Maculopathy from handheld green diode laser pointer

Ziahosseini, Kimia; Doris, J P; Turner, G. S.

doi:10.1136/bmj.c2982

Cited by 39 publications

(17 citation statements)

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“…The morphology of retinal damage from the laser pointers may vary. Fundus findings described in the literature include subretinal hemorrhage [6], retinal edema, scars in the pigment epithelium [7], foveal granularity [8], vitreous or chorioretinal hemorrhage [3], perifoveal drusenoid like deposits/pigment clumps [9,10], or ring-shaped hypopigmented lesions in fovea [11,12] and rarely choroidal neovascularization [13] (Table 1) [3,[6][7][8][9][10][11][12][13][14][15][16][17][18][19]]. Sethi and associates described the laser pointer induced damage among 14 patients, of which punctate epitheliopathy (35.7 %) was more common than retinal damage (14.3 %) and they concluded that long-term damage to the eye was less compared with the transient ocular damage [10].…”

Section: Discussionmentioning

confidence: 99%

Laser pointer induced macular damage: case report and mini review

Turaka¹,

Bryan²,

Gordon³

et al. 2012

Int Ophthalmol

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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.

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Section: Discussionmentioning

confidence: 99%

Laser pointer induced macular damage: case report and mini review

Turaka¹,

Bryan²,

Gordon³

et al. 2012

Int Ophthalmol

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“…26 Similarly there have been several cases of retinal injury in humans who reported gazing into Class IIIa laser pointers for more than 10 seconds 27–30 or Class IIIb lasers for only a few seconds. 14, 31–33 Class II laser pointers, emitting less than 0.1 W, are considered relatively safe. The main problem is that laser devices of 100mW or more, comparable in power to a focal macular laser used for diabetic macular edema, can now be easily purchased over the Internet from foreign countries for the unregulated use by the public.…”

Section: Discussionmentioning

confidence: 99%

Laser-Induced Photic Injury Phenocopies Macular Dystrophy

Zhang

Zheng

Nie

et al. 2016

Ophthalmic Genetics

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Objective To describe the phenotypes associated with laser-induced retinal damage in children. Methods Five patients with maculopathy and reduced visual acuity associated with laser pointer use were evaluated. Best-corrected visual acuity, retinal structure, and function were monitored with color fundus, infrared (IR), and red-free images, fundus autofluorescence (AF), spectral domain-optical coherence tomography (SD-OCT), and full-field electroretinography (ERG). Results All five laser pointer injury patients had retinal lesions resembling a macular dystrophy (1 bilateral and 4 unilateral). These lesions were irregular in shape but all had a characteristic dendritic appearance with linear streaks radiating from the lesion. Photoreceptor damage was present in all patients, but serial OCT monitoring showed that subsequent photoreceptor recovery occurred over time in the eyes of at least 4 patients. 1 patient also had bilateral pigment epithelial detachments (PED). Both hyper- and hypoautofluorecence were observed in the laser damage area. Conclusions In general, OCT and IR images are quite useful to diagnose laser damage, but AF is not as sensitive. Laser pointer damage in children can occasionally be misdiagnosed as a macular dystrophy disease, but the distinctive lesions and OCT features are helpful for differentiating laser damage from other conditions.

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“…3-5, 10-16 . According to ANSI standard each laser pointer has a nominal ocular hazard distance (NOHD), the distance that a laser beam does not cause immediate or long-term damage based on a 0.25 second blink reflex.…”

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confidence: 99%