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Ocular Safety of Recreational Lasers

Glenn Yiu, MD, PhD1; Sujit Itty, MD1; Cynthia A. Toth, MD1
[+] Author Affiliations
1Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
JAMA Ophthalmol. 2014;132(3):245-246. doi:10.1001/jamaophthalmol.2013.5647.
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High-powered recreational lasers with the potential to cause severe ocular injuries are becoming increasingly available to the general public. Recently, a 9-year-old boy presented to our clinic with bilateral vision loss after playing with an adult who directed a handheld laser into both of his eyes. Known as the Spyder III Pro Arctic, the device was a class 4, high-powered 1250 mW laser that is manufactured from the 445 nm blue diode of a dismantled home theater projector and that is commercially available for online purchase from overseas. On initial examination, the patient’s vision was 20/126 in the right eye and 20/100 in the left. Dilated funduscopic examination revealed preretinal hemorrhages in the macula of both eyes (Figure, A). Cross-sectional images obtained by spectral-domain optical coherence tomography demonstrated both hemorrhages to be subhyaloid- or subinternal-limiting membrane in location (Figure, B). Fortunately, the patient’s vision gradually returned to 20/20 in the left eye after a week and to 20/25 in the right eye after 2 months, with corresponding improvement in the preretinal hemorrhages in both eyes (Figure, C). Fundus autofluorescence images revealed no evidence of damage to the retinal pigment epithelium or Bruch’s membrane (Figure, D).

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Retinal Injury From a Recreational Handheld Laser

A, Fundus photos of right and left eyes immediately after exposure to laser showing bilateral preretinal hemorrhages and laser burn site in the left eye (arrow). B, Spectral domain optical coherence tomography images of right and left eyes showing subhyaloid- or subinternal-limiting membrane location of the preretinal hemorrhages. C, Fundus photos of right and left eyes 2 months after laser exposure, showing improvement of preretinal hemorrhages. D, Fundus autofluorescence images of right and left maculae 2 months after laser injury, demonstrating no defect in the retinal pigment epithelium or Bruch’s membrane.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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