The chances of eye injuries from fireworks were slightly higher among residents of areas where fireworks were legal compared with residents of areas where fireworks were banned, according to a UW Department of Ophthalmology study published recently in JAMA Ophthalmology.
At Harborview Medical Center in Seattle, the odds of firework-related ocular trauma were higher among those living in an area where fireworks were legal compared with those living in an area where fireworks were banned, reported Assistant Professor Shu Feng, MD, and colleagues Luke Harrison, BS; Philina Yee, MD; Assistant Professor Miel Sundararajan, MD and Leona Ding, MS.
The odds of firework injuries were higher for patients under age 18 and males. They were also more likely to be vision-threatening compared with non-firework-related injuries.
The findings are surprising since they show that "local firework bans might reduce ocular injury even if someone could easily travel to a neighboring region to buy or detonate fireworks," Feng told MedPage Today. "We see firework stands just outside city boundaries, so people have easy access to fireworks even if they are banned in the area where they live."
Firework injury visits to U.S. emergency departments rose from 2008 to 2017. Nearly three-quarters of injuries occurred in July, and 28% were considered severe. "Hands are the most frequently injured anatomic site, followed by facial/head/neck and ocular injuries," Feng and team noted.
The researchers launched the study because "there have been a lot of changes and controversy within our state in the past decade regarding firework regulations, so we felt that it was worth studying whether these local regulations made any difference in odds of firework-related injury" Feng explained.
The study tracked ocular trauma injuries during the two weeks surrounding July 4 (June 28 to July 11) from 2016 to 2022 and identified 230 cases. Of those, 94 patients had firework-related injuries (mean age 25, 92% male). The majority of injured patients came from urban areas (84%), and most were white (63%).
Corneal abrasion was the most common firework-related injury (52% of cases), followed by bleeding in the eye (32%) and corneal foreign bodies (15%). The most common non-firework-related injuries included orbital fractures (36%), corneal abrasion (29%), and conjunctival or corneal lacerations (17%).
"Some injuries involve mild irritation without treatment and result in no long-term consequences," Feng said. "However, others involve severe vision loss despite extensive surgeries and can even cause eventual loss of the eye and cosmetic disfigurement."
Study limitations included the need for more information about where fireworks were purchased and that it only looked at one center's experience.
Moving forward, Feng and team wrote, "Legislation, including local bans, could be considered to decrease the morbidity of firework-related ocular trauma, and additional studies may determine what actions might lead to greater reductions in harm."