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M. Khan, D. A. Reichstein, F. M. Recchia; Ocular Consequences of Bottle Rocket Injuries in Children. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5379.
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Fireworks-related injuries are a common cause for emergency department visits and a preventable cause of irreversible vision loss, especially in children. Bottle rockets in particular account for a disproportionate number of cases of legal blindness. The purpose of this study was to describe the spectrum of ocular injuries and associated visual morbidity in the pediatric population caused by bottle rockets.
Consecutive records of patients < 18yrs seen through our emergency department between 1-1-06 and 11-15-09 were reviewed. Data collected were: patient demographics; level of patient involvement; visual acuity (VA) at presentation; ocular injuries at presentation; primary and secondary interventions required; VA at most recent follow-up.
11 eyes in 10 patients (8 boys, age range 5-17 yrs) were identified. 8 children were injured within one month of July 4th. 8 patients were actively using bottle rockets; 2 were bystanders. Protective eyewear was not recorded in any patient. Injuries included: corneal epithelial defect (7 eyes), lid lacerations (2 eyes), periocular burns (3 eyes), hyphema (6 eyes), traumatic iritis (1 eye), iridodialysis (4 eyes), cataract (4 eyes), commotio retinae (4 eyes), intraretinal hemorrhage (2 eyes), retinal dialysis (1 eye), and vitreous hemorrhage (2 eyes). 8 eyes required primary intervention (lensectomy in 4 eyes, corneal debridement in 2 eyes, globe exploration and retinal laser photocoagulation in 1 eye each). Secondary interventions included pars plana vitrectomy (2 eyes); muscle surgery for sensory strabismus (2 patients); corneal debridement (1 eye); intraocular lens placement (1 eye). On presentation, 7 of the 11 eyes had VA worse than 20/200. Of the 10 eyes that followed-up, 4 eyes continued to have VA worse than 20/200.
Bottle rockets can cause significant ocular injury in children and incur expense through emergency visits, surgical intervention, and days missed from school and work. 80% of injuries occurred within a month of 4th of July festivities. Such studies are important for education of parents, children, and the public about the repercussions of fireworks-related eye injuries, both to active participants and bystanders.Support:Unrestricted Departmental Grant from Research to Prevent Blindness, Inc.
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