Laser pointers: not to be taken lightly
Editor,—We recently treated a 16 year old boy whose friends exposed both his eyes to a laser beam alternately for 20 seconds from a distance of around 1 metre in the course of horseplay with a key chain laser pointer (class 3a diode, 670 nm, maximum output 5 mW). Immediately thereafter, his vision was blurred bilaterally and he noted a red central scotoma in each eye. These symptoms resolved spontaneously within 2 days. An eye examination performed 3 days later disclosed that his vision and visual fields were normal, but there were retinal pigment epithelial disturbances which appeared in fluorescein angiography as a window defect type hyperfluorescence in both eyes close to the fovea. The macular burns persisted throughout an 8 month follow up period. The literature describes two cases of unilateral macular damage from laser pointers (class 2 diode, 670 nm, maximum output 1 mW and class 3a diode and 670 nm, maximum output 5 mW),1 2 and two other cases of bilateral decreased vision due to large retinal photocoagulation scars from class 3a laser pointer.3
In his review of the safety of laser pointers, Marshall4comprehensively described the classification of the lasers according to hazard. However, no small part of the message of his paper and that of a letter to the Lancet 5 were unmistakably designed to placate the reader into believing that laser pointers are harmless. After witnessing the persistent injury to our own patient and reading the reports of four others who were likewise hurt by this device, we are appalled. The laser pointer is not an innocent toy. It damages the eye and should not be made freely available to youngsters whatever its strength, while the label of the laser pointer only cautions users not to shine the laser pointer light into an eye.6
Media “hype” underpinning reports in the popular press and the pernicious avarice of individuals lurking in wait for opportunities to claim compensation for spurious injury seem to have galvanised estimable individuals to rush to the defence of this instrument. We contend that laser pointers which are regarded as being “safe” carry the risk of potential damage to the eyes and that more such cases will be detected once physicians are alerted to this possibility. We believe that the public must be instructed in the safety measures that need to be taken when using the laser pointer and that they be made aware of the potential hazards associated with improper use. We recommend that use of laser pointers in public should be controlled and that these devices should be kept away from children.
