This 18YO patient presented with sudden painless 20/400 vision loss in his left eye. He admitted to staring 3 days earlier directly into his recently purchased green laser pointer.
There are multifocal small subretinal pigment clumps in the left central macula and fluorescein angiogram reveals variable areas of hypo and hyperfluorescence. OCT shows EZ attenuation with hyperreflectivity above the RPE.
Learning Points:
Ocular damage from these lasers depends highly on the laser wavelength, power and duration. The US regulates hand-held laser pointers as a category 3R, which cannot exceed 5 mW. However, a 2013 study looking at 122 laser pointers labeled as 3R found that 90% of green and 44% of red laser pointers actually exceeded the 5mW limit.
