Firecracker eye injuries: most victims are children, a third are bystanders, and 40% present below 6/60

Design

Prospective multicentre observational study, 3 tertiary centres in India

Population

67 patients with firecracker-related ocular injuries, Diwali 2023-2024

Primary outcome

Injury profile, visual acuity, treatment and cost

Effect

Children 62.7%; bystanders 34.3%; VA worse than 6/60 in over 40%; surgery 23.9%

This prospective observational study enrolled 67 consecutive patients with firecracker-related eye injuries at three tertiary eye centres in Central and Western India over the Diwali periods of 2023 and 2024.

Most were male (89.6%) and children (62.7%). A third (34.3%) were bystanders. Blast injury was the commonest mechanism (80.6%) and closed-globe trauma predominated (82.1%). More than 40% presented with vision worse than 6/60, and 23.9% needed surgery. Median time to presentation was six hours. Estimated cost was about ₹31,500 per patient.

Diwali falls in November this year, and eye departments across India will see these injuries within weeks. The profile here, children and bystanders with severe early visual loss, is what public messaging and emergency preparation need to target.

The series comes from tertiary centres, so it describes the more severe end of injuries rather than their true frequency.

• Plan Diwali-period rostering and theatre access for ocular trauma.
• Brief emergency and casualty staff on shielding the eye and urgent referral for suspected open globe.
• Advise parents that supervision alone does not protect bystanding children; distance and eye protection do.
• Record injury mechanism and bystander status to support local prevention data.

Why it matters

A predictable, seasonal, largely preventable cause of childhood visual loss arrives in India every year within the same few days.

Don't overread it

This tertiary-centre series of 67 patients cannot estimate how common firecracker eye injuries are in the population.

The statistics, in plain English

Percentages from 67 patients are imprecise: the true share of bystander injuries, for example, could plausibly be anywhere from about a quarter to nearly half.

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