Accidental bilateral Q-switched neodymium laser exposure: treatment and recovery of visual function

Harry Zwick; Bruce E. Stuck; Weldon Dunlap; David K. Scales; David J. Lund; James W. Ness

doi:10.1117/12.308151

13 May 1998 Accidental bilateral Q-switched neodymium laser exposure: treatment and recovery of visual function

Harry Zwick, Bruce E. Stuck, Weldon Dunlap, David K. Scales, David J. Lund, James W. Ness

Proceedings Volume 3254, Laser-Tissue Interaction IX; (1998) https://doi.org/10.1117/12.308151
Event: BiOS '98 International Biomedical Optics Symposium, 1998, San Jose, CA, United States

Abstract

A 21 year old female was accidentally exposed in both eyes when she looked into the 10 cm exit aperture of a military laser designator emitting 1064 nm q-switched (30 ns) pulses at a 10 pulse per second rate. Steroid therapy (methylprednisolone sodium succinate) was initiated within 6 hours post exposure. Initial ophthalmoscopic observation revealed small contained macular hemorrhages in each eye. Fluorescein angiography (FA) showed minimal leakage. Visual acuity was 20/100 and 20/60 in OD and OS respectively. Contrast sensitivity in both eyes was depressed across all spatial frequencies by more than 1.5 log units. At four weeks post exposure, no significant macular scarring was apparent and visual acuity returned to 20/25 in both eyes. Contrast sensitivity had improved to normal levels with a peak at 3 cycles/degree. At one year post exposure, visual acuity was 20/13 in both eyes and measures of contrast sensitivity were within normal limits. During the course of recovery, the patient's fixation shifted from a slightly superior temporal site back to the central foveal region. The foveal lesion sites were still evident by ophthalmoscopy and Amsler grid measurements but were deemed functional when the patient placed small targets generated by the scanning laser ophthalmoscope in the lesion site for discrimination. This outcome indicates remarkable recovery of visual function and suggests that early administration of steroids may assist in preserving the natural neural recovery process of the photoreceptor matrix by minimizing intraretinal scar formation.

Citation Download Citation

Harry Zwick, Bruce E. Stuck, Weldon Dunlap, David K. Scales, David J. Lund, and James W. Ness "Accidental bilateral Q-switched neodymium laser exposure: treatment and recovery of visual function", Proc. SPIE 3254, Laser-Tissue Interaction IX, (13 May 1998); https://doi.org/10.1117/12.308151

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