The Fourth of July is almost here. Each year children and adults suffer eye injuries in fireworks accidents. Culver Boldt, MD, UI Hospitals and Clinics ophthalmologist says that when it comes to eye injuries, bottle rockets are definitely worst type of fireworks.

"They cause two thirds of all reported fireworks injuries to the eye. In addition, bottle rockets cause most of the severe eye injuries. Bottle rockets travel at high speeds and take an erratic, unpredictable trajectory. Injuries often occur to unsuspecting bystanders who happen to be within a few hundred feet of the launch site, or they occur when someone tries to relight a bottle rocket and lean over the bottle.  

"Over the last 15 years, we have collected data about fireworks injuries through the United States Eye Injury Registry. Younger people are definitely more likely to be injured. Half of all fireworks injuries occur in individuals 15 years of age or younger," Boldt says. Two-thirds of the eye injuries caused by fireworks occur at home. In contrast, he says, eye injuries at professional fireworks display are rare. Three quarters of injuries are in males. And nearly half of those injured were bystanders.

Moreover, Boldt says, fireworks-related eye injuries are often quite severe. About half of the injuries resulted in vision so bad that you could barely see the big E on the eye chart, and one in 10 injuries required surgical removal of the eye.

For young children - under the age of four - are sparklers safe?

Sparklers are not safe for young children under the age of four. "It's important to realize that sparklers, which were often thought of as the "safe" firework and given to small children, burn at 1,800 degrees Fahrenheit. That's nearly hot enough to melt gold and three times hotter than your outdoor grill on a hot Fourth of July weekend. It's easily hot enough to cause third degree burns. We have seen severe burns and puncture wounds to the eye in children playing with sparklers. Never allow young children to play with fireworks, and provide close supervision if older children use fireworks," Boldt says.  

To be on the safe side, Boldt recommends:

• Never use bottle rockets
• If people are going to operate fireworks at home, safety eyewear should be used by the operators, and spectators
• Never use illegal or "homemade" fireworks
• Never try to relight malfunctioning fireworks.   This is a common cause of injury.
• And finally, attend professionally sponsored public fireworks displays on the Fourth of July. This is really a safe and enjoyable way to celebrate the holiday.

Boldt says that if there is an eye injury as the result of fireworks, you should:

• Not touch, rub or press on the eye.   This can cause further damage.
• Not try to wash out the eye, as this may do more damage too.
• Cover the eye if possible with a protective shield to minimize further damage (a paper styrofoam cup can work).
• Not try to remove any foreign object from the eye. It will only increase the chance for severe damage.
• Seek medical attention urgently if the vision is blurred,   even if the eye does not hurt. If you felt anything more than a minor explosive force hit you eye or eyelids, even if the vision is normal, obtain a thorough eye examination urgently to look for silent but potentially blinding injuries such as retinal tears, or injuries that predispose to glaucoma.

Listeners may believe eye injuries from fireworks happen elsewhere - do you see people injured from fireworks accidents in the Iowa City area? Can it happen here?

Fireworks accidents happen right here in Iowa City. However, injuries to local residents are less frequent than in many Iowa counties.   "I believe this is due in part to the high quality of our local professional fireworks displays.   Most local people attend these public shows, and the safety records for these fireworks professionals are outstanding. Most local injuries occur when people use fireworks at home, and do not follow the safety suggestions we just discussed.

For more information:

Treatment of Firework Eye Injury

Fireworks and Eye Safety

American Society of Ocular Trauma

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