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LETTER TO EDITOR
Year : 2004  |  Volume : 52  |  Issue : 2  |  Page : 169-70

Laser range finder can cause retinal injury



Correspondence Address:
K Shaym Sunder


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Source of Support: None, Conflict of Interest: None


PMID: 15283228

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How to cite this article:
Sunder K S, Shetty N, Singh V K, Chaudhary V S, Sharma S. Laser range finder can cause retinal injury. Indian J Ophthalmol 2004;52:169

How to cite this URL:
Sunder K S, Shetty N, Singh V K, Chaudhary V S, Sharma S. Laser range finder can cause retinal injury. Indian J Ophthalmol [serial online] 2004 [cited 2020 Apr 7];52:169. Available from: http://www.ijo.in/text.asp?2004/52/2/169/14599

Dear Editor,

During the last few years, there has been increasing use of Nd-YAG lasers in the industry, laboratories and by military personnel.[1] This has increased the chances of unintended retinal exposure especially to the macula. We saw two patients accidentally exposed to Nd: YAG range finders (Class 4 laser,[2] Q- switched Nd: YAG laser, wavelength 1064 nm, pulse length 18 nanoseconds, density 12 mj/pulse).

The first patient was a 29-year-old male with a 3-day old history of sudden decrease in vision in the right eye after direct exposure to the beam of the range finder. His best-corrected visual acuity in the right eye was 6/18; N 12 and 6/6; N6 in the left eye. The second patient was a 36-year-old male with a one-month-old history of exposure to the beam of the range finder. He had been treated elsewhere with systemic corticosteroids. On presenta-tion, his best corrected visual acuity in the right eye was 6/18;N 8 and the left eye was 6/6;N6. Anterior segment evaluation in both patients was unremarkable. Fundus in the right eye of both patients should a full-thickness macular hole approximately Z\v DD in size with subretinal fluid cuff of and surrounding retinal pigment epithelial (RPE) atrophy [Figure - 1]a and [Figure - 2]b. Watzke Allen test was positive and Amsler grid showed parafoveal distortion. Fluorescein angiography showed corresponding transmission defects [Figure - 1]b and [Figure - 2]b. In both patients, surgery was not contemplated because of RPE atrophy at the base of the macular hole. The clinical picture remained the same on follow-up over 3 months.

Most reported laser injuries have been caused by Nd:YAG lasers.[3],[4] Such injuries are usually parafoveal. Accidental injuries occur during alignment of the laser beam or during adjustment of the beam,[4] as in our patients. Vision remains stable or may decrease further due to macular hole and chorioretinal scarring. In both our patients, the occurrence of macular hole and retinal pigment epithelial changes had limited the chance of visual recovery. Both injuries were accidental and protective eyeglasses were not worn at the time of injury.

The authors would like to highlight the need for creating proper awareness among personnel using laser range finders and laser pointers and the need to wear protective filters in the goggles used. As more and more lasers are used for industrial and military purposes the incidence of such laser injuries is likely increase in the future.



 
  References Top

1.
Bolderry EE, Little HL, Flocks M, Vassiliadis A. Retinal injury due to industrial laser burns. Ophthalmol 1981; 88: 101-7.  Back to cited text no. 1
    
2.
Mainster M, G Timberlake,K Warren,D H Sliney. Pointers on Laser Pointers. Ophthalmol 1997; 104:1213.  Back to cited text no. 2
    
3.
Thach A, Lopez P, Snady-McCoy L, Golub B, Frambach D. Accidental Nd- YAG laser injuries to the macula. Am J Ophthalmol 1995; 119: 767-73.  Back to cited text no. 3
    
4.
Barkana Y, Belkin M. Photic and Electrical Trauma. In: Kuhn F, Dante J, editors. Ocular Trauma . Principles and Practice. New York: Thieme; 2002. pp 363-65.  Back to cited text no. 4
    


    Figures

  [Figure - 1], [Figure - 2]


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