Sir,

With the usage of laser in the fields of industry, research, and military, the risk of potential injuries is very real. We would like to report a patient who suffered a cosmetic laser-induced retinal injury.

Case report

A 25-year-old female was accidentally exposed to a cosmetic laser (SPECTRA-VRM II, MAX Engineering Ltd, Goyang City, South Korea) in 2012. The laser fired inadvertently when the patient was adjusting target without the use of her protective goggles. Immediately after the exposure, she experienced a bright flash of light followed by floaters in front of her right eye. The pulse duration and energy of the laser were not assessed. The patient’s best-corrected visual acuity was 20/20 OD and 20/20 OS. Intraocular pressure and anterior segment biomicroscopy were unremarkable. Fundoscopic examination of her right eye revealed an inferior retinal laser burn and vitreous hemorrhage (Figure 1a). Prednisolone and vitamins were administered orally. Three days later the floaters in front of her right eye decreased, and fundoscopic examination of the eye revealed a laser burn with retina edema around it and vitreous hemorrhage (Figure 1b). Unfortunately, the patient did not return for further follow-up.

Figure 1
figure 1

Fundoscopic photograph on the day of injury revealed vitreous hemorrhage and the site of laser injury on the inferior retina (a). Three days following the exposure, fundoscopic photograph revealed the laser injury with retinal edema around it (b).

Full size image

Comment

Some laser-induced eye injuries have been reported in the past. However, there has not been a case of cosmetic laser-induced retinal injury reported before. In recent years, 1064-nm Q-switched Nd:YAG cosmetic laser therapy for the removal of age and sun spots has become popular especially in China. In contrast to previously reported cases,1, 2 the location of the injury was not at the macula. The most important factor in determining the functional damage to the retina is the location of the retinal injury. Lesions to the periphery of the eye may not cause symptoms or affect the vision.

The importance of inflammation and oxidative stress in laser injures has been suspected but not studied in detail. Current medical treatment for retinal laser injuries is systemic administration of anti-inflammatory and antioxidant drugs, typically corticosteroids3, 4 and vitamins, that are believed to limit retinal injury, reduce vision loss, and promote recovery.5