Fourth of July last year was a year like no other at Vanderbilt Eye Institute in Nashville, Tenn. Ophthalmology resident Hans Wolfram Andrews, MD, was on call that night. From 11 p.m. to 3 a.m., he rushed between the pediatric and adult emergency departments, tending to 11 patients who suffered serious eye injuries from fireworks.
“It was the busiest time of my entire three years as a resident,” Dr. Andrews said. It was at the height of COVID-19 lockdowns, and professional fireworks displays were cancelled. He thinks perhaps more people were handling more dangerous fireworks last year as they attempted to re-create the grandeur of the holiday in their backyard.
He may be on to something. This week the U.S. Consumer Product Safety Commission released its annual fireworks report, showing an uptick in fireworks-related injuries last year. An estimated 15,600 injuries were treated in hospital emergency departments in 2020. Eighteen people died. The Commission estimates the injury rate increased between 2019 and 2020 from 3.1 to 4.7 per 100,000 individuals.
While the number of injuries treated at the Vanderbilt Eye Institute was unusual, the medical records were anything but. The records reveal a heartbreaking list of the typical, potentially blinding injuries caused by fireworks. As happens every year, most victims were young and male. Some were bystanders, including one woman who was 50-yards away, with her back to the person setting off fireworks. Injuries were caused by mortars, bottle rockets, and other projectiles, as well as the seemingly innocent spinner.
One of the worst was a 6-year-old who suffered a traumatic cataract after being hit in the eye. He was standing about 30 feet away when the firework was ignited. Surgery was successful and his vision restored, but he may need additional surgery as he gets older and he’s at risk for developing other eye conditions later in life, such as glaucoma.
“The worst is seeing the parents,” Dr. Andrews said. “They feel so guilty. They just gave the child a sparkler or a whirly, something that seems innocent. But accidents happen.”
As for this Fourth of July, Dr. Andrews will not be on-call. Instead, he will be celebrating on a boat. No fireworks. “I learned my lesson from last year.”