Title : Retinal injury from accidental laser exposure: A case report
Abstract:
A 31-year-old female dermatologist reported visual disturbances, including haziness and floaters in her left eye, after accidental exposure to a picosecond laser. Initial ophthalmologic evaluation revealed a visual acuity of 20/25 in both eyes, with normal intraocular pressure and no external signs of injury. However, fundus examination of the left eye showed a peripheral retinal burn accompanied by vitreous hemorrhage and surrounding edema. Optical Coherence Tomography (OCT) indicated full-thickness retinal damage extending into the choroid, partially obscured by blood. Conservative treatment with nepafenac eye drops was initiated, which led to reduced edema and hemorrhage absorption upon follow-up.
The literature describes only a few cases of ocular trauma associated with picosecond lasers, frequently used in dermatological procedures. The short pulse duration of these lasers limits heat dissipation, raising the risk of ocular injury, particularly since they may not elicit protective reflexes such as blinking. Although peripheral retinal injuries may not always affect vision, high-energy laser exposure can result in hemorrhage, scotomas, and damage to choroidal or nerve fiber layers, potentially compromising vision regardless of lesion location.
This case highlights the critical need for stringent safety protocols when working with lasers. The ANSI Z136.1-2022 standards recommend essential safety measures, such as limiting laser operation to trained professionals, minimizing reflective surfaces, and enforcing the use of proper eye protection. Awareness of laser physics and adherence to safety guidelines are vital for preventing unnecessary ocular injuries. Ensuring open communication among inter-professional teams, including laser operators, ophthalmologists, and safety officers, is essential to maintain a safe environment for both patients and healthcare providers. This case underscores the importance of laser safety training in clinical settings to reduce the risk of ocular trauma and protect the vision health of all individuals involved in laser procedures.
