Laser Eye Exposure: Symptoms, Treatments, and Specialist Referrals

The eye was exposed to laser light?

Hello, about two months ago, I was exposed to a 532 nm green laser in an experiment (both eyes were scanned, approximately 0.1 mW, without protective goggles).
I didn't notice it at the time, but I felt a flickering sensation in front of my eyes and saw tiny transparent white dots flickering (more noticeable when looking at dark areas or in a dark room).
During a retinal examination at the clinic, it was attributed to my myopia (approximately -600 degrees), and it was noted that my retina was thinning.
A month later, I occasionally experienced moving shadows in front of my vision.
After further examination at the hospital, including a retinal exam, OCT, and wide-angle retinal imaging, the doctor also believed it was related to my myopia.
Both eyes underwent focal retinal laser treatment (the left eye showed degeneration, and the right eye had two or three peripheral holes).
However, after another month, these symptoms persist.

I would like to ask:
1.
If the laser exposure has caused retinal cell death, are there any medications or remedial treatments available? Additionally, since the retinal examination did not reveal any cell death, is there any equipment that can assess whether the visual cells are damaged?
2.
I have had persistent tinnitus in my right ear for about 8 years.
Could this possibly be related to a benign tumor or something similar (as I have had benign tumors in other parts of my body) affecting both my ear and eyes? Should I consider consulting a neurologist? Thank you.

Xiao Ming, 20~29 year old female. Ask Date: 2019/03/26

Dr. He Jianxian reply Ophthalmology

The damage caused by a laser is immediate.
If your retina is hit by laser light, early damage should be visible during a dilated fundus examination; if it is not visible, it is likely that there is no damage.
Furthermore, the energy of the laser light you were exposed to is only about one-thousandth of what we use clinically, making it unlikely to cause any significant issues.

Reply Date: 2019/03/26

More Info

Laser eye exposure, particularly from a green laser, can raise significant concerns regarding potential damage to the retina and other ocular structures. Your experience of flickering sensations and the presence of white spots after exposure suggests that there may have been some impact on your visual system, even if initial examinations did not reveal any immediate damage.

1. Potential Damage and Treatment Options
If laser exposure has indeed caused retinal damage, the symptoms you're experiencing—such as flickering lights and black shadows—could be indicative of retinal photoreceptor cell death or dysfunction. Unfortunately, once retinal cells are damaged, they do not regenerate, and there are currently no medications that can reverse this type of damage. However, there are some treatment options and management strategies that can help mitigate symptoms or prevent further deterioration:
- Regular Monitoring: Continued follow-up with an ophthalmologist is crucial. They can monitor your condition over time, especially since you have a history of myopia and retinal issues. Regular OCT (Optical Coherence Tomography) scans can help assess the health of the retina and detect any changes.

- Protective Measures: If you are still exposed to bright lights or lasers in your work or daily life, using protective eyewear is essential to prevent further damage.

- Symptomatic Treatment: For symptoms like flickering or visual disturbances, some patients find relief through visual aids or specific eye exercises, although these do not address the underlying damage.

- Consultation with a Retina Specialist: If your symptoms persist, it may be beneficial to seek a second opinion from a retina specialist who can provide more targeted assessments and treatment options.

2. Investigating Other Symptoms
Regarding your long-standing tinnitus (ear ringing), it is wise to consider a comprehensive evaluation. While tinnitus is often benign, it can sometimes be associated with other conditions, including vestibular disorders or even tumors, such as vestibular schwannomas. Here are some steps you might consider:
- Neurological Evaluation: Consulting a neurologist can help determine if there is a connection between your ear symptoms and any potential neurological issues. They may recommend imaging studies, such as an MRI, to rule out any structural abnormalities.

- Audiological Assessment: An audiologist can perform tests to evaluate your hearing and assess the nature of your tinnitus. This can provide insights into whether the tinnitus is related to hearing loss or other auditory issues.

- Multidisciplinary Approach: Given the complexity of your symptoms, a multidisciplinary approach involving both ophthalmology and neurology may yield the best outcomes. This way, both your visual and auditory symptoms can be addressed holistically.

Conclusion
In summary, while there are no direct treatments for retinal cell death caused by laser exposure, ongoing monitoring and protective measures are essential. If your symptoms persist, seeking further evaluation from specialists in both ophthalmology and neurology can provide a clearer understanding of your condition and potential management strategies. Always prioritize protective measures in environments where laser exposure is a risk, and maintain regular check-ups to ensure your ocular health is closely monitored.

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