Bottle Rockets Cause Most Devastating Fireworks Injuries to Eye Interview with:
Natasha Nayak Kolomeyer, MD
Glaucoma Service, Wills Eye Hospital
Eric J. Shiuey, MS
Sidney Kimmel Medical College, Thomas Jefferson University
Anton M. Kolomeyer, MD, PhD
Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania
Philadelphia, Pennsylvania What is the background for this study?

Response: I still remember the 6-year-old boy that was brought in to our emergency room on July 4th with a ruptured globe (severe eye trauma) due to fireworks; he permanently lost vision in that eye despite surgery. This is not a rare occurrence especially around certain holidays. What are the main findings? 

Response: Given the limited literature on the subject, we used a national database of US emergency departments to look at rates of eye-related firework injuries. We estimated that there were an average of 1840 ocular injuries per year during the 19-year study period (1999-2017). While ocular burn was the most common injury, we found that bottle rockets disproportionately caused the most severe injuries, including ruptured globe, which requires emergency treatment. 75% of injuries occurred at home. As might be expected, the vast majority of cases occurred around the time of national holidays in July and January. What should readers take away from your report?

Response: Bottle rockets are nearly 7 times more likely than other firework types to cause severe eye injury, but are still legal in many states. This represents an opportunity for regulation.

Only 4 US states ban most or all fireworks, even though research in other countries demonstrates that banning firework use (even just bottle rockets) reduces incidence of injury. Enhanced restriction of firework sales, improved supervision at home, use of protective eyewear, and enhanced regulation of use may reduce morbidity from fireworks.

We believe that restricting bottle rocket use would be an important first step towards decreasing the incidence of injury, especially around the time of national holidays. What recommendations do you have for future research as a result of this work? 

Response: The national database lacks state-specific data; future research might look at how expanded restrictions in certain states has affected injury incidence compared to states that do not restrict firework sales.

 No disclosures.



Shiuey EJ, Kolomeyer AM, Kolomeyer NN. Assessment of Firework-Related Ocular Injury in the US. JAMA Ophthalmol. Published online April 09, 2020. doi:10.1001/jamaophthalmol.2020.0832



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Last Updated on April 13, 2020 by Marie Benz MD FAAD