A British Ophthalmological Surveillance Unit study on serious ocular injuries from fireworks in the UK

We conducted a surveillance study to assess the nature, management, and visual outcomes of serious ocular injuries from fireworks in the UK.

New cases of serious ocular injuries from fireworks were prospectively ascertained through the monthly active surveillance system of the British Ophthalmological Surveillance Unit (BOSU). All ophthalmologists in the UK received a reporting card each month for a 2-year period commencing July 2004. They were asked to indicate any new cases of serious ocular injury from a firework, or to confirm that they had no new cases to report. Information on demographic detail, type of injury, management, and visual outcome was sought through an incident and 6-month follow-up questionnaire.

Eighty-one per cent of the injuries occurred in October and November and 27% (13/47) of the patients were less than 18 years old. Twenty-six per cent (12/47) of patients had a penetrating injury, and ocular surgery was required in 53% (25/47) of cases. Eight patients (17%) required enucleation or evisceration and four (9%) required a cosmetic shell for phthisis. At 6-month follow-up, 53% (21/40) of cases had a visual acuity of 6/60 or worse.

This prospective national survey confirms that firework injuries are an important cause of preventable visual disability particularly to young males. It is likely that such injuries occur year on year and as such represent an important public health concern in addition to the burden placed upon the health service.