Retinal laser accidents: mechanisms and management

Retinal injuries from industrial or military lasers are uncommon, but laser accidents can injure the retina and destroy central vision, permanently. Key principles of retinal anatomy and psychophysics provide a basis for understanding laser-retinal interactions, retinal trauma, and treatment options. Immediate vision loss after a laser accident depends primarily on the location and extent of retinal damage and vitreoretinal hemorrhage. Prompt ophthalmic evaluation of accident victims is indicated to determine the nature and severity of injuries to the cornea, iris, crystalline lens, and retina. There are no clinically proven therapies for minimizing the acute effects of retinal laser injuries, but vitreoretinal surgery is useful for managing complications such as persistent vitreous hemorrhages, macular holes, and epiretinal membranes. The best way to manage laser trauma is to prevent it.