Green lasers are beyond power limits mandated by safety standards

The Danger of Laser Pointer-Induced Retinal Damage in Children: A Large United Kingdom Case Series and Survey of Public Awareness

PURPOSE

To explore the clinical features of laser pointer-related retinal injuries among children and gain insight into the general public awareness around laser pointer use.

METHODS

This was a retrospective case series of 9 children (12 eyes) with laser pointer-related retinal injury from a United Kingdom tertiary ophthalmology unit and a prospective survey of laser pointer use and awareness among children and parents presenting to the hospital eye service for other eye conditions.

RESULTS

Within the case series, 67% of patients were asymptomatic on presentation. A mean follow-up of 25.6 months showed that structural changes persisted in all cases, and in one case, there was progression in the macular lesion size. One case presented with secondary choroidal neovascular membrane, requiring intravitreal anti-vascular endothelial growth factor injections. A survey showed that 9% of children admitted to having played with laser pointers and 13% of parents were aware of their children playing with laser pointers. Only one-third of children and parents were aware of laws regulating laser pointers. Most parents (96%) agreed that there needs to be increased awareness regarding laser pointers' effect on vision.

CONCLUSIONS

This study has highlighted that although children may be asymptomatic at presentation, there is usually permanent structural damage to the macula, and complications such as secondary choroidal neovascular membrane can develop years later. The survey found a relatively high incidence of laser pointer use with little awareness of the regulation laws. There is an urgent need to establish more robust measures to improve public awareness and regulations around laser pointers. [J Pediatr Ophthalmol Strabismus. 2023;60(1):52-59.].

Retinal burns from laser pointers: a risk in children with behavioural problems

OBJECTIVE

To explore self-inflicted retinal burns from laser pointers in children.

METHODS

Literature review of laser pointer retinal injuries in childhood and online survey of UK Consultant Ophthalmologists. A cohort of local children with self-inflicted injury is described. The matter is topical. We review progress in recent legislation and policy change in the UK.

RESULTS

Four of 77 case reports of laser burns in childhood analysed reported psychological or behavioural issues. Three of four children in our cohort had such issues. Delay in diagnosis occurred in two of our patients. Structural retinal damage persisted for over 12 months in all four children (seven eyes). Our survey of UK ophthalmologists found 159 cases of injury (85% male), 80% under 20 years of age. The majority of the laser pointers were purchased online. Many patients (36%) suffered moderate vision loss (6/18 to 6/60 Snellen), while 17% (at least 11 patients) suffered severe vision loss (<6/60 Snellen).

CONCLUSION

We highlight the risk of macular damage and vision loss from handheld lasers specifically in children with behavioural, learning or mental health issues. The diagnosis may be difficult or delayed in such children. In children with uncertain macular changes, ophthalmologists should explore the history for possible instances of exposure to handheld lasers pointers. Regulatory authorities and manufacturers of handheld lasers need to be aware of the risk to children. Furthermore, there is a need to better inform parents, carers and teachers of the risk of ocular self-injury from such lasers pointers.