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 Table of Contents  
PHOTO ESSAY
Year : 2021  |  Volume : 59  |  Issue : 3  |  Page : 320-321

Scars of an old story: Laser pointer injury


1 Consultant, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India
2 Fellow, Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India

Date of Submission17-Mar-2021
Date of Acceptance13-Jun-2021
Date of Web Publication09-Sep-2021

Correspondence Address:
Dr. Murali Krishnan Srinivasan
Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Avinashi Road, Peelamedu, Coimbatore - 641 014, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_25_21

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  Abstract 


A 12-year-old boy presented to us with complaints of nonprogressive diminution of vision and seeing a black spot at the center of his visual field in his right eye following exposure to a red laser pointer accidentally, while playing, 2 years ago. On examination, his best-corrected visual acuity was 6/12 OD and 6/6 OS. His anterior segment examination was clinically normal. Fundus examination revealed a well-defined, pigmented, slightly elevated, hypoautofluorescent scar involving the nasal parafoveal region of the macula in his right eye. His left fundus appeared normal. Optical coherence tomography (swept source) imaging showed an irregular, raised, hyperreflective inner layer with back-shadowing in the parafoveal region corresponding to the pigmented scar seen in his right eye. Laser pointer injuries are fairly common but under-reported health hazard.

Keywords: Laser pointer, pediatric, retinal thermal injury


How to cite this article:
Ganesh SC, Rao SG, Srinivasan MK. Scars of an old story: Laser pointer injury. TNOA J Ophthalmic Sci Res 2021;59:320-1

How to cite this URL:
Ganesh SC, Rao SG, Srinivasan MK. Scars of an old story: Laser pointer injury. TNOA J Ophthalmic Sci Res [serial online] 2021 [cited 2021 Dec 1];59:320-1. Available from: https://www.tnoajosr.com/text.asp?2021/59/3/320/325730




  Case History Top


A 12-year-old boy presented to us with complaints of nonprogressive diminution of vision and a black spot at the center of his visual field in the right eye following exposure to a laser pointer while playing 2 years ago. His best-corrected visual acuity was 6/12 in OD and 6/6 in OS. His anterior segment examination was clinically normal. Fundus examination revealed a well-defined, pigmented, slightly elevated, hypoautofluorescent scar involving the nasal parafoveal region of the macula in the right eye [Figure 1]. The left eye appeared normal [Figure 2]. Amsler's grid showed a well-defined positive scotoma in the temporal field. Optical coherence tomography (OCT) imaging showed an irregular, raised, hyperreflective inner layer with back-shadowing in the parafoveal region corresponding to the pigmented scar in the right eye [Figure 3] and [Figure 4].
Figure 1: (a) Fundus photograph of the right eye showing hyperpigmented scar in the macular region with (b) hypo-auto-fluorescence

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Figure 2: (a,b) Fundus photograph of the left eye showing normal findings

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Figure 3: Optical coherence tomography image of the right eye showing hyper-reflective inner layer in the parafoveal region of the macula with back-shadowing

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Figure 4: Optical coherence tomography image of left eye-normal

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  Discussion Top


Laser pointer injuries are a significant but less reported public health issue in India. The most important variables affecting the visual outcome are as follows: The amount of laser energy, duration of exposure, and location of retinal involvement.[1]

They cause photo-thermal injury. The commonly used laser pointers have a power output <5 mW, which are not considered as harmful to human eye.[2] However, children increase their chance to retinal injury by staring at the laser beam without blinking or averting the eye for a prolonged duration.[3]

Vision loss and persistent central scotoma occur immediately after the laser beam exposure. Final visual recovery is dependent on the lesion location and size.[4]

Treatment with systemic steroids has shown mixed results. In case of choroidal neovascular membrane, intravitreal anti-vascular endothelial growth factor can be given. Observation is usually the option as visual acuity may stabilize over time.[5]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Barkana Y, Belkin M. Laser eye injuries. Surv Ophthalmol 2000;44:459-78.  Back to cited text no. 1
    
2.
Mainster MA, Stuck BE, Brown J Jr. Assessment of alleged retinal laser injuries. Arch Ophthalmol 2004;122:1210-7.  Back to cited text no. 2
    
3.
Xu M, Lin T. Bilateral central scotomas following laser pointer misuse. CMAJ 2014;186:E341.  Back to cited text no. 3
    
4.
American National Standards Institute. American National Standard for Safe Use of Lasers. New York, NY: American National Standards Institute, Inc.; 2000.  Back to cited text no. 4
    
5.
Xu K, Chin EK, Quiram PA, Davies JB, Parke DW 3rd, Almeida DR. Retinal injury secondary to laser pointers in pediatric patients. Pediatrics 2016;1:e20161188.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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