For most Americans, the Fourth of July holiday is a celebration of our nation''s independence. For trauma doctors, however, it means approximately 11,000 trips to the emergency room.

According to the American Academy of Ophthalmology (AAO), 2,000 of these visits are eye related, with about one-third of those resulting in permanent blindness. Even more upsetting is those under age 25 suffer over two-thirds of these injuries.

"Typically, those most likely to be injured are adolescent children, and therefore their injuries are very severe and last their entire lives," says Dr. Gil Grand, ophthalmologist with Barnes-Jewish Hospital in St. Louis.

"It isn't necessarily the person who ignites the fireworks who's at risk, but often it''s innocent bystanders," Dr. Grand says. While bottle rockets are the most dangerous firework, the cherry bomb comes a close second. "Cherry bombs are particularly dangerous because people igniting them often put them beneath another object such as underneath a can, or in a glass jar, or under a flowerpot. And when the explosion takes place there''s literally shrapnel that flies around, and can hit not only the person igniting the firework, but the shrapnel can hit many other innocent bystanders."

The AAO and Dr. Grand agree the only safe fireworks are professional displays. Most communities provide safe displays arranged by trained pyrotechnicians. They recommend people:

• View displays from at least 500 feet away
• Respect arranged safety barriers
• Leave the lighting of fireworks to the professionals
• Never touch unexploded fireworks.

However, Dr. Grand does acknowledge many will still purchase and light their own fireworks. In order to reduce risk of injury, he recommends continual adult supervision, especially while lighting the fireworks, and wearing safety goggles at all times.

"Also, one important rule is when a firework fails to ignite, don't try to re-ignite it because by that time the fuse is often quite short. You could end up with an injury to your hands as well as to your eyes," says Dr. Grand.

An injured eye should be covered and protected, and the patient should be immediately taken to an ophthalmologist or to an emergency room to avoid permanent visual loss. Even minor injuries should be taken seriously; delaying can cause the damage to worsen or lead to blindness.