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Keep an eye on those champagne corks this holiday season -- but not too close an eye, researchers warned.

Eye injuries from popping open bottles of sparkling wine "are an often overlooked and substantial threat to ocular health," Ethan Waisberg, MD, of the University of Cambridge in England, and colleagues

"Although our group usually publishes on the effects of spaceflight on the eye, this article focuses on the launch of sparkling wine corks instead of astronauts," Waisberg and colleagues wrote. "The goal of this article is to ensure that you don't begin the new year on the operating table of an eye surgeon."

Waisberg told MedPage Today in an email that his team focuses on spaceflight-associated neuro-ocular syndrome, or SANS, which "affects astronaut vision during long-duration spaceflight." They study how to detect vision changes, and develop "novel countermeasures" to help astronauts maintain their eyesight during missions.

While watching a friend uncork a champagne bottle in an "unsafe manner," Waisberg got the idea to look at ocular injuries from cork launches and suspected The BMJ Christmas issue -- which he's been reading for many years -- would be the perfect venue.

Fortunately, the friend wasn't injured, Waisberg said, but he was "inspired to explore this problem further."

While there's no clear tally as to how often these injuries occur, Waisberg said they're likely underestimated, though many of these injuries are probably minor and wouldn't result in a trip to the emergency department.

The more serious injuries are the ones that get documented, and the researchers discussed the literature on these cases. That includes the May 2022 case of cyclist Biniam Girmay, who opened a bottle of prosecco to celebrate his victory in the Giro d'Italia -- but the cork hit and caused an anterior chamber hemorrhage, the researchers wrote. He had to withdraw from the rest of the competition.

There were two cases of blunt eye injuries from champagne corks reported by Dutch researchers in the 1990s, one of which was a hyphaema, or a collection of blood in the anterior chamber of the eye. In 2016, Australian researchers reported a case of commotio retinae, or traumatic retinopathy, due to a champagne cork hitting the eye of a 29-year-old from about 10 feet away.

A 2005 retrospective review found champagne corks were responsible for 20% of eye injuries related to bottle tops in the U.S., Waisberg and colleagues found. More than a quarter (26%) of people who suffered injuries due to pressurized drinks remained legally blind, that study showed.

Finally, a 2009 review of 34 cases of eye injuries caused by bottle corks and caps from sparkling wine bottles in Italy showed "various degrees of visual impairment and clinical outcomes such as perforation, trauma, and long-term complications." Early complications included anterior chamber hyphaema, corneal injury, ocular hypertension, lens subluxation, traumatic cataract formation, and post-traumatic retinal edema. Late complications included pupil motility anomalies, iridodialysis, traumatic optic neuropathy and maculopathy, and post-traumatic glaucoma.

The researchers noted that the American Academy of Ophthalmology (AAO) has a public safety campaign called "Uncork with Care" that offers for safely opening bottles of sparkling wine, including putting a towel over the cork and lightly twisting, while holding the bottle away from you at a 45-degree angle.

The AAO reported another instance of a champagne cork causing injury, with reality star Theo Campbell being by a wayward cork in August 2019. Two surgeries have not restored his vision, the AAO said.

The organization also posted a having a close call with a champagne cork after a match with Roger Federer.

Waisberg and team noted that the pressure in a 750-mL bottle of sparkling wine "is about three times that of a standard car tire, with the potential to launch a cork up to [43 feet] at speeds of up to [50 mph]," and that a cork can travel from the bottle to the eye "in less than 0.05 seconds, making the blinking reflex ineffective."

Waisberg told MedPage Today that in consulting with the American Society of Ophthalmic Trauma for the article, he learned of other holiday eye injuries "such as a penetrating eye injury from a Christmas tree needle, or a patient that suffered an eye injury while pulling a tag off a Christmas present."

He and his colleagues concluded their paper: "Let us toast to an excellent new year, keep the bubbly in our glass, and the sparkle in our eyes."

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