Medical History:
A 25-year-old female patient presented with complaint of vision loss in the right eye. She was accidentally exposed to a cosmetic laser.
Diabetes mellitus (-)
Systemic hypertension (-)
Family history (-)
Smoking (-)
Trauma (-)
Examination Findings
Best corrected visual acuity was counting fingers from 1 meter distance in the right eye and 10/10 in the left eye. Intraocular pressure was 17 mmHg in the right eye and 16 in the lefte ye. Anterior segment examination was unremarkable. Fundus examination of the right eye showed a large hypopigmented scar and retinal hemorrhages at the posterior pole. Fundoscopic examination of her left eye was unremarkable (Figure 1).
Optic coherence tomography (OCT) scan demonstrated hyperreflective band on the retinal surface, loss of the foveal depression and subfoveal hyperreflectivity in the right eye (Figure 2).
Diagnosis
Accidental Macular Injury Induced by Cosmetic Laser
Lasers are a commonly used tool for many cosmetic procedures. While these cosmetic laser procedures are generally considered to be safe, ocular injuries may occur rarely. The risk increases when procedures are performed in the periorbital region, where the chance of a misdirected laser at the eye with inadequate safety precautions is higher. Inappropriate use of cosmetic lasers has led to reports of subfoveal and intraretinal hemorrhages. On fundus examination, subfoveal or intraretinal hemorrhage can be noted. Macular SD-OCT would reveal hyper-reflective lesions. Choroidal neovascularization can occur as an adverse event.
Treatment
The treatment of ocular damage due to cosmetic lasers depends on the extent and type of injury sustained. Intravitreal anti-VEGF agents are found to be effective in cases complicated with chroidal neovascularisation.
References:
Asiri MS, Alharbi M, Alkadi T, et al. Ocular injuries secondary to alexandrite laser-assisted hair removal. Can J Ophthalmol. 2017;52:71-75. https://pubmed.ncbi.nlm.nih.gov/28457309/
