Firecracker-related ocular injuries during the Diwali festival: A multicentric prospective study from Central and Western India.

PURPOSE: To comprehensively evaluate the epidemiological profile, clinical characteristics, mechanisms of injury, visual outcomes, and economic burden of firecracker-related ocular trauma presenting to tertiary eye care centers in Central and Western India.

METHODS

This prospective, multicentric observational study was conducted across three tertiary eye care centers during the Diwali festive period (2023-2024). Sixty-seven consecutive patients with firecracker-related ocular injuries were included. Data were collected using standardized electronic medical records and analyzed using SPSS version 22. Variables assessed included demographics, injury mechanism, role (self-handled vs bystander), type of trauma, presenting visual acuity, and treatment modality. Economic burden was estimated using institutional cost averages and published Indian cost-of-illness data.

RESULTS

A total of 67 patients were included, with a predominance of males (89.6%) and children (62.7%). Self-handled injuries accounted for 65.7% of cases, while 34.3% occurred among bystanders. Blast injuries were the most common mechanism (80.6%), and closed-globe trauma predominated (82.1%). More than 40% of patients presented with visual acuity worse than 6/60. Surgical intervention was required in 23.9% of cases. The median time to presentation was 6 hours. The total estimated economic burden was ₹21.1 lakh, with an average cost of ₹31,500 per patient.

CONCLUSION

Firecracker-related ocular trauma remains a major, preventable cause of visual morbidity and financial burden in India. Strengthened regulatory measures, public education, and supervised firecracker use are critical to reducing this avoidable public health problem.