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Special Article
August 2004

Assessment of Alleged Retinal Laser Injuries

Author Affiliations

From the Department of Ophthalmology, University of Kansas MedicalSchool, Kansas City (Dr Mainster); the United States Army Medical ResearchDetachment, Walter Reed Army Institute of Research, Brooks Air Force Base,Tex (Mr Stuck and Dr Brown); and Ophthalmology Associates, Nix Medical Center,San Antonio, Tex (Dr Brown). The authors have no relevant financial interestin this article.

Arch Ophthalmol. 2004;122(8):1210-1217. doi:10.1001/archopht.122.8.1210

  Accidental retinal laser injuries are easily diagnosed when there areknown laser sources, typical macular injuries, and visual deficits consistentwith retinal findings. Decisions are more difficult when retinal findingsare subtle or absent, despite reported visual problems and somatic complaints.Inaccurate diagnosis of an ocular laser injury can precipitate a costly, lengthysequence of medical and legal problems. Analysis of laser-tissue interactionsand the characteristics of unambiguous retinal laser injuries provide 6 keyquestions to facilitate difficult diagnoses. Case reports demonstrate theusefulness of answering these questions before making diagnostic decisions.Retinal laser lesions that cause serious visual problems are readily apparentophthalmoscopically and angiographically. Accidental, intentional, or clinicalretinal laser lesions do not cause chronic eye, face, or head pains. Diagnosisof a retinal laser injury should be evidence based, not a matter of conjectureor speculation.