% Confidence Interval). Closed globe injury was mostly observed in 56 (76.71%)
patients with ocular injuries. The most common age group affected was those less than 30 years old
54 (73.97%).
Conclusions: The prevalence of ocular firework injuries was found to be lower than other studies
done in similar settings. Protective measures should be used to prevent ocular injuries. A public
awareness program needs to be launched before such festivals.
... Smoothing was done to dampen the random variance in day-to-day burn admission numbers, but it also obscured the real impact of events and holidays. We believe this limitation is acceptable, as that was distinctly different from the goals of this study and data on the impact of those events already exists [17,[28][29][30][31]. Another limitation is the single center nature of this study. ...
Background Variations in admission patterns have been previously identified in non-elective surgical services, but minimal data on the subject exists with respect to burn admissions. Improved understanding of the temporal pattern of burn admissions could inform resource utilization and clinical staffing. We hypothesize that burn admissions have a predictable temporal distribution with regard to the time of day, day of week, and season of year in which they present. Study design A retrospective, cohort observational study of a single burn center from 7/1/2016 to 3/31/2021 was performed on all admissions to the burn surgery service. Demographics, burn characteristics, and temporal data of burn admissions were collected. Bivariate absolute and relative frequency data was captured and plotted for all patients who met inclusion criteria. Heat-maps were created to visually represent the relative admission frequency by time of day and day of week. Frequency analysis grouped by total body surface area against time of day and relative encounters against day of year was performed. Results 2213 burn patient encounters were analyzed, averaging 1.28 burns per day. The nadir of burn admissions was from 07:00 and 08:00, with progressive increase in the rate of admissions over the day. Admissions peaked in the 15:00 hour and then plateaued until midnight (p0.05), though weekend admissions skewed slightly later (p = 0.025). No annual, cyclical trend in burn admissions was identified, suggesting that there is no predictable seasonality to burn admissions, though individual holidays were not assessed. Conclusion Temporal variations in burn admissions exist, including a peak admission window late in the day. Furthermore, we did not find a predictable annual pattern to use in guiding staffing and resource allocation. This differs from findings in trauma, which identified admission peaks on the weekends and an annual cycle that peaks in spring and summer.
... The number of eyes involved seems to be related to the type and power of the explosives, for example, 3.33-16.32% for fireworkrelated injuries [6,12] and 72.91% for injuries related to explosive military ammunition [13]. This explosive difference also leads to different types of MEI. ...
... Conversely, the proportion of CGI (64.50-67.34%) was higher than that of OGI (26.53-35.5%) in fireworks-related injuries [6,12]. In cases of ocular trauma derived from common causes, CGI was more frequent than OGI [14,18,19] with a few exceptions [20]. ...
... [3,4,7,8,13,28,37] or the final NLP in 14.04-39.00% [3,4,8,12,28,36,37] of injuries related to firecrackers, bomb or mine explosions, war or weapon use, or OGI. This difference is probably related to the fact that our study included data for various causes of explosive injuries and types of eye injuries from mild to heavy, whereas Feng et al. [36] reported exclusively on eyes with severe explosive injuries that required vitrectomy. ...
Background:
Explosions can produce blast waves, high-speed medium, thermal radiation, and chemical spatter, leading to complex and compound eye injuries. However, few studies have comprehensively investigated the clinical features of different eye injury types or possible risk factors for poor prognosis.
Methods:
We retrospectively reviewed all consecutive records of explosive eye injuries (1449 eyes in 1115 inpatients) in 14 tertiary referral hospitals in China over 12 years (between January 2008 and December 2019). Data on demographics, eye injury types, ocular findings, treatments, and factors affecting visual prognosis were extracted from a standardized database of eye injuries and statistically analyzed.
Results:
Mechanical ocular trauma accounted for 94.00% of explosion-related eye injuries, among which intraocular foreign bodies (IOFBs) resulted in 55.17% of open globe injuries (OGIs) and contusion caused 60.22% of close globe injuries (CGIs). Proliferative vitreous retinopathy (PVR) was more common in perforating (47.06%) and IOFB (26.84%) than in penetrating (8.79%) injuries, and more common with laceration (24.25%) than rupture (9.22%, P < 0.01). However, no difference was observed between rupture and contusion. Ultimately, 9.59% of eyes were removed and the final vision was ≤ 4/200 in 45.82% of patients. Poor presenting vision [odds ratio (OR) = 5.789], full-thickness laceration of the eyeball ≥ 5 mm (OR = 3.665), vitreous hemorrhage (OR = 3.474), IOFB (OR = 3.510), non-mechanical eye injury (NMEI, OR = 2.622, P < 0.001), rupture (OR = 2.362), traumatic optic neuropathy (OR = 2.102), retinal detachment (RD, OR = 2.033), endophthalmitis (OR = 3.281, P < 0.01), contusion (OR = 1.679), ciliary body detachment (OR = 6.592), zone III OGI (OR = 1.940), and PVR (OR = 1.615, P < 0.05) were significant negative predictors for poor visual outcomes.
