Pattern and visual outcomes of ocular fire-cracker injuries during Diwali festival in a tertiary Care Hospital in North India

Background: The firecrackers are used widely during Diwali. Eyeball is one of the most commonly injured organ in firecracker injuries. The fire-crackers can cause irreparable damage to ocular structures, leading to blindness. This study was conceptualized to study the pattern of injuries resulting from fire-cracker use and their visual outcomes, in order to generate evidence for managing these injuries more effectively. Material and Methods: This longitudinal, descriptive study was carried out over a period of one week during Diwali festival in 2019, in a tertiary care teaching hospital in North India in 21 patients who presented to hospital with ocular injuries caused by firecrackers. Visual acuity was recorded and complete slit lamp examination, non-contact tonometery, and gonioscopy was done. Ultrasound B-scan and X-ray were also done, when required. Results: The mean age in our study was 18.42±11.88 years with age range of 7-57 years. There were 20 males and 1 female in the study. Most of the injuries were caused by bombs and sparkles. Most of the patients (50%) had visual acuity in range of 6/6-6/24 at the time of presentation. Conjunctival surface was involved in all the patients, followed by lids and cilia (59.09%). One patient had corneal perforation with uveal tissue proplase.Six patients had vitreous haemorrahge and seven patients had hyphema. Final visual outcome was favorable with 63.64% patients achieving vision of 6/6- 6/24 at the end of six weeks. Conclusion: Severe injuries can lead to permanent loss of vision or decreased vision from squealae of wound healing such as astigmatism. Hence, stricter implementation of existing laws and regulations, public education and awareness is needed to prevent avoidable blindness resulting from use of fire crackers