Laser Pointer Warning: Popular Toy Can Cause Permanent Vision Loss
Laser pointers are a popular toy amongst teenagers in Australia and are easily available for purchase online. However, they have the ability to cause severe and permanent vision loss if pointed directly into the eyes.
A recent case study of injury from a laser pointer involved a 17-year-old patient, who presented at Northern Eye Centre approximately 5 weeks after gazing at a laser pointer with his right eye. The teenager’s vision became blurred immediately after the event but gradually improved, leaving him with central scotoma in his right vision. The patient was scanning with his right eye to achieve 6/9.5, while his left vision was 6/3.8.
A Fundus examination revealed a localised (approximately 500u) area of pallor at the right fovea with discrete multiple black spots at the retinal pigment epithelium (RPE) level. The left retina appeared normal.
Fundus Autoflourescence of the right eye showed spots of hypo autoflourescence surrounding the foveal centre corresponding to the black pigments. Optical Coherence Tomography showed an irregular hyper reflective area at the level of the RPE at the centre of the fovea with disruption of the ellipsoid zone. There was no intraretinal oedema or subretinal fluid. A 10-2 visual field test showed a few central relative scotomas.
The patient and his family were informed that his vision would most likely remain reduced but that it is not expected to deteriorate further. He failed to attend for further follow-up.
Unfortunately, this case is not an isolated incident. Multiple reports from Australia and overseas have identified retinal laser burn injury in children and young adults who gaze directly at laser pointers with one or both eyes.
As damage to the eye is proportional to the power output and the duration of laser exposure; most cases result in permanent moderate visual loss by damaging the outer retinal layers. However, in more severe cases subhayloid or sub ILM haemorrhage can occur or a full thickness macular hole can develop resulting to more severe visual loss.
It is also important to note that many children who present with retinal burns from a laser pointer are hesitant to admit their action to their parents or the treating specialist. This can complicate diagnosis as laser burn injury may simulate other genetically inherited maculopathy presenting at a young age.
Australia has some of the strictest laws regarding the purchase and sale of laser pointers, with only Class 2 laser products with a power of less than 1mW approved for public use. Unfortunately, many laser pointers available for purchase online are incorrectly labelled and often have a much higher output than stated on the label (some as high as 112mW). Making it difficult for parents and consumers in general to assess the safety risks associated with their use.
This case study highlights the need for better education surrounding the safe use of laser pointers and also the need for better monitoring of online laser pointer sales.