Purpose: To assess firework-inflicted ocular trauma in the German capital during the week around New Year’s Eve with regards to patient characteristics and age, severity of injuries, and their management and outcome. Methods: A retrospective chart review of all patients presenting to the department of ophthalmology of Charité—University Medicine Berlin during a 7-day period around New Year’s Eve in the years 2014–2017 was performed. Patients with ocular complaints and injuries caused by fireworks were included. We recorded demographic data, active role, visual acuity at presentation and at last follow-up, the most pertinent clinical findings, management and outcome with regards to visual acuity, and integrity of the eye. Results: A total of 146 patients with 165 injured eyes were included. Median age at presentation was 23 (4–58) years, and 71.2% were male. Fifty-one patients (34.9%) were less than 18 years old. Ninty-seven patients (66.4%) sustained minor, 34 (23.3%) sustained moderate, and 15 (10.3%) sustained severe injuries. Severe trauma was seen in younger patients (median age: 12, range: 4–58 years) than mild and moderate trauma (median age: 23, range: 4–45 years) and resulted in loss of light perception in two eyes and in a visual acuity of only light perception in three eyes. One eye was enucleated. Conclusion: Ocular trauma inflicted by fireworks can have serious consequences for ocular morbidity and visual acuity, especially in severe trauma which affected younger patients. To significantly reduce firework-inflicted trauma, a ban of private fireworks in densely populated areas and in the vicinity of children should be considered.

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A normal fundus autofluorescence does not rule out toxic maculopathy. Optical coherence tomography and multifocal electroretinography seem to be more sensitive in the early stage of the disease. In case of typical complaints and visual fields, the optical coherence tomography has to be evaluated for subtle alterations of the outer retina. Their presence justifies the cessation of the drug. Multifocal electroretinography may be of special value in these problematic cases.

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