Cautious Deepavali – Take Care of Your Eyes – Play Safe

By Dr Ravi Dorairaj, Consultant Opthalmologist, Dr Agarwals Eye Hospital, Bengaluru

Few festivals in India match the excitement and festive spirit of Diwali. Regardless of religion or region, the entire country comes alive to celebrate the festival of lights. Amidst all the joy and celebrations, it is crucial to take precautions to protect ourselves, especially our eyes, from the dazzling lights and fireworks.

Most fireworks injuries which occur during this season have a direct impact on eyes causing serious injuries. A large number of ocular injuries are reported every year, mainly caused due to firecrackers. In fact, our eyes are the second most common affected area after the hands and fingers. Some of the common injuries are caused by sparklers and bombs along with ‘Chakra’ crackers which are capable of causing injuries to eyes.
 
Along with individuals who handle crackers, more than 50% of bystanders are also at a higher risk of sustaining eye injuries.

Mode of Injury 
The severity of ocular injury can range from mild irritation and corneal abrasions to retinal complications and open globe injury leading to potential blindness. The chemicals in the explosive substances mixed in the crackers, could also be harmful. Constant and higher levels of smoke can cause irritability and watering of eyes. Fumes, emanating from firecrackers, may also cause laryngitis and other throat infections. Sparklers are dangerous because they burn at a temperature hot enough to melt gold (1,800° F), nearly 1,000 degrees hotter than the boiling point of water, hot enough to melt glass and cause third-degree burns to the skin. Necessary precautions need to be taken to avoid such injuries. 

Contact lenses may cause irritation to the eyes if exposed to direct heat for a prolonged duration. So, people wearing contact lenses should be doubly cautious while handling fireworks, to prevent chemical injuries to the eye and thermal burns.

Major Ocular injuries
    Open globe injury – Full thickness injury of the eye wall
    Closed globe injury – Injury to the globe without a full thickness ocular wall laceration/rupture
    Contusion - Bruise around the eye
    Lamellar laceration - partial thickness wound of the eyewall
    Laceration - Full-thickness injury of eye wall caused by a sharp object
    Penetrating injury – An Open globe injury with an entrance wound
    Perforating injury – An Open globe injury with an entrance and exit wound

Patients with closed eye injuries are usually treated on an outpatient basis, whereas open eye injuries require more careful evaluation. In severe cases, serious complications may occur, such as tears in the clear front layer of the eye (corneal tear) or the white part (scleral tear). Trauma can also cause the iris to detach from its base (iridodialysis), bleeding inside the front of the eye (hyphema), a suspected intraocular foreign body (IOFB), or globe rupture. Such cases will require hospital admission for further management and observation.
Do’s
•    If something gets into your eye, hold your eyelids open and flush continuously with water.
•    If a large or stuck particle cannot be removed, keep your eyes closed and see an eye doctor.
•    If chemicals get in the eye, rinse immediately for 30 minutes and consult an eye doctor.
•    Always burst crackers in an open space.
•    Wear protective glasses or goggles when handling fireworks.
•    Maintain a safe distance: arm’s length while lighting, at least 5 meters while watching.
•    Remove contact lenses before bursting crackers; use protective glasses instead.
•    Defuse used fireworks by soaking them in water before disposal.
•    Keep a bucket of water or sand nearby to put out accidental fires.
•    Store fireworks safely, out of children’s reach.
•    Wear sturdy slippers to avoid stepping on burnt crackers.
•    Supervise children at all times while handling fireworks.
Don’ts
•    Do not rub or scratch your eyes.
•    Do not apply pressure to an injured eye.
•    Do not try to remove a large or stuck particle yourself.
•    Do not use over-the-counter medicines, including pain relievers, for eye injuries.
•    Do not wear synthetic clothing while bursting crackers.
•    Do not keep fireworks near your face, hair, or clothing.
Make Diwali more safe, more green and more healthy.
(VIews are personal)