The biggest festival of India is here and everyone is jumping with joy. With Crackers and similar \'weapons\' one should very very careful, because a small error (of judgement), ignorance or a casual approach can take away the eye-sight, partially or totally, in one or both the eyes. I am not at all happy treating young and innocent children of serious and grievous Fire-cracker eye injuries - often resulting in permanent loss of vision and disfigurement - sustained during this period of Diwali and Dussehera, year after year. Ivividly remember a 10 year old child and the injury he sustained last Diwali. He lighted the cracker and when it did not go off, he went again to ignite it but by that time the previous ignition had reached inside the cracker and it burst. This is one of most ignored issues in crackers\' injury. Do not ever try to re-ignite or re-light the crackers. He was diagnosed to have sustained burns of the eyelids, eyelashes and the eyes resulting in serious damage to vital tissues of the eyes that included holes, tears and perforation of the eye-ball.
The situation was indeed grim. It was indeed an unusual case and most difficult to treat. The impact of the cracker-burst was too much and it was complicated by chemical,
thermal and mechanical damage. I had to undertake a series of difficult and complicated eye procedures and like symblebharonectomy, Conjuctival auto-grafting and transplantation, Conformer application, lamellar keratectomy and eye-plastic surgery for a couple of weeks with follow-up of few months. I am really happy for him and his complete recovery of vision. But everybody afflicted with fire-cracker injuries might not that lucky and best way is to prevent them and take adequate precautions, if bursting of crackers is must, that is. Anaars, Bombs and Rockets are notorious for causing such accidents. The quality of the crackers is also not predictable - a cracker which is supposed to burst in sky may do in front of use to catch you unawares. Some of them even contain small pebbles that act as high-speed splinters that cause extensive damage.
Few do\'s and don\'t that everybody should observe
• Do not lean over the cracker to light it.
• Do not try to find what\'s wrong if lighted cracker hasn\'t burst.
• Wear cotton clothes during the act.
• Do not splash water if the injury appears to severe inside the eye
• However, for eye-lid burn, cool water helps.
• Do not rub the eyes.
• Children should be supervised by \'responsible\' adults, meaning thereby that they are watching each move of the child and not just standing there.
• Use long handle wooden sticks with candles on their end to light the crackers - so that you remain as away as possible from them.
• Do not wrap crackers in papers or bombs in boxes to have increased effect.
• Wear (large sized) glasses. They might shield the eyes.
• Don\'t try home remedies in case of an accident ; rush to an eye-surgeon. Eye sight can be lost in minutes and might be saved if prompt treatment is made available.
• Do not drink or eat anything following the injury. Small children might require general anaesthesia for which one has to empty stomach.
• Cover the injured eye with cotton and tape and rush to an Eye-specialist immediately for final evaluation of the extent of the damage.
• Don\'t venture out on diwali light, you might be hit by a stray cracker.
• Don\'t keep all of your crackers at one place - all of them might explode by just one sparkle.
• Don\'t keep crackers on the main street - it may explode when somebody\'s car/scooter is passing over it.
• \'Bow and Arrow\' injuries should also be avoided. When your child asks for \"arrow\", don\'t \"bow\" !
The child with a fire-cracker needs to be in constant touch with the eye surgeon over a long period for assessment of visual recovery, especially \'lazy eye\' and general eye health. Injury to one eye can threaten visual loss in the fellow (sound) eye by a natural body mechanism called \'sympathetic ophthalmitis\' which is very serious condition than it might appear and should be borne in mind. This can happen during varying intervals after the injury, sometimes after years of injury, when everybody has forgotten about it, and the child has become father of a child !! The other eye, without any fault of it, can go blind because of this phenomenon which is really a tragedy should it occur-imagine one eye blind due to the injury, and the other one due to this. But proper early treatment of either eye can save it from damage through this serious process.
T.V./Media can play a big role in such education of children and their parents. The teachers at school can spend five minutes daily during this period to tell their wards to shun away from crackers and processions by students against crackers augurs well for this cause. If crackers are not in demand the problem of child labour in south, when these are made would automatically be addressed.
Prevention is certainly better than cure, and it can be easily done. No half measures help.
Dr. Rajan Chugh, MS, DOMS, FAIMS
Gold Medalist
Eye Surgeon & Laser specialist
Director,CEMiF ( Chugh Eye Microsurgery Foundation, Lasers )
3159, sec 21 D Chandigarh, India
9815041500
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Dr. Rajan Chugh, MS, DOMS, FAIMS, Eye Surgeon & Laser specialist,
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