title: Maculopathy following exposure to visible and infrared radiation from a laser pointer: a clinical case study.
abstract: OBJECTIVE
  Laser pointer devices have become increasingly available in recent years, and their misuse has caused a number of ocular injuries. Online distribution channels permit trade in devices which may not conform to international standards in terms of their output power and spectral content. We present a case study of ocular injury caused by one such device.
  
  
  METHODS
  The patient was examined approximately 9 months following laser exposure using full-field and multifocal electroretinography (ERG and MF-ERG), electrooculography (EOG), and optical coherence tomography (OCT), in addition to a full ophthalmological examination. MF-ERG, OCT, and the ophthalmological examination were repeated 7 months after the first examination. The output of the laser pointer was measured.
  
  
  RESULTS
  Despite severe focal damage to the central retina visible fundoscopically and with OCT, all electrophysiological examinations were quantitatively normal; however, qualitatively the central responses of the MF-ERG appeared slightly reduced. When the MF-ERG was repeated 7 months later, all findings were normal. The laser pointer was found to emit both visible and infrared radiation in dangerous amounts.
  
  
  CONCLUSIONS
  Loss of retinal function following laser pointer injury may not always be detectable using standard electrophysiological tests. Exposure to non-visible radiation should be considered as a possible aggravating factor when assessing cases of alleged laser pointer injury.
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland. james.hanson@usz.ch.
authors.forename: James V M
authors.initials: JV
authors.lastname: Hanson
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
authors.forename: Julian
authors.initials: J
authors.lastname: Sromicki
authors.affiliation: Institute for Quantum Electronics, ETH Zurich, Auguste-Piccard-Hof 1, 8093, Zurich, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Mangold
authors.affiliation: Institute for Quantum Electronics, ETH Zurich, Auguste-Piccard-Hof 1, 8093, Zurich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Golling
authors.affiliation: Department of Ophthalmology, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
authors.forename: Christina
authors.initials: C
authors.lastname: Gerth-Kahlert
mesh_terms: D002648:Child; D004585:Electrooculography; D004596:Electroretinography / Q000379:methods; D005260:Female; D006801:Humans; D007259:Infrared Rays / Q000009:adverse effects*; D007834:Lasers / Q000009:adverse effects*; D008027:Light / Q000009:adverse effects*; D012160:Retina / Q000503:physiopathology / Q000528:radiation effects*; D012164:Retinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
keywords: ERG; MF-ERG; OCT; Ocular laser injury