Health Sentinel: Using fireworks carries big risk for eye injury

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Growing up in a rural area in Illinois, there were no city and few county ordinances limiting residents' activities.

We burned trash in a barrel between our house and the orchard. We erected a fence where we wanted one. And when it came to the Fourth of July, my brothers and I, under supervision of our parents, ran around the yard with sizzling, snapping, light-spraying sparklers.

No one got hurt. Ignorance is bliss, I guess, especially when you are a child.

Though potential for injury then was high, it's even more significant today with the thousands of backyard fireworks options available at temporary stores that have popped up everywhere this time of year. With a drought-induced cancellation of fireworks in many communities, there is concern more families this summer may set off their own fireworks, even if there are community burn bans.

Fort Wayne ophthalmologist Dr. Scott Miller was not looking forward to being on call this past weekend for his group practice, Ophthalmology Consultants of Fort Wayne, 7232 Engle Road and 2512 E. Dupont Road.

“It's a given that I'm going to see injuries from fireworks. Through the years we've seen about everything,” he says, from superficial to deeper burns and abrasions, debris and pieces of glass in the eye to severe bleeding caused by impact trauma.

“Most of the stuff I see is totally inadvertent things — people shooting of bottle rockets and something gets in the eye,” he says. “But I've seen other people who are having a picnic in their backyard and someone two or three houses down shoots the fireworks and it travels several houses away and hits someone.”

Every year, nearly 10,000 injuries of all kinds occur from fireworks, according to the U.S. Consumer Product Safety Commission. About half of fireworks-related injuries are to a child's or adult's head, with one in three of those to the eye.

Sparklers burn at 1,200 to 2,000 degrees. A lot of damage can be done in a very short time if a shooting spark lands in the eye. Those kinds of injuries are most common in young children, according to the American Academy of Ophthalmology (AAO).

For every four people with eye injuries from fireworks, one will have permanent damage, even blindness, according to the American Academy of Ophthalmology (AAO). So that 14-year-old who gets an injury when shooting a bottle rocket can develop cataracts or glaucoma, conditions most people think of as age-related.

“The thing about the eye is it's a closed system, with a very delicate balance,” Miller says. “It has a certain homeostatic basis. The pressure must be maintained at a certain level.”

At the front of the eye is fluid that protects and nourishes that area of the eye. The fluid is continually made and drained through a system called the trabecular mesh. If damage occurs to the trabecular, the fluid cannot drain properly. Pressure builds in the eye, which can quickly damage the optic nerve.

“The other thing is, if there is enough trauma to the eye to cause bleeding in the eye, there is a 15 percent chance of retinal damage,” Miller says. Cataracts can develop when impact trauma causes a cloudy patch on the lens.

“The lens of the eye is living, breathing tissue,” Miller says. It has to have a balance in the environment, fluid flow, oxygen. “If you have traumatic injury, it completely upsets the balance.”

In a perfect world, no untrained, unprotected person would be buying fireworks from a street-corner vendor and shooting them off in their backyard or even a field, Miller says. “But I raised three boys,” he adds. “Despite my imploring about not doing fireworks, they did. But I have no interest. I've seen so many bad eye injuries from fireworks.”

And in this imperfect world where Americans are drawn to purchase and set off their own fireworks, Miller and the AAO advise:

•If there is any indication an injury has or may have occurred to the eye, get to a hospital emergency room right away. Pain is usually the first sign that something has burned or impacted the eye. In some cases, however, the pain may be minimal and the individual self-treats, thinking the injury is not that bad.

•Besides pain, other signs of injury include discharge from the eye, blurriness or vision loss.

•Because many of the agents used in fireworks are caustic, the longer they stay in the eye the more damage will occur. Don't delay seeking medical care.

•Even if you are watching a fireworks display, keep a distance of at least 500 feet from where the fireworks are being lit.

•If you find unexploded fireworks, don't pick them up or even touch them. Call the fire department or police.