Conclusions:
Explosion ocular trauma has complex mechanisms, with multiple eyes involved and poor prognosis. In lethal level I explosion injuries, eyeball rupture is a serious condition, whereas contusion is more likely to improve. In level II injuries, IOFBs are more harmful than penetrating injuries, and level IV represents burn-related eye injuries. PVR is more associated with penetrating mechanisms than with OGI. Identifying the risk predictors for visual prognosis can guide clinicians in the evaluation and treatment of ocular blast injuries.
... [6][7][8] Firecrackers can also lead to burns and eye injuries during various festivals. [9,10] The smoke which is produced from the firecrackers can also cause the deadliest health effect such as acute eosinophilic pneumonia. [11] The general population is always unaware of the recent environmental issues as a result of which the pollution is rising on a daily basis. ...
Background: Diwali is a major festival in India and is celebrated with great enthusiasm and fervor. Due to bursting of firecrackers on large scale during Diwali releases harmful gases and toxic substances into the atmosphere leading to air pollution. It causes health problems for children, patients, and senior citizens.
Objectives: The objective of this study was (1) To assess the knowledge, attitude, and practice of school-going students regarding the use of firecrackers. (2) To determine the prevalence of symptoms related to bursting of firecrackers among students and their families. (3) To find out the association between students' knowledge about health effects of firecrackers and their parents' education.
Materials and Methods: An observational, cross-sectional study was done by using self-administered, validated, and pretested pro forma. The study was conducted in all schools located within 250 m2 of distance from the urban health training center of a private medical college. There were three schools falling under these criteria. All 8th standard students (215) of these three schools were included in the study.
Results: Out of the total, 77% were boys. Many, i.e. 63% of students burst firecrackers during Diwali. The majority of students, i.e. 67% have knowledge about health effects of firecrackers. The majority, i.e. 80% of students promote eco-friendly Diwali celebration. The use of firecrackers was highly significant among boys (
... Our findings for the age of <20 years are consistent with the various studies reported worldwide. [17][18][19][20][21][22][23] Further, there were only eight children among 25 affected children who had direct supervision during the period of firework celebration. The loss of vision in children is a matter of great concern as it changes their entire lifestyle, adding to psychological trauma and social burden to the family and society at large. ...
... The most common injuries were lid injuries, corneal abrasions, superficial foreign bodies of the cornea and conjunctiva, and hyphema, which were analogous to findings of other large series as described in [Table 5]. [1,5,6,8,13,14,19,21,23,[26][27][28]30] Corneal injuries were the commonest manifestation in our series (40.3%), followed by eyelid injuries ( [14,21] Posterior segment injuries were observed in 12 patients (18.5%); among these, the most common was retinal detachment (2.9%), followed by vitreous hemorrhage 2.3%. Further delayed complications of ocular trauma, such as angle recession glaucoma and traumatic cataract, were also seen during follow-up. ...
... [23] Despite diagnostic and therapeutic advances, firework-related ocular injuries remain a significant cause of visual loss. [9,19] In our study, 20 (30.7%) patients had light perception at presentation, which reduced to 10 (15.4%) patients following treatment in the final visit. Smith et al. [9] reported a hospitalization rate of 11% in their study. ...
Purpose:
:Ocular trauma is one of the major preventable causes of ocular morbidity and blindness in children and young adults. Firework injuries account for 20% of ocular trauma. The purpose of this study was to describe the clinical profile and assess the severity of the ocular injuries sustained from fireworks in Eastern India mainly during the festive season.
Methods:
:This was a retrospective, hospital-based case study of patients with ocular injuries sustained from fireworks during the year 2017-2020. The study was conducted at a tertiary care hospital in Eastern India. Demographic details, type of injury, duration of injury, visual status, diagnostic tests, and management were recorded.
