High-power blue-laser gadgets readily available online and increasingly popular among teens and young adults can cause serious, sometimes irreversible, eye damage.
“These are potent, dangerous devices capable of inflicting serious injury, yet easily accessible and vastly appealing to a segment of the population that is anything but cautious,” says ophthalmologist Saba Al-Rashaed, associate chief of the retina division at King Khaled Eye Specialist Hospital (KKESH) in Saudi Arabia.
A new report in the journal Opthamology describes a cluster of 14 cases of previously unseen eye damage treated at KKESH between 2012 and 2013, all of which were caused by high-power blue laser gadgets. The injuries included four perforations of the retina, the nerve-rich, light-sensitive innermost layer of the eye responsible for detailed central vision.
“We fear our experience may mark the beginning of an alarming trend and may portend a growing number of young people suffering serious eye damage as these high-power lasers become more ubiquitous,” says J. Fernando Arevalo, professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins University and chief of the retina division at KKESH.
Arevalo says 16 more patients have been seen and treated at KKESH for laser-induced injuries since the writing of the report.
The authors of the report say these high-power laser toys resemble the more benign low-power laser pointers used during lectures and can be easily confused with them.
Laser warnings not enough
The investigators say the warning labels that such devices carry are apparently not enough to prevent injuries, and they urge physicians, parents and educators to talk to children about the dangers of these devices.
In addition, doctors should ask about laser use in all cases of unexplained sudden loss of vision, particularly among boys, teens and young males, among whom such devices are most popular.
The patients in the study all experienced sudden loss of vision in one eye and either brought their devices with them to the emergency room or reported being exposed to a laser device. Ten of the 14 patients required surgery or another intervention, and while most of the injuries were reversed with treatment, two patients sustained permanent damage to the retina.
All patients sought treatment promptly, which may explain why so many recovered fully, say the authors. They urge users, parents and caregivers to seek immediate medical attention if vision is affected while using a laser device.
All injuries occurred during play and involved teenage boys and young males between ages 11 and 30. Some injuries were accidental, but others involved a playmate intentionally pointing the laser beam at the victim’s eye. The distance between the victim’s eye and the laser beam ranged from a half-meter to 6 meters, roughly 1.7 feet to 20 feet. Those who suffered retinal holes were injured at the closest distance, around a half-meter. Generally, injury from greater distance resulted in less serious damage.
Too fast to blink
Such severe laser-induced eye damage is a new phenomenon stemming from the growing popularity of high-power laser gadgets. While blue laser technology has been used for a long time in medical diagnostics and electronic equipment, blue lasers have only recently been packaged as toys for mass consumption. Such devices are most often used for play but also to light cigarettes and set plastic or paper on fire from a distance.
High-power lasers can damage the retina by shooting a powerful light current into the eye that penetrates the organ’s deepest layers in fractions of a second. The eye’s protective blink reflex is not fast enough to shut out the laser beam.
In comparison, low-power laser pointers are relatively safer with short exposure because they emit a much weaker current that is blocked out by the blink reflex before it reaches the deep layers of the eye. Blue lasers are also more dangerous than red and green ones because blue is more easily absorbed by pigments in the retina and thus more damaging to it.
Lasers burned holes in the maculas of four patients in the study. The macula is the highly light-sensitive center of the retina. All four underwent surgery to close the holes, and all experienced improved vision.
Five patients suffered retinal bleeding; three of them were treated successfully with laser therapy. Two of the five did not improve as a result of treatment because the bleeding had produced clots resulting in permanent damage to the retina. Two patients had bleeding around the fovea, the central part of the macula. Both of those injuries resolved on their own over a few months. Two patients sustained splitting of the retinal layers, which healed spontaneously. One patient underwent a procedure to remove scar tissue and abnormal fluid buildup under the retina.
The authors of the report are planning to ask the Saudi government to consider a ban on the sale of blue laser devices. Johns Hopkins and KKESH have collaborated on clinical care, medical education and research since 2010.
Source: Johns Hopkins University