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Proceedings Paper

Accidental bilateral Q-switched neodymium laser exposure: treatment and recovery of visual function
Author(s): Harry Zwick; Bruce E. Stuck; Weldon Dunlap; David K. Scales; David J. Lund; James W. Ness
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Paper 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.

Paper Details

Date Published: 13 May 1998
PDF: 10 pages
Proc. SPIE 3254, Laser-Tissue Interaction IX, (13 May 1998); doi: 10.1117/12.308151
Show Author Affiliations
Harry Zwick, Walter Reed Army Institute of Research (United States)
Bruce E. Stuck, Walter Reed Army Institute of Research (United States)
Weldon Dunlap, Brooke Army Medical Ctr. (United States)
David K. Scales, Retina and Uveitis Consultants of Texas (United States)
David J. Lund, Walter Reed Army Institute of Research (United States)
James W. Ness, Walter Reed Army Institute of Research (United States)

Published in SPIE Proceedings Vol. 3254:
Laser-Tissue Interaction IX
Steven L. Jacques; Jeff Lotz, Editor(s)

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