Results:
Sixty-five patients were reported to suffer from firework-related ocular injuries. The majority of cases were male (51/78.5%). The mean age was 21.78 ± 16.82 years (range: 0-90 years). Children and young adult males were mostly affected (n = 40, 61.5%). Most common offending agent was the bottle rockets (n = 23, 35.4%), followed by bomb and crackers in (n = 18, 27.7%). Majority of the injuries occurred at home environment (n = 37, 56.9%), followed by street (n = 15, 23.1%). About (n = 39, 60%) of the injuries occurred among bystanders. About 40 cases (61.5%) hailed from rural areas. The majority of the cases (n = 46, 70.8%) suffered from closed globe injuries and surgical intervention was required in (n = 40, 61.5%) of the cases. The mean length of hospital stay of fewer than 5 days was required in (n = 42, 64.6%). The final visual acuity of 6/18 or better was achieved in 41 cases (63.1%).
Conclusion:
:Ocular injuries from fireworks remain a public health problem. Awareness among the masses, preventive measures, and strict implementation of government legislation may help in bringing down the incidence of firework-related ocular morbidity and blindness.
... To date, the greatest health concern regarding fireworks has been the potential for injury to life and limb due to the explosive force of fireworks. Each year, approximately 10,000 to 25,000 people (predominantly male teenagers) in the U.S. suffer physical and burn injuries, due to fireworks, which include the loss of fingers, limbs, eyesight, and sometimes, life [3][4][5]. The environmental effects are also a concern as evidenced by numerous publications that describe the release and contamination of air and waterways with perchlorates and other toxicants [6,7]. ...
... Yet, the adverse health effects of fireworks have been evaluated almost exclusively for: 1) the injuries and burns produced by the rapid changes in the physical environment attributed to the explosive forces of fireworks; and 2) the release of chemicals that pollute waterways. Injuries to limbs and fingers occur predominantly in males during the teen years and such accidents are recorded and reported at many levels of the health care system in the U.S. [3][4][5][22][23][24]. These acute injuries and burns are significant adverse health effects and largely preventable by the use of proper safety procedures. ...
Background:
Particle matter (PM) has been associated with increased morbidity and mortality rates across the world. This study was designed to test the hypotheses that pyrotechnic firework displays introduce significant amounts of toxic metals into the atmosphere and are hazardous to human health. Size-selective emissions from 10 different fireworks displays were collected during particle generation in a dynamic, stainless steel chamber and tested for toxicity in cells. A subset of 2 particle types were tested in vivo in mice. At doses that did not produce cytotoxicity in an LDH assay, in vitro reactive oxygen species (ROS) formation was measured in bronchial epithelial airway (BEAS-2B) and human pulmonary microvascular endothelial (HPMEC-ST1.6R) cell lines treated with size-fractionated particles from the emissions of fireworks.
Results:
Significant increases in ROS, in both cell types, were dependent upon the type of firework but not particle size. The in vitro ROS activity was correlated with lung inflammation produced in groups of mice treated by oropharyngeal aspiration with 0, 50, or 100 μg fireworks PM10/mouse. Trace metal analyses of the PM10 samples showed significant differences in metal content among fireworks type. Interestingly, the PM10 sample for the fireworks type producing the greatest in vitro ROS response in BEAS-2B cells contained ~ 40,000 and ~ 12,000 ppm of lead and copper, respectively. This sample also produced the greatest inflammatory response (i.e., increased neutrophils in bronchoalveolar lavage fluid) in mice.
Conclusions:
These findings demonstrate that pyrotechnic display particles can produce adverse effects in mammalian cells and lungs, thus suggesting that further research is needed to expand our understanding of the contribution of metal content to the adverse health effects of fireworks particles. This information will lead to the manufacture of safer fireworks.
... This is consistent with observation from previous studies. [7][8][9] This is due to the fact that males are more outrageous and have higher presence in streets. 10 The most common firecracker causing injury in our study were bombs followed by flower pots (Figure 1). ...
... 12 Most bottle rocket injuries were of serious nature same as reported by other studies. 8 Although almost all age groups could be equally affected by firecracker injuries but majority of the cases in our study was of age group 11-15 years ( Figure 2). Other studies 13,14 had majority of cases in age group 6-10 years. ...
... Corneal abrasion, an injury known for its chronic course and long healing time 2-3 week was quite common in our study (74%). While, one of study shows 13.8% presence and is consistent with the study by Venkatesh 7 while in study by Patel and Mukherjee,8 hyphaema and traumatic cataract were more common. ...
... Fireworks-related injuries (e.g. hand and eye injuries) have been reported around the world, including in the United States, India, Philippines, Columbia, and China (Chaparro-Narváez et al., 2017;Jing et al., 2010;John et al., 2015;Moore et al., 2014;Patel and Mukherjee, 2016;Roca et al., 2015;Wang et al., 2014a). Studies of fireworks-related injuries have reached a consistent conclusion: the largest number of injuries associated with fireworks occurs during festivals, such as the Festival in China (Wang et al., 2014a). ...
