While firecrackers and shrapnel cause complex eye injuries, ophthalmologists are also seeing an increase in cases of retinal damage in children due to substandard laser pointers and firearms, the professor said. Vishali Gupta of Advanced Eye Center, PGI. PARUL learns more about eye injuries and what to do in case of injury.
Every year, patients present with eye injuries caused by firecrackers. What is the nature of these injuries?
The nature of injuries can vary from minor, where a spark lands in the eye and there is an abrasion on the cornea, to serious complications, where virtually the entire eye is damaged due to the impact of a firecracker striking the eye. This is due to thermal damage from the heat as well as the speed with which the cracker hits the eye. There may be an open globe injury with bleeding in the eye, retinal detachment, and pooling of blood behind the retina. Most of these injuries are complex, requiring multiple surgeries over a period of time and there is a high chance of losing an eye if the injury is severe.
Additionally, we also see retinal damage from laser pointers. There are inferior lasers on the market that children play with and can focus on each other’s eyes. This won’t cause any visible injury but will damage the center of the retina, which is the most crucial part and can lead to permanent damage to your eyesight. Since children don’t even complain about them, many of these injuries are detected later in life, during a school check-up when parents or teachers notice that the child cannot see well in one eye. Unfortunately, it resembles eclipsing retinopathy and is usually irreversible. I bring this up because children frequently use toys and laser pointers during festivals. It is therefore the responsibility of parents to educate themselves and protect their children from these harmful toys.
What are the most common injuries and which area of the eye is most affected?
Generally, the person who burns the cracker is cautious and walks away as soon as it is lit. The problem occurs with passers-by, who look up to the sky to watch fireworks. Often the remnants and particles fall back to the ground after burning at high speed and can injure the person’s eyes. These are the most dangerous of all injuries that damage all structures including the cornea, lens and retina. A damaged eye can be lost despite great effort and the best care.
How serious can these injuries be?
These injuries can be serious and it is difficult to save the eyes. Since most of these injuries involve children, they can affect their future, including their career choices.
What are the different precautions to take to avoid injuries?
The first and most important is to wear goggles outside on Diwali night if you want to burn or watch firecrackers. The type of firecrackers must be chosen wisely and there must be parental supervision. Most injuries are caused by neglect, overcrowding and excitement. Parents must collectively ensure responsible behavior because a single act of carelessness could deprive children of a normal life.
What protective gear do you recommend?
Goggles and a visor to cover your eyes and face are important. Fortunately, they are now widely available thanks to Covid. I think the schools are doing a great job in promoting education about these injuries and
the children themselves are very cautious.
Yet we need to raise awareness. It is equally important that you also protect those around you. Often parents buy goggles for their children, but other children may not be protected when popping crackers.
What are the immediate actions for eye trauma, corneal damage, or eye distress from burns or shrapnel?
Care should be taken not to rub your eyes or use eye drops. It is advised not to wash with water as the patient may have an open globe wound as this could be more damaging. The safest option is to gently cover the eye with a sterile eye swab (if you don’t have one, just wear glasses), not touch it, and consult the nearest ophthalmologist. Our team at PGI has dedicated doctors working around the clock during the Diwali week. Delay in initiation of repair further delays referral of the patient to a higher center whenever necessary. This can often result in the loss of