Exposure for even fractions of a second to high-powered blue handheld laser devices can cause serious eye injuries, according to a study recently released online in Ophthalmology, the journal of the American Academy of Ophthalmology. The researchers have concluded that the wide availability of these devices, which are often marketed as toys, could lead to an epidemic of ocular injuries, and greater public awareness and government intervention should be encouraged.
The U.S. Food and Drug Administration, the Laser Institute of America and the American National Standard Institute have all released safety notifications to the public about the risk of injury from handheld lasers with an output power of more than five milliwatts. The natural protective mechanisms of the eye -- such as the blink reflex -- are ineffective against these lasers, and severe retinal damage may occur, even after momentary exposure. Studies have also shown that blue lasers are more likely to cause retinal injury compared with green or red lasers. Yet, blue laser devices are sold widely on the Internet, which resemble laser pointers with lower wattages but actually have an output power of up to 1200 milliwatts. After witnessing a rise in the occurrence of eye injuries caused by these lasers and to better illustrate the dangers of these devices, researchers in Saudi Arabia documented the case histories of 14 young males, ages 11 to 30, who sought treatment for these injuries from January 2012 -- January 2013.
Each of the 14 patients in the study had sustained injuries to one eye. Four of the patients suffered a full-thickness macular hole (break in the part of the eye responsible for detailed, central vision). Other macular injuries documented in the study included hemorrhages in different retinal layers, a macular pucker (when cells proliferate on the surface of the retina, causing visual impairment), a retinal disruption and a cavity in the retina. Only four eyes (29%) improved spontaneously with increase in vision, whereas 10 eyes (71%) required intervention, including vitrectomy (surgery in which an operating microscope and small surgical instruments are used to remove blood and scar tissue that accompany abnormal vessels in the eye).
"High-power handheld laser devices may lead to an epidemic of ocular injuries that requires attention at different levels," wrote the study's authors from the King Khaled Eye Specialist Hospital Collaborative Retina Study Group in Riyadh, Saudi Arabia. "The difference between these new high-power laser devices and the low-power pointers cannot be overemphasized and government action such as banning the importation of these high-power handheld laser devices, laws for assault or malicious intent and a general public awareness campaign may be warranted."
- Sulaiman M. Alsulaiman, Abdulaziz Adel Alrushood, Jluwi Almasaud, Sultan Alzaaidi, Yahya Alzahrani, J. Fernando Arevalo, Nicola G. Ghazi, Emad B. Abboud, Sawsan R. Nowilaty, Mohammad Al-Amry, Saba Al-Rashaed. High-Power Handheld Blue Laser-Induced Maculopathy. Ophthalmology, 2013; DOI: 10.1016/j.ophtha.2013.09.006
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