Fireworks displays are a traditional form of celebration during the Chinese Spring Festival (Festival). In response to the heavy air pollution caused by fireworks, Shanghai, a megacity in China, has imposed regulatory measures on the use of fireworks in recent years. To investigate air quality trends before and after firework regulation was established and quantify its efficiency, gaseous pollutants, PM2.5 levels, and PM2.5 chemical composition were synchronously measured at 1 h time intervals at an urban site and a suburban site in Shanghai in the period during and around the Festival from 2013 to 2017. PM2.5 concentrations at the urban site during the Festival over the five-year period were 79 (max: 524), 94 (290), 53 (163), 50 (146) and 32 (156) μg/m3, respectively, presenting a decreasing trend at a rate of −13.8 μg/m3/yr (p = 0.05). K+ concentrations, which serve as a tracer of fireworks, were 8.2 (max: 159.4), 2.5 (14.6), 2.2 (10.4), 4.3 (44.2) and 0.8 (4.5) μg/m3 during the Festival from 2013 to 2017, respectively, and thus decreased at a rate of −1.3 μg/m3/yr (p = 0.17). Accordingly, fireworks contributed 41 (51.9%), 38 (36.5%), 6 (10.3%), 21 (35.6%), and 4 μg/m3 (12.1%) to PM2.5, respectively, implying the effectiveness of firework regulation in Shanghai. Health effects attributed to PM2.5 pollution in Shanghai during the Festival were assessed based on Poisson regression. The number of premature deaths related to short-term PM2.5 exposure in Shanghai during the Festival from 2013 to 2017 was 75 (95% CI: 27, 108), 92 (30, 129), 55 (18, 76), 49 (19, 70), and 31 (12, 45), respectively. Daily mortality due to PM2.5 exposure during the Festival from 2013 to 2017 accounted for 1.4–3.8% of total daily mortality in Shanghai. This study provides scientific evidence of air quality improvement and the effectiveness of firework regulation in Shanghai. Keywords: Fireworks, Air pollution, Health effects, Shanghai
... This is consistent with observations from previous studies. [3,[8][9][10][11][12][13][14] Males are more adventurous, more likely to take risks, and have a higher presence on the streets. [3,4] Information on whether the patient was actively involved in launching the fireworks or was just a bystander was not available in most of the case files. ...
... There was a preponderance of CGI in this study. This is similar to findings from other studies in India, [3,8,[10][11][12] Britain, [13] and the United States. [16] Studies from China documenting firework-related injuries during the spring festival, however, found a higher proportion of OGI. ...
... [9,17] In this study, hyphema and traumatic cataract were the most common anterior segment findings, whereas vitreous hemorrhage was the most common posterior segment finding. This is consistent with the findings by Patel and Mukherjee, [8] also in south India. In north India, Venkatesh et al. reported corneal epithelial defect and corneal foreign body as the most common anterior segment injuries and vitreous hemorrhage as the most common posterior segment finding. ...
... In our study, fireworkrelated ocular trauma occurred more frequently in January and February than during other months of the year. This finding is consistent with other reports (Yuan et al. 2010;Patel & Mukherjee 2014;Qi et al. 2015). Several factors account for this negative phenomenon. ...
Purpose:
Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China.
Methods:
A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system.
Results:
Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0???19.3?years (range from 1 to 87?years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n?=?482), followed by the 51- to 60-year age group (16.9%, n?=?339). Overall, open-globe injuries had a higher frequency (70.7%, n?=?1420) than closed-globe injuries (28.6%, n?=?575) and thermal/chemical injuries (0.7%, n?=?14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n?=?646) followed by rupture (21.5%, n?=?432) and an intraocular foreign body (16.2%, n?=?325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n?=?795), followed by the home (28.4%, n?=?570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n?=?112, p?<?0.001). In patients under 18?years, the most frequently occurring injury was open globe (84.5%, n?=?349) with corneal penetration (59.3%, n?=?245). Overall, an operation was performed in 1865 (92.8%) cases, and 144 cases (7.2%) were treated conservatively with medication. The average OTS score was 47.1???19.5. The visual prognosis was closely correlated with the initial VA (r?=?0.570, p?=?0.000) and the OTS score (r?=?0.603, p?=?0.000).
Conclusion:
This study describes the epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China. Notably, a high rate of firework-related ocular trauma occurred during the months adjacent to the Chinese New Year festival. Specific injury prevention strategies, such as the use of protective eyewear, need to target the workplace to reduce the incidence and severity of ocular trauma.
