<b>By Mark Siegel, MD, FAAO</b>

As the Fourth of July holiday approaches and Americans make plans to celebrate the stars and stripes with a little red glare from celebratory rockets, ranging from professional public fireworks displays to amateur impromptu backyard shows, I’m urging the public to take important steps to prevent fireworks-related eye injuries. Parents and other adults need to exercise caution when handling fireworks themselves and to be especially diligent in managing and monitoring their use by children.

Of the more than 9,000 fireworks injuries that occur in the United States each year, approximately 45 percent are sustained by children ages 15 and under. Eyes are among the most injured body parts, and 1 in 6 fireworks-related eye injuries results in permanent vision loss or blindness.

I recall a particularly horrific firework injury while I was still an ophthalmology resident. A 6-year-old boy found an M-80 firework in his home and lit it with a grill lighter. The explosion resulted in a traumatic injury that impacted the boy’s throat, face and eyes. His parents called 911 for help and his eye injuries required an immediate cornea transplant, intraocular lens replacement, and he has undergone several additional eye surgeries since then with permanently reduced vision.

All fireworks are dangerous if not properly handled; however, sparklers cause the most injury and are particularly dangerous since many children handle them on their own. Sparklers typically burn at 1,200 degrees Fahrenheit. That temperature is nearly 1,000 degrees hotter than the boiling point of water, double the heat required to burn wood, hot enough to melt glass and cause third-degree burns to the skin. Out-of-control bottle rockets also cause some of the most serious eye injuries, including corneal abrasions, traumatic cataract, retinal detachment, optic nerve damage and rupture of the eyeball — all of which can lead to potential blindness.

I feel that the best way to avoid potentially blinding injuries is to attend a professional public fireworks display instead of putting on a backyard fireworks show. For those who decide to purchase and use legal consumer fireworks, here are a few safety tips to prevent eye injuries:

• Never handle fireworks without protective eyewear and ensure that all bystanders are also wearing eye protection.

• Never let young children play with fireworks of any type. If older children are permitted to handle fireworks, ensure they are closely supervised by an adult and wear protective eyewear.

• Clear the area of flammable materials and view fireworks from at least 500 feet away.

Leave the lighting of professional-grade fireworks to trained pyrotechnicians. If you find unexploded fireworks, do not touch them. Immediately contact your local fire or police departments. If you do experience an eye injury during a fireworks accident, seek immediate medical help.

Always remember our eyes are very delicate, and you only get two of them.