The objective of this study was to describe the potential clinical presentations of retinal pathology resulting from exposure to laser pointers. The study included eight eyes of seven patients. Mean age was 18.7 years (12-36). Most were accidental self-inflicted while playing with the device (n=5). One was accidentally injured by a classmate and one by an unknown source at a nightclub. Six had brief direct exposure of several seconds and one with bilateral injury played with the laser for several minutes with an unknown exposure time to the eyes. Five were exposed to a 5mW green laser, one 5mW red beam and one unknown. Presenting visual acuity was counting fingers at 2 metres up to 6/6. Bilateral ophthalmoscopy showed yellow-orange retinal lesions at the foveolar in five cases, premacular subhyaloid haemorrhage in two eyes and full-thickness macular hole in one eye. Retinal lesions were round and well-defined at the level of the retinal pigment epithelium and 150-350um in diameter. SD-OCT confirmed foveal changes in all eyes. Green lasers with a wavelength of 532um require lower durations of exposure than red. All patients were treated with oral steroids with prednisolone. There was a gradual improvement in acuity and resolution of the structural outer retinal damage over eight to 48 weeks except for the patient with macular hole. The authors conclude that this requires increased public awareness of the potential dangers with laser pointers.

Laser pointer-induced maculopathy: more than meets the eye.
Mtanes K, Mimouni M, Zayit-Soudry S.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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