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Greece: 9-year-old "repeatedly gazing" into laser causes hole in his eye

A 9-year-old boy in Greece suffered serious, permanent damage to his left eye, after “repeatedly gazing” into a green beam from a laser pointer. (Note: This is not unknown. As of June 21 2018, LaserPointerSafety.com has reported on around 15 other cases of self-inflicted eye injuries.)

The most serious injury that the boy caused was a large hole in his macula, shown with the yellow arrows.

Pic 2018-06-21 at 8.59.23 PM

Two other areas of injury were not immediately visible in a funduscopic exam of the retina (photo A, using ordinary white light) but were clearly visible using fundus autofluorescence imaging (blue arrows in photo B, using a narrow wavelength of light). The round area to the left in both photos is the optic disc, a natural feature where the optic nerve begins — it is not laser damage.

The macula is where central vision occurs. The fact that the injury occurred in the macula indicates that the boy looked directly into the laser light with his left eye. Damage to the macula is serious as this area provides high resolution, color vision in the center of the visual field.

The injury reduced the boy’s vision to 20/100 in the injured left eye; his right eye remained at 20/20. The boy’s ophthalmologists felt the hole was too large and too much time had passed since the injury for surgery. (The doctors suspected that the boy had injured his eye at least a year earlier.) Because surgery might make things worse, causing a cataract without improving the macula, they “favored conservative management.”

There was no improvement in vision even 1 1/2 years after the injury was first presented to the ophthalmologists.

The power of the laser pointer, and other details of the incident, were not described in the one-paragraph report published June 21 2018. One of the authors told CNN the boy’s father “had bought the laser as a toy from a street merchant.”

From the New England Journal of Medicine (N Engl J Med 2018; 378:2420, DOI: 10.1056/NEJMicm1714488) Authors: Sofia Androudi, M.D., Ph.D., and Eleni Papageorgiou, M.D., Ph.D. Additional reporting by CNN. This story was picked up by many other news sites around the world.