Champagne cork eye injuries: Ocular safety during the holidays

The joyous bubbles of champagne are associated with happiness, celebrations and the holiday season. As a champagne bottle is uncorked, the rapid release of carbon dioxide gas is a memorable moment enjoyed by everyone.  

However, there is a potential dark side to this beverage. Eye injuries from champagne corks pose a unique, yet significant threat to eye health. While my usual research focuses on the launch of astronauts into space and protecting astronaut ocular health,^1-3 the focus of this article is instead on the protection from the launch of champagne corks.  

The goal of this article is to ensure that your holiday season does not include a visit to an eye surgeon’s operating table. 

Although the threat posed by champagne corks may initially sound overly-cautious or insignificant, the American Academy of Ophthalmology previously launched an ‘Uncork with Care’ campaign due to the significant risk champagne corks pose.⁴  

A standard champagne bottle encases enough pressure to launch a cork over 13m away, and nearly the same pressure as a standard bus tyre.⁵ Once it releases from the bottle, a champagne cork can hit the eye in under 0.05 seconds, which is faster than the time required for the blinking reflex to be effective.  

Therefore, a champagne cork to the eye can cause significant structural damage, including ocular bleeding, acute glaucoma, lens dislocation, retinal detachment and permanent blindness. 

In a study examining cases of severe eye injuries from pressurised drink bottles in the United States, Mexico and Hungary, Kuhn et al⁵ found corks from champagne bottles accounted for 71% of bottle top injuries in Hungary, 20% in the United States and 0% in Mexico. Another key finding from this study was that 26% of individuals that sustained these eye injuries remained legally blind.⁵ For eye injuries from bottle tops, the champagne cork continues to be the largest contributor.^6-9  

Two cases of eye injuries from champagne corks were reported in the Netherlands, with one of these injuries being a hyphema. One of the injuries required surgical evacuation, while the other resolved with medical treatment.⁷  

Typical causes of hyphema include blunt trauma, post-surgery (such as following cataract removal), and spontaneous hyphema, which may occur due to blood thinning medications, clotting disorders or patients with sickle cell disease.  

While most hyphemas can self-resolve or with conservative treatment, close monitoring is essential to prevent permanent visual loss or glaucoma. In severe cases of hyphemas, surgical drainage may be required. 

A case report from 2016 found an instance of a 29-year-old struck in the eye with a cork from three meters away, which resulted in commotio retinae.¹⁰ There is no specific treatment for commotio retinae, and the condition typically self-resolves within several weeks, with vision gradually improving as retinal swelling decreases.  

However, in some cases, particularly in cases with trauma to the macula, permanent vision loss may occur. Three-months later, follow-up in this patient revealed persisting mild retinal haemorrhage.¹⁰  

Cavalini et al¹¹ conducted a review on 34 cases of cork and bottle cap injuries and found that early injuries can include corneal injuries, anterior chamber hyphema, traumatic cataract formation, post-traumatic retinal oedema, ocular hypertension and lens subluxation. 

These early manifestations, particularly hyphema and corneal trauma, necessitate prompt evaluation to ensure secondary manifestations do not develop. In addition to this, the potential for increased intraocular pressure following an eye injury highlights the need for vigilance to prevent long-term optic nerve damage.  

Late complications can include traumatic optic neuropathy, iridodialysis, post-traumatic glaucoma, pupil motility anomalies.¹¹ These various complications often necessitate a multidisciplinary approach to achieve optimal management, including both surgical and medical interventions.  

How can these ophthalmic risks be reduced while opening a champagne bottle? I propose the following steps:  

1. Cool the bottle prior to uncorking. A cooler bottle will have less pressure and will launch a cork with less speed.
2. Carefully remove the wire cage at the top of the bottle.
3. Cover the top of the bottle and grip it firmly with a towel.
4. Slowly twist the bottle at the bottom, to loosen cork, while pressing down to counteract the force of the cork. 

All things considered; champagne corks represent an underestimated threat to eye health. Proper safety precautions, such as safe uncorking technique or protective eyewear can reduce the risk of champagne cork-related eye injuries.  

Proactive measures can also be implemented, such as improved labelling or the use of devices to regulate cork pressures, are highly important in reducing the risk of injuries.  

• Dr Ethan Waisberg is an Academic Foundation Programme Doctor at the University of Cambridge.  

References 

1. Waisberg, E. et al. The Case for Expanding Visual Assessments During Spaceflight. Prehosp. Disaster med. 1–4 (2023) doi:10.1017/S1049023X23005964.
2. Waisberg, E. et al. Radiation-induced ophthalmic risks of long duration spaceflight: Current investigations and interventions. European Journal of Ophthalmology 11206721231221584 (2023) doi:10.1177/ 11206721231221584.
3. Waisberg, E. et al. Mitochondrial dysfunction in Spaceflight Associated Neuro-Ocular Syndrome (SANS): a molecular hypothesis in pathogenesis. Eye (2024) doi:10.1038/s41433-024-02951-3.
4. Ophthalmologists Warn: Flying Champagne Corks Cause Serious, Blinding Eye Injuries Each Year. American Academy of Ophthalmology https://www.aao.org/newsroom/news-releases/detail/ophthalmologists-warn-flying-champagne-corks-cause (2012).
5. Kuhn, F., Mester, V., Morris, R. & Dalma, J. Serious eye injuries caused by bottles containing carbonated drinks. British Journal of Ophthalmology 88, 69–71 (2004).
6. Archer, D. & Galloway, N. Champagne-Cork Injury To The Eye. The Lancet 290, 487–489 (1967).
7. Keunen, J. E. & Storimans, C. W. [With an eye on... the champagne cork. Ned Tijdschr Geneeskd 138, 2594–2596 (1994).
8. Savir, H. Ocular Injuries From Exploding Beverage Bottles. Archives of Ophthalmology 97, 1544 (1979).
9. Sellar, P. W. & Johnston, P. B. Ocular injuries due to exploding bottles of carbonated drinks. BMJ 303, 176–177 (1991).
10. Cham, K. M., Di pasquale, D. N. & Jaworski, A. A case of commotio retinae following champagne cork injury. Clinical and Experimental Optometry 101, 140–142 (2018).
11. Cavallini, G. M., Martini, A., Campi, L. & Forlini, M. Bottle cork and cap injury to the eye: a review of 34 cases. Graefes Arch Clin Exp Ophthalmol 247, 445–450 (2009).