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April 11, 2011

Ocular Consequences of Bottle Rocket Injuries in Children and Adolescents

Author Affiliations

Author Affiliation: Vanderbilt University School of Medicine (Ms Khan) and Division of Vitreoretinal Diseases and Surgery, Vanderbilt Eye Institute (Drs Reichstein and Recchia), Vanderbilt University Medical Center, Nashville, Tennessee.



Arch Ophthalmol. 2011;129(5):639-642. doi:10.1001/archophthalmol.2010.336

Fireworks-related injuries are frequently seen among patients admitted to the emergency department because fireworks are a popular means of expression during Independence Day and other celebrations in the United States. In 2006, a total of 11 deaths and approximately 9200 emergency department admissions resulted from fireworks-related injuries, with most affecting boys and 36% of injuries occurring in individuals younger than 15 years.1 An estimated 1400 cases annually involve injury to the eyes.2 A disproportionate number of cases of severe ocular morbidity and visual impairment are caused by bottle rockets.3,4

A bottle rocket is approximately half the size of a normal firework and consists of 3 main parts: the core (“engine”), which is a tube filled with black powder or a similar explosive; the nose cone, which guides the flight of the firework and may contain explosive components or other decorative items; and a guide stick, which stabilizes the rocket in flight. When ignited, the explosion propels the bottle rocket into the air, often setting off further colorful explosions, including star bursts, trails, or sparklers. Many manufacturers of bottle rockets also design them with whistles that shriek as the rockets climb into the air or explosives that make a concussive bang when they explode. The guide stick is typically stuck in the ground or braced in a bottle (hence the name) prior to launch. Injuries may result from direct high-velocity contact with the intact rocket, from parts of the rocket that may break off during flight, or from neighboring debris propelled by the force of the rocket's combustion.