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Fireworks eye injuries can cause vision loss, infection – SC Times

Hamburgers, family reunions and swimming are on our minds over the Fourth of July holiday weekend.
Eye safety and potential vision loss from the use of fireworks usually are not.
“It’s pretty colors, but not worth a lifetime of vision loss,” said Dr. Nicholas Colatrella, medical director at PineCone Vision Center in Sartell.
Fireworks can cause injuries to eyes, but also the head, face, ears, hands, torso and legs.
According to a study released in 2014 by the U.S. Consumer Product Safety Commission, there were 11,400 fireworks-related injuries in 2013 and eight deaths nationwide.
For the month surrounding July 4, 2014, Minnesota hospitals reported 70 fireworks injuries, according to the Minnesota State Fire Marshal Division.
Locally, every Fourth of July weekend, doctors at the PineCone Vision Center see about five to 10 injuries.
“I would prefer to have a quiet weekend,” Colatrella said.
With fireworks, there are three types of potential injuries: Explosive injury, thermal burn and chemical burn.
“The nasty thing about fireworks is not only do you get this explosive force that hits the eye, but you get a thermal injury because of the heat,” Colatrella said. “So it burns everything. A lot of the fireworks have magnesium hydroxide, which is the kind of coating that gives it the color. … So it gives an alkai burn.”
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Nineteen percent of fireworks injuries affect eyes; heads, faces and ears account for another 19 percent, while 36 percent of injuries are to the hands and fingers. More than 50 percent of the injuries were burns.
Colatrella advocates using safety glasses when using fireworks and standing in a safety zone away from the fireworks.
Sunglasses don’t work because they are not impact resistant. But they’re better than nothing.
“We advocate safety glasses, pretty much for everything,” he said. “My wife laughs at me. She says I wear safety glasses carrying the groceries in.”
He advises caution with sparklers and young kids.
Sparklers burn at about 2,000 degrees and are often handled by youngsters. That leads to a number of eye-related injuries.
Kids may wave the sparkler and get their parent in the eye, he said, giving a thermal and chemical injury.
In 2013, there were an estimated 2,300 emergency department-treated injuries associated with sparklers in the U.S. and 300 from bottle rockets, according to the U.S. Consumer Product Safety Commission.
Children younger than 15 accounted for approximately 40 percent of the 2013 injuries.
There isn’t much danger of injuring the retina by staring directly at a sparkler or firework. You’d have to stare intently for more than five minutes for that to happen, Colatrella said.
He tends to see the more destructive injuries in kids, because they may not be paying attention or may not realize they are in harm’s way.
But as with any injury, kids do a better job of healing. With adults, once some damage is done, it’s hard to recover.
Going to the doctor soon after an injury also helps a thermal burn. There, doctors can scrape away the dead cells on the surface of the eye, which reduces inflammation and allows it to grow back within 24-36 hours.
In some cases, injuries can result in a secondary glaucoma, which results in permanent vision loss.
“There’s no way to fix that,” Colatrella said. “I’ve seen some crazy ones over the years.”
He doesn’t name a particular type of firework to avoid.
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Colatrella says he’d prefer to eliminate fireworks altogether. In particular, he’d eliminate those that are highly explosive, with TNT.
Fireworks aren’t the only hazard. In the fall, hunters come in with tree branches to the eye. During the summer, Colatrella’s practice sees a lot of fish hooks.
He also is seeing more eye infections from mud races. He tells his patients to keep their head out of the mud, to avoid the bacteria. There is a water-borne organism — Acanthamoeba — that can cause a deadly infection to the brain and spinal cord if it gets in the eye.
As for fireworks, there is one tip Colatrella can offer if an accident occurs:
“Irrigate the eye,” he said. “Irrigation is the key right away. A lot of people don’t understand if they irrigate the eye immediately, they do a much better job of reducing the long-term effects of the chemical.”
Colatrella says there is probably no scenario where irrigating the eye would do more harm than good.
In an emergency room, doctors may be more concerned about the explosive and thermal injury, and not treat the chemical injury immediately.
“Once the damage is done, it perpetuates for weeks afterward. That can cause some serious issues on the cornea,” he said. “Then the damage is already done. You can’t fix that. You just have to wait and see.”
Follow Stephanie Dickrell on Twitter @SctimesSteph, call her at 255-8749 or find more stories at www.sctimes.com/sdickrell.
Tips to avoid eye and other injuries from fireworks:
•Discuss fireworks safety with children and teens and never allow children unsupervised near fireworks.
•Wear protective eyewear when lighting or handling fireworks of any kind. Store fireworks, matches and lighters in secure places where children won’t find them.
•Never point or throw fireworks at another person.
•Don’t carry fireworks in a pocket or light them in a metal or glass container.
•If you are an onlooker at a fireworks display, keep a safe distance.
•Never place your body directly over a fireworks device while lighting it.
•Keep a bucket of water and a hose handy and douse fireworks when spent.
•Don’t try to relight a device that hasn’t fully ignited.
•Make sure that the fireworks are legal in the state where you are during the holidays. For example, if you buy explosive fireworks in Wisconsin, you can’t use them in Minnesota.
Source: Minnesota Optometric Association.
By the numbers …
• In 2014, U.S. Consumer Product Safety Commission staff conducted a study of fireworks injuries from June 20 through July 20.
• 230 people on average go to the emergency room every day with fireworks-related injuries in the month around the July 4th holiday.
• 67 percent of these fireworks injuries in 2014 occurred during the month surrounding July 4th.
• 9 people died due to eight fireworks-related incidents. In at least two incidents, the victims were not the users.
Source: U.S. Consumer Product Safety Commission.


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