![]() 10 Wavelength, pulse duration, spot size, and irradiance(power density, or laser power divided by area) determine the magnitude andlateral extent of temperature rises in exposed tissue produced by incidentlaser beams. 6 - 9 Transmissionand absorption of optical radiation by ocular media depend on the wavelengthof the incident UV radiation, visible light, or infrared radiation. Diagnosisof a retinal laser injury should be evidence based, not a matter of conjectureor speculation.Įxposure to UV radiation (200-400 nm), visible light (400-700 nm), andinfrared radiation (700-10 000 nm) can damage the eye. Accidental, intentional, or clinicalretinal laser lesions do not cause chronic eye, face, or head pains. Case reports demonstrate theusefulness of answering these questions before making diagnostic decisions.Retinal laser lesions that cause serious visual problems are readily apparentophthalmoscopically and angiographically. ![]() Analysis of laser-tissue interactionsand the characteristics of unambiguous retinal laser injuries provide 6 keyquestions to facilitate difficult diagnoses. Decisions are more difficult when retinal findingsare subtle or absent, despite reported visual problems and somatic complaints.Inaccurate diagnosis of an ocular laser injury can precipitate a costly, lengthysequence of medical and legal problems. Shared Decision Making and CommunicationĪccidental retinal laser injuries are easily diagnosed when there areknown laser sources, typical macular injuries, and visual deficits consistentwith retinal findings.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.45 Itis caused by choriocapillaris scarring, so the prognosis for visual improvementafter macular surgery may be worse for laser-induced than idiopathic macularholes. This increasedreflectivity is a characteristic of laser-induced macular holes. C, Optical coherence tomographydocuments a macular hole with increased reflectivity at its base. B, Fluorescein angiography documents a prominent foveal windowdefect due to retinal pigment epithelium atrophy. A, Ten weeks after the injury, there is a full-thicknessmacular hole with surrounding retinal pigment epithelium depigmentation inthe right eye. After the accident, visual acuity was 20/40 OD at 1 year and20/30 OD at 2 years. Thevitreous hemorrhage cleared, and his visual acuity returned to 20/70 duringthe next month. He reportedimmediate vision loss in his right eye, with some improvement after 5 minutes.He sought medical assistance 18 hours after the injury, at which time visualacuity was 20/150 OD, where there was a macular and vitreous hemorrhage. A severe accidental laser injury.A 20-year-old male technician deliberately viewed the output of a laser rangefinderdespite reading warning labels and undergoing laser safety training.
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