Joy or Tragedy? Firecracker- inflicted Traumatic Optic Neuropathy

Abstract

Purpose:

To report two cases of firecracker- inflicted traumatic optic neuropathy (TON) in Hospital Sultanah Nora Ismail during Hari Raya Aidilfitri 2022.

Results:

During Hari Raya Aidilfitri 2022, a 4-year-old boy and a 29-year-old gentleman presented with blast injury by firecrackers. Visual acuity at presentation were hand movement (HM) and perception of light (PL) respectively with marked relative afferent pupillary defect (RAPD). Both patients were diagnosed with TON and were treated with high dose of intravenous methylprednisolone for 3 days. However, the visual recovery remained poor after completion of treatment. At one month post trauma, their best corrected visual acuity were counting finger (CF) and PL respectively.

Conclusion:

TON due to firecracker injury is potentially blinding and has poor visual outcome with current treatment modalities. Awareness among the public and strict law enforcement is necessary to bring down the incidence of firecracker- related ocular morbidity and blindness.