High-Power Handheld Blue Laser-Induced Maculopathy

Laser-Induced Photic Injury Phenocopies Macular Dystrophy

“…34 Although the use of lasers as children’s toys is probably never advisable, it is especially dangerous with higher-powered lasers, increased accessibility to which likely explains the sizeable number of cases we have seen in our clinic in the last two years. In Great Britain, general use of Class IIIa, but not Class II, lasers is banned, 3 and here in the United States a similarly policy discussion may be warranted. At the clinical level, patient and physician education are important means by which to improve both prevention and timely diagnosis of accidental laser-induced injuries in children.…”

Laser Pointers Revisited

“…Alsulaiman et al, 17 reported the largest case series of 14 patients with various maculopathies including subhyaloid hemorrhage (35.7%), sub-internal limiting membrane (ILM) hemorrhage (14.2%), schisis like cavity (7.1%), full-thickness macular hole (FTMH) (28.5%), ERM (7.1%), and outer retinal layer disruption caused by a high-power handheld blue laser device with a wavelength of 450 nm and a power of 1200 mW. In this case series, 5 eyes showed significant improvement in vision following pars plana vitrectomy for FTMH and ERM; 5 had Nd:YAG hyaloidotomy for subhyaloid hemorrhage, and the others demonstrated spontaneous resolution of lesions with complete restoration of foveal contour.…”

“…10, 11, 17 Cases usually present with visual disturbances at 4 hours to 1 week following exposure to laser beam, however the interval between exposure and presentation may be prolonged, particularly in pediatric patients who may not be aware of ophthalmological symptoms. Most of the reported cases had asymmetric injury, most likely due the method of injury when the laser pointer is directed at one eye from a short distance to the head.…”

“…Although some of the cases showed spontaneous improvement in vision during the follow-up, late complications such as chorioretinal scarring may be responsible for delayed worsening of visual function after the initial improvement. 10, 11, 13, 17 The spectra- domain optical coherence tomography (OCT) findings of laser injuries are characterized by vertical hyper-reflective bands, ellipsoid and external limiting membrane disruption, and hyporeflective cavities. 19 The vertical bands typically originate from the retinal pigment epithelium and overlying photoreceptor outer segments and follow the remainder of the photoreceptor cell toward the outer plexiform layer.…”

Pediatric Bilateral Blue Laser Pointer-Induced Maculopathy

“…Over a 1-year span during 2014 in Saudi Arabia, researchers reported 14 cases of blue laser pointer injuries to the retina including full-thickness macular holes and prehyaloid hemorrhages with epiretinal membrane formation [15]. …”