There was a very intersting Letter to the Editor in last weeks New England Journal of Medicine last week, Retinal Injuries from a Handheld Laser Pointer.  The authors report a case of a 15 year old boy who bought a laser pointer on the internet to use as a toy. 

The boy’s life changed when he was playing with his laser pointer in front of a mirror to create a “laser
show,” during which the laser beam hit his eyes several times. He noticed immediate blurred vision in both of his eyes. Hoping that the visual loss would be transient and afraid of telling his parents, he waited 2 weeks before seeking an ophthalmic assessment, when he could no longer disguise his bad vision. His visual acuity was so poor in his left eye that he was only able to count fingers at a distance of 3 ft, and it was 20/50 in his right eye.

The clinical findings were consistent with severe bilateral retinal laser injury. After 4 months, the boy’s visual function remained impaired but improved to 20/32 in the right eye spontaneously and to 20/25 with a remaining scar just beside the center of the fovea in the left eye after one intravitreal injection of ranibizumab

This kid was very lucky, although he does have a visual deficit, he had an excellent response to treatment!  There are several take away points from this letter:

  1. Never shine a laser pointer at anyone. Laser pointers are designed to illustrate inanimate objects.
  2. Do not allow minors to use a pointer unsupervised. Laser pointers are not toys.
  3. Do not point a laser pointer at mirror-like surfaces. A reflected beam can act like a direct beam on the eye.

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