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High-powered recreational lasers with the potential to cause severe ocular injuries are becoming increasingly available to the general public. Recently, a 9-year-old boy presented to our clinic with bilateral vision loss after playing with an adult who directed a handheld laser into both of his eyes. Known as the Spyder III Pro Arctic, the device was a class 4, high-powered 1250 mW laser that is manufactured from the 445 nm blue diode of a dismantled home theater projector and that is commercially available for online purchase from overseas. On initial examination, the patient’s vision was 20/126 in the right eye and 20/100 in the left. Dilated funduscopic examination revealed preretinal hemorrhages in the macula of both eyes (Figure, A). Cross-sectional images obtained by spectral-domain optical coherence tomography demonstrated both hemorrhages to be subhyaloid- or subinternal-limiting membrane in location (Figure, B). Fortunately, the patient’s vision gradually returned to 20/20 in the left eye after a week and to 20/25 in the right eye after 2 months, with corresponding improvement in the preretinal hemorrhages in both eyes (Figure, C). Fundus autofluorescence images revealed no evidence of damage to the retinal pigment epithelium or Bruch’s membrane (Figure, D).
Yiu G, Itty S, Toth CA. Ocular Safety of Recreational Lasers. JAMA Ophthalmol. 2014;132(3):245-246. doi:10.1001/jamaophthalmol.2013.5647