The dangers of laser pointers for children

Dr. Amanda Rey, a member of the Retina and Vitreous Department at ICR, explained the dangers associated with the use of laser pointers on the retina in one of the weekly Clinical Sessions at ICR. The main risk of this kind of device lies in looking straight into the beam of light, whether it is directly or through a mirror.

As Dr. Rey informed, there has been an increase of pediatric patients in the emergency service with injuries in their retina caused by playing with this type of lasers. In some cases the consequences are very serious for the patient’s sight, who can have their reading and driving capacity compromised for life.

The gravity of the injury will depend fundamentally on the kind of laser and its power, the time of exposure and the distance from which the ray reaches the eye. Several medical studies confirm that if the laser reaches the fovea, the most vulnerable area of the retina, a thermal burn might occur, unchaining a loss of vision.

The clinical spectrum may widely vary: alteration of the external layers of the retina, hemorrhage, macular hole, membrane epiretinal or choroidal neovascularization. In some cases the patients have required invasive treatments like intravitreal injections o la vitrectomy eye surgery.

The FDA (Food and Drug Administration), provided some guidelines in order to reduce the injury risk with laser pointers. They insisted in the importance of avoiding to point directly at the eyes of people or animals, as well as not using these devices on reflective surfaces.

If a laser pointer must be used, it is necessary to be aware of its power and characteristics. At the same time it is necessary to remember that it cannot be used with ludic purposes since although it is very attractive for the little ones, a misuse can have fatal consequences. If any symptom appears, it is essential to go to a centre of Ophthalmological Emergencies 24h.

FDA suggestions for the use of laser pointers

• Never point anyone with a laser pointer
• Don’t use it over reflective surfaces
• Don’t buy laser pointers for children
• Don’t use them with ludic purposes
• The power of the beam of light should not exceed five milliwatts, because over that power, the time for a safe exposure decreases. Permanent damage in the eyes and skin can happen quickly.
• When buying a laser pointer, always check the label. It should indicate the name of the manufacturer and the date of making, with a warning to avoid the exposure to laser radiation.

How can we know if a laser pointer is too strong?

If the power of the laser pointer is unknown, the following guidelines can be indicative:

1. If the pointer is small and works with button cells, it is likely that its power is under five milliwatts.
2. If the pointer is the size of a pen and works with AA or AAA batteries, it is likely to be stronger and therefore above 5 milliwatts.
3. If it has the size of a flashlight and works with AA, AAA or lithium batteries it is likely that the pointer has more than 5 milliwatts.
4. If the pointer is used without the removable lid that distributes the light following a pattern, the light coming from the laser becomes the single beam of light, therefore its power increases.
5. If the pointer is bought online, there are keywords that manufacturers use, that might indicate that the laser pointer has more than 5 milliwatts. For instance: powerful, bright, ultra, super, military, strong, pop balloons, burn o lithium battery.

Why are blue and violet light lasers more dangerous?

The human eye is less sensitive to the colors blue and violet. That is why, according to the FDA, blue or violet light lasers can be particularly dangerous. The blinking or dodging response will be slower with these colors than the one with red or green lights. Thus, the first mentioned colors can cause a bigger injury.

More information

• Laser Toys: How to Keep Kids Safe, U.S. Food and Durg Administration (FDA)
• Is Your Laser Pointer Dangerous Enough to Cause Eye Injury?, American Academy of Ophthalmology (AAO)
• Macular Hole from a Laser Pointer. Sofia Androudi, M.D., Ph.D., and Eleni Papageorgiou, M.D., Ph.D. The New England Journal of Medicine, Juny 2018.