Peer-reviewed

High-Power Handheld Blue Laser-Induced Maculopathy: The Results of the King Khaled Eye Specialist Hospital Collaborative Retina Study Group – Corrected Proof

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Purpose: To report various types of maculopathy caused by momentary exposure to a high-power handheld blue laser.Design: Consecutive case series.Participants: Fourteen eyes of 14 patients.Methods: Patients with a history of eye exposure to a blue laser device (450 nm and a power range of 150–1200 mW) to a single institution were included. Evaluation included a full ophthalmic examination, fundus photography, macular spectral-domain optical coherence tomography, and fundus fluorescein angiography.Main Outcome Measures: Analysis of the types of maculopathy and vitreoretinal pathologic features.Results: All patients were young males. The most common setting for injury was accidental at play. The types of maculopathies encountered were: a full-thickness macular hole (FTMH) in 4 eyes, a premacular subhyaloid hemorrhage in 5 eyes, premacular sub–internal limiting membrane hemorrhage in 2 eyes, an outer retinal disruption at the fovea in 1 eye, an epimacular membrane in 1 eye, and a schisis-like cavity in 1 eye. Best-corrected Snellen visual acuity at presentation ranged from 20/40 to 4/200 (mean, 20/290). Only 4 eyes (29%) improved spontaneously with increase in vision, whereas 10 eyes (71%) required intervention. The latter consisted of neodymium:yttrium–aluminum–garnet hyaloidotomy in the 5 eyes with subhyaloid hemorrhage and pars plana vitrectomy (PPV) for the eyes with FTMH and epimacular membrane. All 4 FTMH were closed successfully after PPV. Final mean best-corrected visual acuity in all cases was 20/35 (range, 20/15–20/300).Conclusions: Exposure to high-power handheld laser devices can cause a variety of maculopathies that can reduce central vision permanently. Although vision may improve spontaneously, most cases require intervention. Unrestricted access to commercially available high-power handheld laser devices is dangerous and public awareness should be encouraged.Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.