Department of Ophthalmology, Bolton Hospitals NHS Foundation Trust, Bolton, UK.
Department of Ophthalmology, Lancashire Teaching Hospitals NHS Foundation Hospital, Preston, UK.
Eye (Lond). 2019 Mar;33(3):492-504. doi: 10.1038/s41433-018-0276-z. Epub 2018 Dec 13.
To explore self-inflicted retinal burns from laser pointers in children.
Literature review of laser pointer retinal injuries in childhood and online survey of UK Consultant Ophthalmologists. A cohort of local children with self-inflicted injury is described. The matter is topical. We review progress in recent legislation and policy change in the UK.
Four of 77 case reports of laser burns in childhood analysed reported psychological or behavioural issues. Three of four children in our cohort had such issues. Delay in diagnosis occurred in two of our patients. Structural retinal damage persisted for over 12 months in all four children (seven eyes). Our survey of UK ophthalmologists found 159 cases of injury (85% male), 80% under 20 years of age. The majority of the laser pointers were purchased online. Many patients (36%) suffered moderate vision loss (6/18 to 6/60 Snellen), while 17% (at least 11 patients) suffered severe vision loss (<6/60 Snellen).
We highlight the risk of macular damage and vision loss from handheld lasers specifically in children with behavioural, learning or mental health issues. The diagnosis may be difficult or delayed in such children. In children with uncertain macular changes, ophthalmologists should explore the history for possible instances of exposure to handheld lasers pointers. Regulatory authorities and manufacturers of handheld lasers need to be aware of the risk to children. Furthermore, there is a need to better inform parents, carers and teachers of the risk of ocular self-injury from such lasers pointers.
探讨儿童因激光笔导致的自伤性视网膜烧伤。
对儿童激光笔视网膜损伤的文献进行回顾，并对英国顾问眼科医生进行在线调查。描述了一组当地因自伤而受伤的儿童。这是一个热门话题。我们回顾了英国最近立法和政策变化的进展。
在分析的 77 例儿童激光烧伤病例报告中，有 4 例报告有心理或行为问题。我们的患儿队列中有 3 例有此类问题。我们的两名患者出现了诊断延迟。四名患儿（七只眼）的结构性视网膜损伤持续了 12 个月以上。我们对英国眼科医生的调查发现了 159 例伤害病例（85%为男性），年龄均在 20 岁以下。大多数激光笔是在网上购买的。许多患者（36%）视力中度下降（6/18 至 6/60 视力表），而 17%（至少 11 名患者）视力严重下降（<6/60 视力表）。
我们强调了行为、学习或心理健康问题的儿童手持激光笔可能导致黄斑损伤和视力丧失的风险。在这些儿童中，诊断可能困难或延迟。对于黄斑变化不确定的儿童，眼科医生应在病史中探索是否存在接触手持激光笔的可能。手持式激光笔的监管机构和制造商需要意识到儿童面临的风险。此外，有必要让父母、照顾者和教师更好地了解此类激光笔对眼部自伤的风险。
