Laser eye injuries in military occupations.
BACKGROUND
Lasers (light amplification by stimulated emission of radiation) play an important role in our world and their use is increasing. They are powerful tools for good, but can also cause tragedy, especially in an aviation environment. Information about injuries associated with lasers is limited. This study highlights several laser eye injuries in the U.S. military and discusses issues pertaining to them.


METHODS
We gathered data from the U.S. Army Safety Center, the U.S. Army Center for Health Promotion and Preventive Medicine, and the Walter Reed Army Institute of Research. This paper describes ten representative cases of laser eye injury that occurred in the U.S. military between 1984 and 2000.


RESULTS
Patients suffered retinal damage, though no corneal injury occurred. Most were caused by accidental exposure to a Q-switched, Neodynium:YAG (Nd:YAG) laser at 1064 nm wavelength. The incidents occurred both on and off duty, indoors and outdoors, and from close and long ranges. None of the victims were wearing eye protection. Inadequate training and poor equipment design were major factors in at least six of the nine unintentional cases. The tenth occurred during military operations in the Persian Gulf. All of the victims needed several months medical care and follow up. Two received medical discharges as a result of their injuries.


CONCLUSIONS
As illustrated by these cases, human and societal costs from unintentional laser eye injuries can be reduced by improving operator training, safety procedure compliance, and equipment design. In addition, intentional laser eye injuries are a growing concern and further research is needed to design appropriate protection, treatment and countermeasures.
D000328:Adult; D005131:Eye Injuries / Q000209:etiology*; D006801:Humans; D007834:Lasers / Q000009:adverse effects*; D008297:Male; D008889:Military Personnel; D009354:Neodymium / Q000009:adverse effects; D009784:Occupational Diseases / Q000209:etiology*; D012160:Retina / Q000293:injuries*; D012166:Retinal Hemorrhage / Q000209:etiology; D012607:Scotoma / Q000209:etiology
D009354:Neodymium