A new type of firework caused severe eye injuries and blindness in children and adults at last year's bonfire night celebrations, warn doctors in a letter to this week's BMJ.
Edward Pringle and colleagues describe how on the evening of 5 November 2011, eight patients attended the Sussex Eye Hospital, five with serious eye injuries - two were blinded and the other three have a lifelong glaucoma risk.
Police inquiries suggest the new explosive was derived from "rope banger deer scarers," which have a slow burning rope fuse that ignites several explosives along the rope. When cut down, the fuse and explosive can be lit and thrown.
All serious injuries were consistent with a blunt injury to the eyeball, caused by material within the explosive charge, explain the doctors. They also say that this rate of serious eye injury was greater than expected for a bonfire night, based on British Ophthalmic Surveillance Unit data.
"Numbers of blinding injuries have fallen in countries with legislation that controls the use and distribution of fireworks," say the authors. "The UK has legislation to limit distribution, but deer scarers are exempt because they are not actual fireworks."
In the UK in 2005, 52% of firework injuries occurred at public events. Yet the authors point out that there is no legislation to impose safety restrictions at firework displays as serious accidental injury is not included in the Public Order Act.
They call on organisers to "actively engage their audience in safer use of fireworks and encourage eye protection" and conclude: "If we cannot create effective legislation we must create a culture that does not tolerate the throwing of banger-type explosives into crowds. Extraordinarily, this remains a challenge."