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.