Laser pointer full thickness macular hole: a case report and literature review

Author: Pablo González de los Mártires (Spain)

Co-authors: Gonzalo Guerrero Pérez, Santiago López Arbués, Nerea Gangoitia Gorrotxategi, Iñigo Salmeron Garmendia, Esther Compains Silva, Juan Ferreiro López

Purpose

To report a case of macular hole from a laser pointer, as well as a briefly review of this entity in the scientific literature

Setting/Venue

Hand-held laser pointers emit electromagnetic waves tha spread in the form of the light beam that can cause retinal and cutaneous lesions. The European standard for laser products allows the use of laser divices that emit visible radiation (400 to 700 nm) and where ocular protection is ensure by palpebral closure reflex. However, this protection cannot be guaranteed if the gaze is intentionally fixed on the beam. Therefore, the use of this devices can produce severe VA loss that can impair the quality of life of the who uses it, especially the childs.

Methods

Case report. A 15 year-old boy had an acute reduction of visual acuty in the left eye after staring into a commercial class 2 laser pointer for aproximately 6 seconds

Results

The patient´s best corrected visual acuty (VA) was 20/40, and he had a full thickness macular hole (FTMH) of 220 micras at the diagnosis. Nevertheless, a year later, the macular hole began to get bigger (up to 522 micras) with an halo of cystic edema and a recent hiperrefractive subfoveal material. Therefore, the VA went down to 20/60, and a vitrectomy associated with peeling of the internal limitating membrane and SF6 gas was performed to attempt to recover the previous functionality. Fortunately, the FTMH get sealed and the VA attained to a very encouraging 20/40

Conlusions

Commercial laser pointers, commonly used for teaching and entertaiment purposes, may cause notable macula damage. Morphologicaly, this may manifest from a retinal epithelial distubance to a full thickness macular hole. In this last case, the surgery can be performed with a good functional visual outcome

Financial Disclosure

None