Severe Linear Retinal Burn from a Handheld Laser Pointer in a Pediatric Patient: A Case Report

This paper presents a unique case of handheld laser-induced retinal injury associated with maculopathy and linear scotoma in a pediatric patient.

A 12-year-old boy with no significant medical or ocular history presented with a scotoma in his right eye after using a handheld green laser pointer, labeled as 5 mW, 532 nm. Visual acuity was 20/20 in both eyes. Fundus examination revealed focal retinal damage at the macula with a linear burn extending from the 10 o'clock to 4 o'clock position, consistent with laser-induced phototoxicity. Fundus autofluorescence (FAF) demonstrated focal hyperfluorescence along the linear path, indicative of outer retinal and retinal pigment epithelium (RPE) disruption. With observation, symptoms improved, although the scotoma remained at most recent outside follow-up three years after injury.

High-power handheld laser pointers are widely available and capable of causing significant retinal damage, particularly in children. This case demonstrates a previously unreported pattern of retinal injury, highlights the importance of multimodal imaging in diagnosis, and underscores the need for further investigation into treatment options. Additionally, increased public awareness and stricter safety regulations are essential to reducing the incidence and impact of these preventable injuries.