Retinal burns from laser pointers: a risk in children with behavioural problems

Abstract

Objective To explore self-inflicted retinal burns from laser pointers in children. Methods Literature review of laser pointer retinal injuries in childhood and online survey of UK Consultant Ophthalmologists. A cohort of local children with self-inflicted injury is described. The matter is topical. We review progress in recent legislation and policy change in the UK. Results Four of 77 case reports of laser burns in childhood analysed reported psychological or behavioural issues. Three of four children in our cohort had such issues. Delay in diagnosis occurred in two of our patients. Structural retinal damage persisted for over 12 months in all four children (seven eyes). Our survey of UK ophthalmologists found 159 cases of injury (85% male), 80% under 20 years of age. The majority of the laser pointers were purchased online. Many patients (36%) suffered moderate vision loss (6/18 to 6/60 Snellen), while 17% (at least 11 patients) suffered severe vision loss (<6/60 Snellen). Conclusion We highlight the risk of macular damage and vision loss from handheld lasers specifically in children with behavioural, learning or mental health issues. The diagnosis may be difficult or delayed in such children. In children with uncertain macular changes, ophthalmologists should explore the history for possible instances of exposure to handheld lasers pointers. Regulatory authorities and manufacturers of handheld lasers need to be aware of the risk to children. Furthermore, there is a need to better inform parents, carers and teachers of the risk of ocular self-injury from such lasers pointers.

Macular pigment changes after cataract surgery with yellow-tinted intraocular lens implantation

“…This situation is called blue light hazard. Acute damage to the retina by accidentally gazing at sun light, arc welding light, laser light from medical and industrial equipment, and light emission diodes used in toys has been reported [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. However, the harmfulness of chronic exposure to blue light of certain wavelengths is still controversial [23][24][25][26].…”

Plötzliche bilaterale Visusminderung und Gesichtsfeldausfälle

“…Insbesondere sollte auch gefragt werden, ob der Laser ggf. an einem Spiegel oder anderen spiegelnden Flächen wie in unserem Fallbeispiel reflektiert worden sein könnte [7].Da einige Studienzudem eine erhöhte Inzidenz selbstinduzierter Laserpointerassoziierter Makulopathien bei psychisch auffälligen Kindern und Jugendlichen gezeigt haben, sollte auch dieser Umstand nicht außer Betracht gelassen werden [8,9].…”

“…Die klinische Diagnostik sollte neben der Visusbestimmung für Ferne und Nähe auch eine Augeninnendruckmessung, einen Amsler-Gitter-Test, eine Testung der Lichtreaktion, eine Motilitätstestung sowie eine komplette spaltlampenmikroskopische Untersuchung inklusive einer Fundoskopie in Mydriasis beinhalten [2][3][4][7][8][9]. Fundoskopisch präsentiert sich der Makuladefekt in der frühen Phase meist in Form eines gelblichen Fleckes umgeben von einem rötlichen Randsaum (.…”

Knowledge and attitude towards hazardous effects of laser pointers among attendees of football matches in Riyadh, Saudi Arabia

“…[ 8 ] In the UK, it was found that children with behavioral issues were at higher risk of laser exposure secondary to self-harm. [ 9 ]…”