Laser pointer induced macular damage: case report and mini review

Abstract

To report laser pointer induced damage to retina and choroid and briefly review literature. A case report of a 13-year old Caucasian boy developed blurry central vision and central scotoma in right eye (OD). He was exposed for one minute to class IIIA green laser pointer of 650 nm wavelength and 5 mW power. Clinical examination showed a grayish lesion in foveal region. Ancillary testing revealed disruption of the retinal pigment epithelial (RPE) layer in foveal region and indocyanine green angiography demonstrated evidence of choroidal hypofluorescence suggestive of choroidal infarction in OD. Visual acuity improved from 20/100 to 20/60 in one day and he was treated with tapering doses of oral prednisolone (40 mg) for 3 weeks. Laser pointer with a power of >5 mW caused damage to RPE in the macula. Children should not be given laser pointers as toys especially those with label of danger instructions.

Light damage to the retina: an historical approach

“…Nowadays, pointers with outputs exceeding 100 mW are, unfortunately, easily purchased through the internet, or, for example, on a beach resort in the Mediterranean; the consequences might be disastrous. 20,21 The newly developed light sources and techniques evidently should be of great concern to ophthalmologists. Traditionally, their task of course was to warn against solar blindness-not only at solar eclipses but also after conventional widening of the pupil, to wear sunglasses.…”

‘Toy’ laser macular burns in children

“…Similar macular disturbance has been reported following exposure to laser pointers in children. [2][3][4] Furthermore similar changes occurred wherein a patient with an ocular melanoma was exposed to a Class 3A green laser pointer prior to enucleation. 5 The retinal damage reported following such injuries is variable.…”

“…5 The retinal damage reported following such injuries is variable. [4][5][6] This is due to variety of laser powers and wavelengths as well as ocular factors such as fundal pigmentation, blink responses, pupil size, and proximity of the laser burn to the fovea. 5 Assessment of alleged laser eye injury requires accurate history and examination.…”

Laser Pointer Related Maculopathy: Case Report

“…13 yaşında Sınıf 3a yeşil lazer işaretleyiciye yaklaşık 1 dk direkt maruz kalan bir erkek çocu-ğunda görmenin 20/100 seviyesine düştüğünü, OKT ve fundus FA bulgularında RPE ve koroidal hasar olduğunu saptamışlardır. 19 Sonuç olarak, günümüzde lazer işaretleyiciler kırtasiyelerde ve oyuncak marketlerinde yaygın olarak çocukların rahatça ulaşabilecekleri yerlerde satıldıklarından bunlara bağlı göz yaralanmaları artmaktadır. Bu lazerlerin zararları toplumda iyi anlatılıp gerekli tedbirlerin alınması sağlanmalıdır.…”