Abstract

Purpose: To report a case of laser induced maculopathy in a child.

Methods: A eleven-year-old-healthy boy presents to the emergency room with sudden bilateral visual loss for four days. He denied any previous trauma or known etiology. His best corrected visual acuity (BVCA) was 20/200 for far and 20/100 for near, with both eyes. Fundus examination revealed bilateral foveal yellowish-orange (“Best-like”) lesions. Optical coherence tomography (OCT) showed bilateral disruption involving mainly the outer retinal layers. OCT-angiography showed vascular rarefaction on choriocapillaris. A second more thorough anamnesis revealed the boy had been playing with a high power (up to 1000mW) green laser in front of a mirror five days prior. As such, a laser pointer-induced maculopathy diagnosis was assumed and treatment with oral prednisone (1 mg/Kg/day) and topical nepafenac 0.1% for four weeks was instituted. Eighteen months after, his BCVA improved to 20/32 for far and 20/50 for near and fundoscopy shows foveal retinal pigment mottling, with almost no OCT translation.

Conclusion: The safety of laser pointers is a growing major public health concern, especially within the pediatric population. A high degree of suspicion is needed as children most times don’t associate/don’t want to confess a previous laser exposure. Tighter regulations and awareness campaigns are of uttermost importance.

Keywords: Laser Pointer; Maculopathy; Pediatric; Photic Retinopathy

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