Written By: Jennifer Churchill Reviewed By: Dianna L Seldomridge, MD, MBANatasha L Herz MDThomas L Steinemann MD Jun. 18, 2018

Firefighter Jay Northup with his ophthalmologist Dr. Thomas Steinemann.

Firefighter Jay Northup is thankful to ophthalmologist Thomas Steinemann, MD, for helping to save his vision after a fireworks injury.

Every year, about 10,000 people are rushed to the emergency department for fireworks injuries. Fire Captain Jay Northup never thought he would be counted among them. He took all the right precautions as he organized his backyard Fourth of July fireworks celebration. But a split second of poor judgement nearly cost him his vision and his life.

A 23-year veteran of the Euclid Fire Department in Euclid, Ohio, he had the training and experience to safely execute a pyrotechnic display to impress family and friends. And it wasn’t the first time Northup, 47, had organized the neighborhood fireworks display.

He had strategically placed the launch pad behind his garage, where he set up a 12-shot box of mortars that, when lit, would shoot a couple hundred feet into the air. The kids, including his 15-year-old twins, and adults were at the front of the house, safely away from the launch pad.

Alone in the backyard, he started lighting up $600 worth of fireworks. The first three mortars went off as intended, but then, silence. After about 10 minutes, he decided to investigate the dud. His face was about 12 inches above the cylinder, when the dud suddenly exploded. The blast threw him to the ground, leaving him completely disoriented and unable to see.

“It felt like something was pouring out of my right eye, and I just had no idea what was going on,” Northup said. “I thought I was dying.”

His wife, an ER nurse, managed to stay calm as she rushed her bleeding husband the 12 miles from their home to Metro Health in Cleveland, where doctors immediately began treating his life-threatening injuries.

The impact from the explosion caused a subdural hematoma, one of the deadliest of all head injuries. Once doctors controlled the bleeding and pressure in his brain, they turned to the cuts on his forehead that required 35 stitches to close. His face was also burned and bruised.

“I thought I was dying.” – Jay Northup, firefighter

After Northup was stable, it was up to ophthalmologist Thomas Steinemann, MD, to save his sight. His right eye took a direct hit from the mortar, burning off his eyelashes and the skin around his eye. The impact deformed the front part of his eye, damaging the cornea and sending shockwaves to the back of his eye, bruising the retina. Blood had begun to pool inside his eye, a dangerous condition that increases pressure inside the eye and can lead to blindness.

Dr. Steinemann treated him with special eyedrops to control the inflammation in his eye, and antibiotic eyedrops and ointment to prevent infection. In about a week, Northup’s vision began to improve, but Dr. Steinemann could already detect trouble ahead. A traumatic cataract was beginning to form. Like a typical cataract caused by aging, a traumatic cataract happens when the lens of the eye begins to get cloudy and must be surgically removed to restore normal vision. It’s a common condition following a traumatic injury to the eye.

About 10 months after the fireworks injury, Dr. Steinemann performed cataract surgery on his right eye, restoring Northup’s sight once again. While Northup made a full recovery and returned to work as a firefighter, he was left with a lasting defect. His pupil is paralyzed; it can no longer expand and contract to accommodate lighting conditions.

The pupil is like a camera, it opens to a larger setting when indoors to let the light in and to a smaller setting outdoors to keep the light out. Dr. Steinemann explained that Northup’s “camera” is permanently stuck on the indoor setting, making it painful to be outside without sunglasses.

Content shared from the AOA.org

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