Non-Therapeutic Laser Retinal Injury

Abstract

BACKGROUND: As lasers have become an increasingly important component of commercial, industrial, military, and medical applications, reported incidents of non-therapeutic laser eye injuries have increased. The retina is particularly vulnerable due to the focusing power and optical transparency of the eye. Continued innovations in laser technology will likely mean that lasers will play an increasingly important and ubiquitous role throughout the world. Critical evaluation should thus be paid to ensure that non-therapeutic injuries are minimized, recognized, and treated appropriately. METHODS: A comprehensive literature review on the PubMed database was conducted to present case reports and case series representative of the variety of laser eye injuries in different injury circumstances, tissue types, and biological damage mechanisms. RESULTS: A general summary of non-therapeutic laser retina injuries is presented, including information about growth of the industry, increasingly accessible online markets, inconsistent international regulation, laser classifications, laser wavelengths, and laser power, mechanisms of tissue injury, and a demonstration of the variety of settings in which injury may occur. Finally, 68 cases found in the literature are summarized to illustrate the presentations and outcomes of these patients. CONCLUSIONS: As non-therapeutic laser eye injuries increase in frequency, there is a greater need for public health, policy, diagnosis, and treatment of these types of injuries.

Case of laser induced maculopathy and treatment outcome after use of corticosteroids and lutein.

“…Class two lasers are, in theory, the highest category available commercially in the UK [3,5]. These should only cause injury after direct gaze for 10 seconds or more via the photochemical mechanism [1,3]. Whilst the dark surroundings and consequent mydriatic pupil would increase risk of injury, the blink reflex of up to 0.25 seconds and "aversion response" to the brightness of the laser should be protective in this case [1,2,6].…”

“…These should only cause injury after direct gaze for 10 seconds or more via the photochemical mechanism [1,3]. Whilst the dark surroundings and consequent mydriatic pupil would increase risk of injury, the blink reflex of up to 0.25 seconds and "aversion response" to the brightness of the laser should be protective in this case [1,2,6]. Although we do not have enough information to suggest a higher power laser was involved in this instance, other papers have highlighted the lack of regulation and poor labelling standards online, meaning that exposure to higher powered laser devices and retinal injury are an increasing possibility [1,3,4,6].…”

“…Lasers are an important tool in a variety of sectors and are also widely available for commercial purchase, in the form of laser pointers and toys, amongst other products [1]. The potential for lasers to cause retinal injury is well documented [1].…”

“…Lasers are an important tool in a variety of sectors and are also widely available for commercial purchase, in the form of laser pointers and toys, amongst other products [1]. The potential for lasers to cause retinal injury is well documented [1]. Through a mixture of photochemical, thermal and ionising mechanisms, lasers can cause retinal damage ranging from subclinical to involving all the layers in the foveal and parafoveal areas [1,2,3].…”

“…The potential for lasers to cause retinal injury is well documented [1]. Through a mixture of photochemical, thermal and ionising mechanisms, lasers can cause retinal damage ranging from subclinical to involving all the layers in the foveal and parafoveal areas [1,2,3]. The extent of the damage depends on several factors: exposure time and properties of the laser such as diameter of the beam, wavelength and power output [2,3].…”