Accidental Macular Injury with a Nd:YAG 1064 nm Wavelength Laser Machine: A Case Report
Year: 2022
Type: article
Study design: Case Report
Abstract: A31-year-old beautician trainee who was 30 weeks pregnant was operating a Nd:YAG (neodymium-doped yttrium aluminum garnet) cosmetic laser machine of 1064 nm wavelength without wearing protective glasses. While adjusting the lens, the laser fired inadvertently into her right eye and immediately she experienced a sudden loss of central vision followed by floaters. Her best-corrected visual acuity was 20/160 OD and 20/20 OS. The intraocular pressure and anterior segment examination were bilaterally unremarkable. Fundus examination of the right eye revealed subfoveal and intraretinal hemorrhage at the fovea with breakthrough pre-retinal and vitreous hemorrhage over the macula. The left fundus was unaffected. Optical coherence tomography (OCT) scan of the right eye showed full-thickness retinal hyperreflectivity with posterior shadowing at the fovea due to hemorrhage. Overlying hyperreflective dots was corresponding to vitreous hemorrhage (Fig. 1). Seven weeks after observation, her vision improved to 20/40. The foveal and vitreous hemorrhage resolved completely leaving a small, pigmented scar just inferior to fovea. OCT scan showed loss of ellipsoid zone and external limiting membrane at the fovea and atrophy of the retinal pigment epithelium (Fig. 2). This report highlights the importance of eye safety protocols for those operating lasers in the cosmetic industry.Figure 1: A, Color fundus photo of the right eye showing foveal hemorrhage, pre-retinal and vitreous hemorrhage over the macular area. B, Optical coherence tomography macular scan showing of the right eye showed full-thickness retinal hyperreflectivity with posterior shadowing in the foveal area with pre-retinal hyperreflective dots.Figure 2: A, Color fundus photo of the right eye 7 weeks later showing the small, pigmented scar just inferior to fovea. B, Optical coherence tomography scan of right eye showing subfoveal loss of ellipsoid zone, external limiting membrane, and foveal atrophy.
Authors: Janika Shah, Robert Chong, I-Van Ho
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W4207001763