Type, severity, management and outcome of ocular and adnexal firework-related injuries: the Rotterdam experience

Sonja Frimmel, J Tjeerd de Faber, Rene J Wubbels, Christoph Kniestedt, Dion Paridaens

Research output: Contribution to journalArticleResearchpeer-review


PURPOSE: To study the type, severity, management and outcome of firework-related adnexal and ocular injuries during New Year's Eve festivities.

METHODS: A retrospective analysis of 123 injured patients (143 eyes) treated at the Rotterdam Eye Hospital between 2009 and 2013. All ages were included and analysed according to age, gender, active participant or bystander, laterality, location, dimension and severity of injury. Outcome parameter was the final best-corrected visual acuity.

RESULTS: The mean age was 22 ± 13 years with 87% males and 53% bystanders. 52% were ≤18 years. There was a higher number of female than male bystanders (63% versus 51%, p = 0.30). 50% of the eyes sustained mild, 13% moderate and 37% severe trauma. Adults suffered more from severe injuries compared to children (42% versus 31%). The most frequent intervention was gunpowder removal (20%), followed by traumatic cataract surgery (12%) and amniotic membrane grafting (8%). 76% of patients were followed over 1 year. At the end of follow-up, 88 (61.5%) eyes had recovered fully, while 55 (38.5%) eyes suffered from persistent complications with reduced vision ≤0.8 in 30% of injured eyes. 15 patients (12%, 10 adults, five children) were considered legally blind (vision ≤0.1). Three (2%) eyes were subject to evisceration.

CONCLUSION: Every year, around New Year's Eve 30-45 victims were referred to the Rotterdam Eye Hospital; 50% sustained moderate-to-severe trauma. In severe firework injuries, patients required multiple treatments that may not prevent permanent blindness and/or functional/cosmetic disfigurement. The majority was bystander and younger than 18 years.

Original languageEnglish
Pages (from-to)607-615
Number of pages9
JournalActa Ophthalmologica
Issue number6
Publication statusPublished - Sept 2018


  • Adolescent
  • Adult
  • Age Distribution
  • Blast Injuries/diagnosis
  • Child
  • Child, Preschool
  • Disease Management
  • Eye Burns/diagnosis
  • Eye Injuries/diagnosis
  • Female
  • Follow-Up Studies
  • Holidays/statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Multiple Trauma
  • Netherlands/epidemiology
  • Ophthalmologic Surgical Procedures/methods
  • Reconstructive Surgical Procedures/methods
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Trauma Severity Indices
  • Visual Acuity
  • Young Adult


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