Abstract
Handheld laser devices are easily available to purchase through the internet and unregulated marketplaces at a relatively low cost. They are particularly attractive to children as they are seen as ‘high tech', brightly coloured, and known to be able to burn holes in objects such as balloons. There is a widespread lack of knowledge about the risks of viewing the beam emanating directly from handheld lasers, and particularly those with high-output powers. The number of reported laser induced retinopathy (LIR) injuries in children is on the increase in the United Kingdom and represents a major public health issue. The number of individuals affected by LIR is likely to be underestimated owing to lack of presentation to health professionals, general poor awareness and non-reporting by children after the incident. The presentation of LIR is highly variable and dependent on many factors including type of laser, length of exposure and how it is administered. In this article, we review the features of retinal damage associated with inadvertent or deliberate laser administration using a handheld laser device. We highlight the importance of educating the wider public about this increasing problem; children who play with these devices are usually completely unaware of the long-term consequences of laser damage to the eye. It is also important that the features of LIR are recognised by health professionals involved in eye care as they can be mistaken for retinal dystrophies, particularly if the history of laser exposure is not volunteered or elicited.
摘要
手持激光设备很容易以便宜的价格通过互联网和不正规的市场购买。由于看起来十分“高科技”以及色彩鲜艳, 而且还可在物体上如气球上烧洞, 对孩子们有着特别的吸引力。人们对直视手持激光器, 特别是那些具有高输出功率的激光器可能会导致眼病病变的风险普遍认识不足。在英国, 激光所导致的儿童视网膜(LIR)损伤的数量逐年增加, 已经成为一个重大的公共卫生问题。由于健康管理人员缺失, 公众对其普遍认识不足以及缺乏儿童发生事故的报道, 激光导致的视网膜损伤人数似乎被低估。激光导致的视网膜损伤临床表现多变, 同时取决于许多因素, 包括激光种类, 曝光长短, 使用方式。本文中, 我们回顾了由于不经意或是故意用手持激光设备造成的视网膜损伤的特点, 特别强调了向公众普及这种日益增加的风险的重要性; 玩这种设备的儿童完全忽略了长时间的激光照射最终会导致眼部的损伤。同样, 非常重要的是, 从事眼科专业的医生要了解激光导致视网膜损伤的特点, 需要鉴别的其他疾病如视网膜萎缩, 尤其是当患者没有自己陈述激光暴露史的时候。
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Acknowledgements
We thank Mark Mackenzie and Fiona Thorburn (Institute of Photonics and Quantum Sciences, Heriot Watt University, Edinburgh) for providing the photographs of the red and green lasers.
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Neffendorf, J.E., Hildebrand, G.D. & Downes, S.M. Handheld laser devices and laser-induced retinopathy (LIR) in children: an overview of the literature. Eye 33, 1203–1214 (2019). https://doi.org/10.1038/s41433-019-0395-1
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DOI: https://doi.org/10.1038/s41433-019-0395-1
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