Session Title: New Drug Treatment and Technology I
Session Date/Time: Friday 18/09/2015 | 11:00-12:30
Paper Time: 11:32
First Author: : N.Pawlowska UNITED KINGDOM
Co Author(s): : N. Raoof F. Quhill
PURPOSE:To establish the presence of additional cases of macular injury as a result of misuse of handheld laser devices within Europe.
Anonymised online survey distributed among Euretina members via email.
A brief online survey was emailed to all active members of Euretina, asking if they had encountered any patient who suffered macular injury as a result of misuse of a handheld laser device. Members who gave us a positive answer were further asked the following: i) the number of patients they had come across, ii) the ages of the patients, iii) whether the injury was accidental, self-inflicted or deliberate, iv) the colour of the laser beam, v) its power output, vi) the device’s purchase history (online/high street/within or outside the EU), vii) if patients suffered long-term vision loss and whether there was any evidence of injury on optical coherence topography (OCT) or visual field testing. In order to keep the survey brief and encourage survey completion, members who indicated seeing more than 2 patients were only asked to provide the details of the most and least affected patients. Not all the members who reported seeing a patient with macular injury due to handheld laser device completed the survey fully. The data has been analysed based on fully completed surveys.
146 survey responses were received. 59 members reported a patient with a macular injury secondary to a handheld laser (40.4%) with 7 members (4.8%) seeing more than 5 patients. A majority of respondents had encountered patients more than 1 year ago, however at least 16 members (41%) came across a case more recently. Most of the affected patients were 10 to 20 years old (56.4%), with 6 members (15.3%) reporting injuries in children aged below 10. The majority of the injuries (53.8%) were accidental, with 10 members (25.7%) reporting self-inflicted injuries; a minority of 8 members (20.5%) reported that these injuries were the result of an assault. The power of most of the devices was unknown, although the power of known devices exceeded 50 mW in 50% of cases. Where known, most devices were purchased on the high street outside the European Union, with 12 and 8 members reporting devices bought within the EU and online, respectively. Most patients (36%) suffered mild vision loss (6/9-6/12 Snellen), while 18% suffered severe vision loss (less than 6/60 Snellen). Acuity was not affected in 28% of cases.
As our survey shows, macular injuries secondary to handheld laser device exposure are considerably more common than anticipated. The majority of patients suffer vision loss as a result, and most patients are in their teenage years. Such an injury can have detrimental lifelong effects. Worryingly, the output power of most of the devices was significantly higher than that deemed safe for consumer use, as recommended by the European standard for laser products (EN 60825-1:2007) and EC directive 2014/59/EU (up to 1mW). Such devices can be purchased online or on the high street within or outside the EU. We intend to share our findings with the Director of Consumer affairs at the European Commission and CENELEC (European Committee for Electrotechnical Standardisation). We also encourage ophthalmologists to report cases of injuries secondary to handheld laser exposure to their local trading standards or to the online consumer rapid alert system (RAPEX) to promote a change in legislation.