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Free 51,000+ file retina image bank cataloged by disease state. Highlights over 14,000 critical journal articles for additional education.

Being on the wrong end of a bullseye 🎯

Laser maculopathy with acute sub-ILM hemorrhage

Today’s European VitreoRetina Society (EVRS) (@evrsimagebank) was submitted by Shraddha Chandorkar (dr.shraddhachandorkar).

This healthy 19YO female noted sudden vision loss in her right eye, immediately after she looked directly at the light, while attending a DJ laser party. When she presented to us 2 days later, vision was hand motion OD and 20/20 in her normal OS.

Fundus photography and OCT show a partially layered central macular sub-internal limiting membrane (ILM) hemorrhage (image 1).
DJ laser machines typically fall into Class 3R or Class 4, depending on their power output. These lasers emit visible light in the red (635–650 nm), green (520–532 nm), and blue (445–460 nm) wavelengths, often combined for full RGB effects. While visually stunning, high-powered lasers, especially Class 4, can pose serious risks, including retinal burns, if beams enter the audience area or are viewed directly. Blue wavelengths are particularly hazardous due to their shorter wavelength and higher energy density. A strikingly similar case to our patient was reported by Perz-Montano et al (Doc Ophthalmol 2019;138:71–76).

To protect audiences, professional setups use a combination of engineering controls and regulatory compliance. This includes scan fail-safe systems, beam termination zones, and power-limiting protocols to stay below the Maximum Permissible Exposure. In the US, the FDA’s Center for Devices and Radiological Health oversees these devices, requiring manufacturers to submit safety documentation and operators to file a Laser Light Show Variance for public performances. Proper mounting, trained personnel, and adherence to ANSI and IEC standards are essential to ensure safe and compliant laser shows.
When examined 1 week later, the blood was drained via a YAG laser due to no improvement in her vision or sub-ILM blood. Two months later, vision improved to 20/20 despite multiple paracentral scars (image 2).

Go to www.retinarocks.org/cases for more laser maculopathy cases.

Cr: @retina.rocks

#eye #goviral #optometrists #ophthalmologist #eyeclinicinabuja

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$#RetinaRocks Choroidal rupture Tennis, Anyone? Today’s case was submitted by Abhishek Karra and and Ravindra Karra. This 16YO male presented with acute vision loss in his left eye 3 days earlier following blunt trauma from a tennis ball. Vision was counting fingers. Fundus photography (image 1) shows diffuse thin subretinal blood with multiple choroidal ruptures (arrows). Observation was recommended. Vision improved to 20/200 at 6 weeks, with resolution of all blood (image 2). There are mild granular pigmentary changes in the central macula. An acute submacular hemorrhage following blunt trauma almost always indicates an underlying choroidal rupture. As the blood clears, the rupture appears as a curvilinear or crescent-shaped yellowish-white lesion. It occurs due to rapid compression-expansion stress on Bruch's membrane, which is less elastic and has less tensile strength than the sclera, leading to its fracture. The final vision is usually good unless the rupture extends through the macular center. These patients need to be followed long-term due to the increased risk of macular neovascularization. Go to www.retinarocks.org/cases for more choroidal rupture cases. [This case can be found on www.retinarocks.org in the Image Gallery, Choroidal rupture folder, Choroidal rupture ZIL-] Have an interesting case and want to help your peers learn something about the retina? Submit your images at www.retinarocks.org. This case is courtesy of www.retinarocks.org, one of the world’s largest online, open-source retina teaching collections. This free 45,000+ file image bank is cataloged by disease state and also includes over 11,000 critical journal article citations for additional education. Cool cases are posted Monday thru Friday on Instagram @retina.rocks (Link in bio)$

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