Keep away from laser guns, pointers and firecrackers. You could damage your eye
Every year, the Advanced Eye Centre, PGI, has patients come in with eye injuries caused firecrackers. What is the nature of these injuries?
The nature of injuries could vary from mild ones, where a spark lands in the eye and there is an abrasion on the cornea, to severe complications, where practically the whole eye is damaged due to the impact of a firecracker hitting the eye. This is because of thermal injury due to heat as well as the velocity with which the cracker hits the eye. There may be open globe injury with bleeding in the eye, detachment of the retina and accumulation of blood behind the retina. Most of these injuries are complex, requiring multiple surgeries over a period of time and there is a high chance of losing the eye if the injury is severe.
In addition, we are also seeing damage to the retina caused laser pointers. There are substandard lasers available in the market that children play with and may focus on the eyes of each other. This will not cause any visible injury but will damage the centre of the retina, which is the most crucial part of the eye and may result in permanent damage to eyesight. Since children won’t even complain about it, many such injuries are detected later in life, during the regular school check-up when parents or teachers notice that the child is unable to see well from one eye. Unfortunately, this is like Eclipse retinopathy and is mostly irreversible. I am bringing this up because children frequently use laser toys and pointers in the festive season. So, it is the responsibility of parents to educate themselves and protect their children from such harmful toys.
A high percentage of eye injuries also happens to standers. What are the more common injuries and which area of the eye is most affected?
Generally, the person who is burning the cracker is careful and walks away as soon as the firecracker is lit up. The problem happens with standers, who are gazing into the sky to watch fireworks. Often remnants and particles fall back on the ground after they burn out with great speed and may hurt the eyes of the person looking up. These are the most dangerous of all injuries that damage all the structures of the eye, including the cornea, lens and retina. A damaged eye may be lost despite huge efforts and best of the care.
How serious can these injuries be?
These injuries can be serious, making it difficult to save the eyes. Since most of these injuries involve children, it can impact their future, including career choices.
What are the various precautions one can take to avoid injuries?
The first and foremost is to wear protective glasses while outdoors on Diwali night if you wish to either burn or watch firecrackers. The type of firecrackers should be selected wisely and there should be parental supervision. Most injuries are caused carelessness, overcrowding and excitement. Parents must collectively ensure responsible behaviour as their one act of carelessness could deprive their children of a normal life.
What is the protective gear you recommend?
Protective eyeglasses and a visor to cover your eyes and face are important. Fortunately, they have now become widely available courtesy COVID, so there are no issues with the availability. I think schools are doing a great job in promoting education about these injuries and children themselves are very careful. Still, we need to increase awareness. It is equally important that you also protect those around you. Many times, parents will buy protective glasses for their children but other children may be unprotected while bursting crackers.
Should contact lenses be avoided while bursting crackers?
Though there is no hard and fast rule, it is better to avoid them as the first instinct for anyone who has an irritant in the eye is to rub it. That time, a contact lens can cause more problems.
What are the immediate steps one should take in case of trauma to the eye due to firecrackers, corneal injury, or ocular dress due to burns or shrapnel fragments?
One should be very careful about not rubbing the eyes or using eyedrops. It is advisable not to wash with water as the patient may have an open globe injury. This action might be more damaging. The safest option is to gently cover the eye with a sterile eye pad (if you don’t have any, just wear glasses), not to touch it and consult the nearest eye special. Our team at PGI has dedicated doctors working around the clock during Diwali week. The delay in initiating repair protocols and further delay in getting the patient referred to a higher centre whenever required are the major reasons that people end up losing their eyes for good.——-
WHY? Prof Vishali Gupta is an accomplished vitreo-retina and uvea expert of international repute working at the Advanced Eye Centre, PGIMER Chandigarh. She has delivered more than 900 lectures and conducted several instruction courses at various international and national meetings. She has 316 publications in peer-reviewed journals; has edited six books and contributed 72 book chapters in textbooks. She has recently been selected as the president of the prestigious International Uveitis Study Group (IUSG), and the president of the Uveitis Society of India. She has received several awards and holds a US patent for multiplex PCR.