Kurien Neethu Ann, Peter Jayanthi, Jacob Pushpa
Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India.
J Emerg Trauma Shock. 2020 Jan-Mar;13(1):39-44. doi: 10.4103/JETS.JETS_62_18. Epub 2020 Mar 19.
Ocular injury due to fireworks requires urgent ophthalmic assessment and management to preserve vision.
Spectrum of injury, type of intervention, visual outcome, and reasons for visual loss were assessed in consecutive patients presenting over 2 years with firework-related eye injury. The final visual outcome was recorded as best-corrected visual acuity.
In the 96 patients (75 males) enrolled, 122 eyes were involved. Twenty-six patients had bilateral eye injury. The median (interquartile) age was 14 (8, 28.5) years. Injuries occurred during Diwali festival (59.4%) and funeral processions (20.8%); over half (53.8%) were bystanders. Injury was due to negligence (78%), device malfunction (12.5%), and attempts to reignite (5.2%) or recover failed device (4.2%). Presenting symptoms were redness (100%), pain (97%), watering (86%), and reduced vision (77%). Facial laceration, contusion, or hematoma occurred in 13 patients. The most frequent adnexal and ocular surface injuries were lid burns (57.3%), edema (44.2%), charred eyelashes (24.6%), and laceration (13.9%). Open-globe injury occurred in 8 eyes. Common anterior segment injuries were corneal epithelial defect (51.6%) and hyphema (20.5%). Posterior segment injuries included commotio retinae (13.1%) and Berlin's edema (7.4%). Surgical treatment was required in 15 eyes; 107 (88%) were managed conservatively. At study completion, of the 99 eyes evaluated, 21 had reduced visual acuity (<6/6) including 7 with monocular blindness. Factors associated with poor vision were open-globe injury ( < 0.001) and poor initial visual acuity ( = 0.05).
Open-globe injury and poor visual acuity at presentation predict the final visual outcome. Monocular blindness following firecracker injury is common.
烟花造成的眼外伤需要紧急眼科评估和处理以保护视力。
对连续两年因烟花相关眼外伤就诊的患者，评估其损伤范围、干预类型、视力预后及视力丧失原因。最终视力预后记录为最佳矫正视力。
纳入的96例患者（75例男性）中，累及122只眼。26例患者为双眼损伤。年龄中位数（四分位间距）为14（8，28.5）岁。损伤发生在排灯节期间（59.4%）和葬礼游行时（20.8%）；超过半数（53.8%）为旁观者。损伤原因包括疏忽（78%）、装置故障（12.5%）、试图重新点燃（5.2%）或找回失效装置（4.2%）。就诊时症状包括眼红（100%）、疼痛（97%）、流泪（86%）和视力下降（77%）。13例患者出现面部裂伤、挫伤或血肿。最常见的眼附属器和眼表损伤为眼睑烧伤（57.3%）、水肿（44.2%）、睫毛烧焦（24.6%）和裂伤（13.9%）。8只眼发生开放性眼球损伤。常见的眼前段损伤为角膜上皮缺损（51.6%）和前房积血（20.5%）。眼后段损伤包括视网膜震荡（13.1%）和柏林水肿（7.4%）。15只眼需要手术治疗；107只眼（88%）接受保守治疗。研究结束时，在评估的99只眼中，21只眼视力下降（<6/6），其中7只眼单眼失明。与视力差相关的因素为开放性眼球损伤（<0.001）和初始视力差（=0.05）。
开放性眼球损伤和就诊时视力差可预测最终视力预后。鞭炮伤后单眼失明很常见。
