UAB ophthalmologists offer tips to prevent firework related injuries

Fourth of July 2013: Family members were shooting fireworks in the backyard of Dianne Peterson's home in Vincent, Alabama, as she walked out of the house.

"As I stepped out the back door, they were saying a firework went off; but they didn't know which way it went," Peterson said. "Then it hit my eye."

The damage to her left eye was severe. Peterson suffered a full laceration of the cornea along with bleeding and debris in the back of the eye and damage to the iris. She had a cataract caused by the trauma of the bottle rocket's impact.

"Fireworks injuries are an emergency," said Jay McCollum, M.D., an ophthalmologist and director of emergency services at the UAB Callahan Eye Hospital. "They can run the spectrum from a minor injury right up to loss of vision or the loss of the eye."

Peterson's local hospital sent her to Callahan that night, where eye surgeons Priscilla Fowler, M.D., and Doug Witherspoon, M.D., were still on duty. Instead of enjoying a Fourth of July celebration, she was undergoing surgery at midnight.

"We're fortunate to have a 24-hour emergency room and the ability to do surgery relatively quickly," said Fowler, an assistant professor in the UAB Department of Ophthalmology and director of the cornea service. "We were able to do surgery that night; many places don't have those capabilities. I think that had a lot to do with our success with Mrs. Peterson. Now she is able to wear a contact lens and achieve vision of 20/40, which, given the severity of her injuries, is an excellent result."

Peterson is one of the lucky ones. Some 8,700 people were injured by fireworks in 2012, according to the Consumer Product Safety Commission, most of those occurring in the 30-day period before and after the Fourth of July. More than 1,000 of those suffered injuries to the eye.

"Being a cornea specialist, I've seen too many injuries related to fireworks," said Fowler. "And many of these occur in children and innocent bystanders and result in permanent vision loss."

The UAB Callahan Eye Hospital is the safety sponsor for Birmingham's Thunder on the Mountain fireworks show, and hospital officials strongly recommend that professional shows are the best way to enjoy fireworks.

"It's better to just leave the fireworks alone and go to a show like Thunder on the Mountain and let the professionals do it," said McCollum. "That's the safest thing."

But a doctor's recommendation won't be enough to stop everyone from using fireworks. The American Pyrotechnics Association says Americans spend $940 million each year on fireworks. Doctors at Callahan Eye Hospital know they'll be busy on Independence Day, and they are ready.

"We have the equipment, the staff and the surgical backup to deal with any type of eye injury," McCollum said. "We're the only eye emergency room in the state of Alabama and one of only a handful in the country. We're available 24/7, and if there is a question about an eye injury of any kind, we encourage people to come in and let us take a look."

Peterson says there won't be any fireworks at her house this year. She's always known they were dangerous, but as so often happens, didn't expect an injury to happen to her.

"I never dreamed that, when I stepped out the back door that day, something like that would happen," she said. "They were doing the fireworks, and I said, 'guys, we really have to be careful.' I have two small grandkids. I hate that it happened to me, but I'd rather it be me than the children."

Fowler and McCollum say that, if you must use fireworks, follow these safety procedures to avoid injury, burns or blindness:

•Always have an adult present.
•Never use bottle rockets.
•Never allow young children to play with fireworks, even sparklers. Sparklers can reach 1,800 degrees Fahrenheit, hot enough to melt gold.
•Never try to re-light fireworks that did not explode or ignite the first time.
•Keep a bucket of water or fire extinguisher present in case of fire.
•Light fireworks on a clean, flat surface away from the house or flammable materials.
•Read and follow all manufacturers' warnings and instructions.
•If there are no instructions or product labels, the item may have been made illegally and could be unsafe; illegal fireworks, which are made without the quality-control standards of legal products, are extremely unpredictable.
•In the event of eye injury, do not touch, rub or press on the injured eye; seek immediate care from an ophthalmologist or hospital emergency room.
•Light only one item at a time.
•Never throw fireworks at another person.
•Never carry fireworks in your pocket.
•Never shoot fireworks from metal or glass containers.
•Never experiment with or modify fireworks.
•Never attempt to make your own fireworks.

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