– By: Dr S. Soundari,
(Zonal Head – Clinical services, Dr. Agarwals Eye Hospital)
Deepavali is often celebrated with two most essential elements, the diya and fireworks. Certainly, age is not a factor for bursting crackers and everyone loves fireworks. If such celebration with crackers is considered as a tradition, then it is essential to take extra care while handling them.
Most fireworks injuries which occur during this season have adirect impact on eyes causing serious injuries. A large number of ocular injuries are reported every year, mainly caused due to firecrackers. In fact, the eyes are the second most common affected area after the hands and fingers. Some of the common injuries are caused by sparklers and bombs along with ‘Chakra’ crackers which also cause eye injuries.
High risk individuals
Along with individuals who handle crackers, more than 50% bystanders are at high risk of sustaining eye injuries. The other major casualties are street by-passers who are exposed to ignited firecrackers in the streets.
Mode of Injury
The severity of ocular injury can range from mild irritation and corneal abrasions to retinal complications and open globe injury leading to potential blindness. Chemical injuries are due to the chemicals in the gunpowder mixed in the crackers. The constant smoke can cause irritability and watering of eyes. Fumes, emanating from firecrackers, may also cause laryngitis and other throat infections. Sparklers are dangerous because they burn at a temperature hot enough to melt gold (1,800° F). That temperature is nearly 1,000 degrees hotter than the boiling point of water, hot enough to melt glass and cause third-degree burns to the skin. Necessary precautions need to be taken to avoid such injuries.
Most fireworks contain gunpowder, which causes these devices to explode. Because fireworks explosions are unpredictable, injuries can occur even if the person is careful or is under supervision. Pollution levels are at peak during Diwali, with nitrous oxide and sulphur dioxide levels rising considerably.
Also, noise pollution levels cross the permitted levels. Flowerpots and bursting crackers are packed with multiple small particles which travel at high speed causing mechanical damage to the tissues.
Contact lenses may cause irritation to the eyes if exposed to direct heat for a long time. So people wearing contact lenses should be doubly cautious while bursting crackers .In a nutshell, the damage to the eye by a cracker depends on the velocity of the cracker or the intensity with which it hits the eye, chemical reaction in the eye and thermal burns.
Major Ocular injuries
▪ Open globe injury – Full thickness injury of the eye wall
▪ Closed globe injury – Injury to the globe without a full thickness ocular wall laceration/rupture
▪ Contusion – Bruise around the eye
▪ Lamellar laceration – partial thickness wound of the eyewall
▪ Laceration – Full-thickness injury of eye wall caused by a sharp object
▪ Penetrating injury – An Open globe injury with an entrance wound
▪ Perforating injury – An Open globe injury with an entrance and exit wound
Patients with closed eye injuries will be treated on an outpatient basis and cases with open eye injury, corneal and scleral tears, traumatic iridodialysis with hyphema, suspected intraocular foreign body (IOFB), and globe rupture will require admission for further management and observation.
DO’s AND DON’TS
■ Do not rub your eyes or scratch your eyes.
■ Wash your eyes and face properly.
■ In case of any irritation or foreign body in the eye , hold the eyelids open and flush the eyes continuously with water.
■ If a particle is large or stuck in the eye, do not attempt to remove it.
■ Keep eyes closed and go to the eye doctor.
■ If there is any chemical that has entered the eyes, immediately irrigate the eyes and under the eyelids, with water, for 30 minutes. Seek an eye doctor immediately
Do’s and Don’ts – in case for children
▪ Not to rub affected eye. This may increase bleeding or worsen the injury.
▪ Not to apply pressure to the affected eye.
▪ Never use OTC medicines including pain relievers.
▪ Never allow children to play with fireworks even with guidance and supervision.
■ Always burst crackers in an open space, wear goggles, wash hands with clean water
■ Children should be supervised while playing with crackers. Never take any injury lightly; visit a doctor and take professional help
■ Keep a bucket of water and sand readily available for accidental fire.
■ Store fireworks in a closed box in a safe location, away from the reach of children
■ Keep fireworks away from the face, hair and clothing
■ Do not wear synthetic clothing while bursting crackers
■ Maintain a distance of an arm’s length while lighting firecrackers, and at least five meters while watching
■ Remove your contact lenses before going out to burst fire crackers. Use a spare glass instead, which can protect your eyes in a better way.
■ Defuse used fireworks properly by soaking them in a bucket of water before disposal
■ Always wear good slippers which will protect from accidental stamping of burnt crackers
We have kept emergency services available to the people in case of any unfortunate event of eye injury, please contact, 95949 24048.
Make Diwali more safe, more green and more healthy.