Laser pointers: how much does the general medical community know?

To the Editor: In the last several years, laser pointer-related eye injuries have been increasing. The wave started after the manufacture of highly powered laser pointers that resemble the legally available low power (<5 mW) pointers and following their availability at a low cost. Several studies reported various retinal laser injuries including outer foveal disruption, full thickness macular hole, epiretinal membrane, retinal hemorrhage, and choroidal neovascularization [1–4]. Some of these manifestations required surgical intervention, and some caused permanent visual loss. Since physicians commonly use laser pointers and are at risk of mistakenly obtaining a high-power pointer instead, we sought to assess their awareness about the ocular hazards of laser pointers. A cross sectional, international, internet-based anonymous survey of 11 questions (supplementary document) was distributed via email and social media to physicians in various specialties and optometrists. One hundred and three (35.6%) respondents were ophthalmologists, 128 (44.1%) were internists, 30 (10.3%) were surgeons, and 18 (6.2%) were optometrists. The following significant findings were noted: First, 194 (67%) participants use laser pointers during lectures. The pointers were self-owned in 46% of them. Ophthalmologists were more likely to use laser pointers during lectures [73 of 96 (73%)] compared to nonophthalmologists [121 of 194 (62.4%)]; (P = 0.02). Out of these 194 participants, 159 (82%) did not know the power of the pointer they use and 80% never checked its power before using it. Second, 263 (90.7%) respondents did not know the power limit below which the pointer is considered safe. Only 168 of 290 (58%) respondents thought that laser pointers are not safe as far as the eye is concerned while 75 (26%) respondents thought they are, and 47 (16%) did not know if pointers are safe or not. Third, only174 (66%) participants were aware of the availability of high-power pointers at low cost. Fourth, ophthalmologists were more likely to know the safety threshold (P = 0.008), to be aware of the availability of high-power pointers at low cost (P = <0.0001), and to know some of the hazards of laser pointers (P = <0.0001). While larger studies are needed to prove these results, the findings of this survey suggest that we as physicians lack sufficient knowledge regarding laser pointer hazards and safe laser power limits. Besides the associated hazard, since strict regulatory governmental measures and international awareness campaigns, which most likely will involve physicians, are needed to combat the potential public hazard that high-power laser pointers pause, improved physician knowledge of laser basics seems critical.