Protect Your Eyes on July Fourth

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(FactsAndFears reprints this piece prior to each 4th of July.)

As befits any birthday, Americans will celebrate this July 4 with food, pageantry, and, of course: fireworks!

Who cannot remember the thrill of their first fireworks display, the childish wonder that is rekindled each 4th? Fireworks are a big part of this holiday.

But would anyone claim that such celebrations are worth $100 million -- the amount that fireworks-related injuries cost Americans each year? Each year, over 10,000 Americans seek treatment in emergency rooms and almost a dozen people die from fireworks-related injuries. Nearly half of these injuries occur during the July 4th holiday weekend.

Most frequently, fireworks-related injuries involve the eyes -- nearly a third of these ER visits are for serious eye injuries. And 33% of ocular fireworks injuries result in a permanently blind eye (U.S. Eye Injury Registry Data). With nearly 50% of the victims being children, about seventy-five children lose an eye each July 4th weekend due to fireworks.

According to the volunteer organization Prevent Blindness America, in 2004 there were 9,600 firework-related injuries for that year: 300 more than in 2003. And 6,600 of these were treated around the Fourth of July. Forty percent of all fireworks injuries are to those aged fifteen or less.

But we respond to people, not to statistics.

Carleen was your average, happy fifteen year-old when some of her friends were playing with bottle rockets. Two rockets went up. When Carleen glanced at the third rocket that didn't launch, it exploded, crushing her left eye.

She was brought to the hospital for emergency surgery. Despite the heroic efforts of her ophthalmologists, who performed seven surgeries over a period of five years, she never saw again. Eventually, because of constant pain from glaucoma, her eye had to be removed and replaced with a prosthetic eye.

This case illustrates the enormous danger of bottle rockets. Although they account for only a fraction of all fireworks, bottle rockets caused 70% of all ocular fireworks injuries in 2000 -- half resulting in blindness. In a seven-year analysis by the Eye Injury Registry of Alabama, bottle rockets accounted for 100% of fireworks injuries requiring surgical removal of an eye. The average age of the victims: thirteen.

Bottle rockets were invented by the Chinese in the thirteenth century, not for entertainment but as a weapon of war. A small Class C bottle rocket can take off at seventy-five miles per hour with an explosive payload. Yet over twenty states still allow the sale of bottle rockets, according to the U.S. Consumer Product Safety Commission.

The American Academy of Ophthalmology advocates legislation banning the sale, resale, use, and possession of bottle rockets, except by trained professionals. A wide range of organizations support this ban, including the American Medical Association, the American Academy of Pediatrics, Helen Keller International, the National Fire Protection Council, and the National Safety Council.

But it is not just bottle rockets that pose a significant hazard. Even sparklers, those seemingly innocuous toys, can be extremely dangerous in the hands of young children. In 2004, 300 children under the age of five were hurt by sparklers. Don't forget, a burning sparkler can reach 1800 degrees at its burning tip -- not something that a young child should be waving around!

While Americans do not want to see an end to fireworks, most would support a specific bottle rocket ban; half of the states have already adopted such legislation. A uniform ban in every state would be much more effective, preventing individuals from purchasing bottle rockets in neighboring states.

What can one do as a parent? Write, call, or fax your elected representatives, telling them you support a bottle rocket ban. Encourage your children to attend only professional fireworks displays, rather than using fireworks themselves. If your child must use fireworks, while nothing can eliminate the danger, the following guidelines (adapted from the American Academy of Ophthalmology) can help decrease risk:

-- Always have adult supervision and use protective eyewear.

-- Use a specially designed stick, or "punk," rather than a match to light fireworks.

-- Have a bucket of water ready.

-- Always follow manufacturers' directions and dispose of used fireworks properly.

-- Never give a firecracker to a child.

-- Never use a bottle rocket.

-- Do not light firecrackers bigger than your pinkie or light them indoors, and avoid relighting duds.

-- Never put fireworks in your pocket, throw them while lit, or make homemade firecrackers.

-- In case of eye injury, do not touch the eye. Tape a clean paper cup over the eye to prevent contamination or further injury. Immediately seek medical attention -- preferably from an ophthalmologist.

As a first-generation Chinese-American ophthalmologist, I have a unique perspective. A beautiful fireworks display can be among the most moving of cultural expressions, evoking a visceral reaction, whether on Chinese New Year or July 4th.

At the same time, fireworks, invented for war, hold great destructive potential, which I am unfortunate enough to witness each year. I am proud of my ancestors for their invention. I would be many times as proud of my fellow Americans if they joined together to end needless blindness caused by fireworks.

Emil WilliamChynn, MD, FACS, MBA is a LASIK surgeon and advisor to the American Council on Science and Health ( He can be contacted at drchynn[at] or his website,