Supplementary Material for: SPARKS AND SCARS: A CASE SERIES ON FIRECRACKER OCULAR INJURIES DURING DIWALI

Introduction:
Diwali, a widely celebrated festival across India, is traditionally associated with the extensive use of fireworks. While fireworks add to the festive atmosphere, they pose significant safety risks, particularly to the eyes. Firework-induced ocular injuries range from minor burns to severe trauma, often resulting in lasting visual impairment. This case series examines the range of ocular injuries observed during Diwali, their clinical outcomes, and highlights preventive measures to address this ongoing public health concern.

Case Presentation(s):
This retrospective case series includes patients who presented with firework-related ocular injuries at a tertiary eye care center during November 2024, within a week of the Diwali festival. Comprehensive patient histories were documented, followed by detailed ocular examinations. Data collected included injury mechanisms, clinical findings, and treatments administered. The age of the patients ranged from 7 to 35 years, with a predominance of closed-globe injuries (5 out of 6 cases), while one case was involved in an open-globe injury. Injuries were categorized using the Birmingham Eye Trauma Terminology (BETT) into open-globe and closed-globe injuries and classified according to the Ocular Trauma Scoring System (OTSS). Surgical intervention was required in two cases (33%), primarily involving more severe injuries such as conjunctival-scleral tears and traumatic cataracts.

Conclusion:
Firework-related ocular injuries during Diwali remain a pressing public health issue, especially for children and bystanders. Although timely medical intervention can improve visual outcomes, severe injuries often result in irreversible vision loss. It is imperative to raise public awareness about firework safety, encourage the use of protective eyewear, and enforce stricter regulations on firework usage. Manufacturers should be mandated to produce safer, less hazardous fireworks. Additionally, directives for registering ocular injury cases at hospitals should be implemented to better understand and address this preventable problem.