Sir,

We thank Ms Mc Loone and Dr O’Neill for their response to our article. It is with dismay, however, that we see another case series of retinal laser injuries caused by recreational laser devices in children. The authors highlight a number of points that we have also encountered in dealing with such injuries; namely that on-line and street vendors are not appropriate places from which to acquire laser devices. They also highlight that children may not be forthcoming regarding a history of exposure to laser devices, and that clinicians must therefore be aware of laser-induced retinal injury and its clinical features, which include a macular vitelliform-like lesion in the acute stage and, most commonly, retinal pigment epithelial disturbance in the chronic phase.1, 2

We are encouraged to see other Ophthalmologists also calling for more action against an entirely preventable cause of visual impairment in children. While we are glad to hear that all children in this series had a Snellen visual acuity of 6/9 or greater, there are reports of children with laser injuries that have poor visual acuities of 20/100 or worse.3, 4 Furthermore, 8 of the 10 children reported here with laser injuries date from at least 6 months after our initial report of 5 children from Sheffield with retinal injuries secondary to ‘toy’ lasers,1 which one could argue ought to have therefore been prevented by an effective national public health educational programme. We agree that a public health safety programme aimed at school children would be an excellent idea to discourage the purchase and recreational use of hand-held lasers. One of the authors has lobbied at a recent UK Government Cross Whitehall meeting and the National Home Safety Committee of the Royal Society for the Prevention of Accidents calling for the same. We strongly encourage any ophthalmologist encountering children with laser-induced retinal injury to report such cases, adding to evidence to support legislation and action against those responsible.