Laser injury - Revision history

ClaireLewis at 20:03, 1 October 2019

2019-10-01T20:03:59Z

← Revisión anterior		Revisión del 20:03 1 oct 2019
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	''Main organ of concern; range of effects as below starting with the most severe to the least; damage from thermal / photochemical / photomechanical process''		''Main organ of concern; range of effects as below starting with the most severe to the least; damage from thermal / photochemical / photomechanical process''
	* Tissue vaporization		* Tissue vaporization
	* Retinal hemorrhage / ocular holes		* [[Retinal hemorrhage]] / ocular holes
	* Retinal burn / corneal burn / irreversible scotoma/minimal visible lesion		* Retinal burn / corneal burn / irreversible scotoma/minimal visible lesion
	* Histological damage / irreversible scotoma / cataract		* Histological damage / irreversible scotoma / cataract
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	** Can be calculated if power (mW), divergence (mrad), and diameter at aperture (mm) is known		** Can be calculated if power (mW), divergence (mrad), and diameter at aperture (mm) is known
	* Flash blindness / after images / reversible scotoma		* Flash blindness / after images / reversible scotoma
	** visual loss temporary		** [[visual loss]] temporary
	** lasts seconds to minutes		** lasts seconds to minutes
	** similar to flashbulb effect		** similar to flashbulb effect
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	===Skin===		===Skin===
	''Second organ of concern; effect more dependent on wavelength of laser''		''Second organ of concern; effect more dependent on wavelength of laser''
	* thermal ~~burn~~ - IR, visible, UV-A laser		* thermal [[burns]] - IR, visible, UV-A laser
	* photosensitivity - Visible, UV-A laser		* photosensitivity - Visible, UV-A laser
	* darkening - UV-A laser		* darkening - UV-A laser

Rossdonaldson1: /* Evaluation */

2018-02-16T07:55:58Z

Evaluation

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	** Stereopsis		** Stereopsis
	** Color vision		** Color vision
	** Slit lamp examination		** [[Slit lamp examination]]
	** Retinal (fundoscopic) examination		** Retinal (fundoscopic) examination

Rossdonaldson1: /* Evaluation */

2018-02-16T07:55:27Z

Evaluation

← Revisión anterior		Revisión del 07:55 16 feb 2018
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	* accelerated skin aging - UV-B		* accelerated skin aging - UV-B
	* skin cancer/erythema - UV-C		* skin cancer/erythema - UV-C

			==Differential Diagnosis==

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* References */

2018-02-16T07:55:07Z

References

← Revisión anterior		Revisión del 07:55 16 feb 2018
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	[[Category:Military]]		[[Category:Military]]
			[[Category:Dermatology]]
			[[Category:Ophthalmology]]

Rossdonaldson1: Rossdonaldson1 moved page Laser Eye Injury to Laser injury

2018-02-16T07:54:15Z

Rossdonaldson1 moved page Laser Eye Injury to Laser injury

← Revisión anterior	Revisión del 07:54 16 feb 2018
(Sin diferencias)

Rossdonaldson1: /* Clinical Features */

2018-02-16T07:53:52Z

Clinical Features

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	==Clinical Features==		==Clinical Features==
	* Eye ~~- main~~ organ of concern; range of effects as below starting with the most severe to the least; damage from thermal / photochemical / photomechanical process		===Eye===
	** Tissue vaporization		''Main organ of concern; range of effects as below starting with the most severe to the least; damage from thermal / photochemical / photomechanical process''
	** Retinal hemorrhage / ocular holes		* Tissue vaporization
	** Retinal burn / corneal burn / irreversible scotoma/minimal visible lesion		* Retinal hemorrhage / ocular holes
	** Histological damage / irreversible scotoma / cataract		* Retinal burn / corneal burn / irreversible scotoma/minimal visible lesion
	** Nominal ocular hazard distance (NOHD)		* Histological damage / irreversible scotoma / cataract
	*** Distance from laser source which the intensity of a single laser beam becomes safe by not exceeding the maximum permissible exposure		* Nominal ocular hazard distance (NOHD)
	*** Laser is dangerous if viewed from a closer distance than this		** Distance from laser source which the intensity of a single laser beam becomes safe by not exceeding the maximum permissible exposure
	*** Can be calculated if power (mW), divergence (mrad), and diameter at aperture (mm) is known		** Laser is dangerous if viewed from a closer distance than this
	** Flash blindness / after images / reversible scotoma		** Can be calculated if power (mW), divergence (mrad), and diameter at aperture (mm) is known
	*** visual loss temporary		* Flash blindness / after images / reversible scotoma
	*** lasts seconds to minutes		** visual loss temporary
	*** similar to flashbulb effect		** lasts seconds to minutes
	** Glare/dazzle		** similar to flashbulb effect
	*** no permanent damage results		* Glare/dazzle
	*** similar to driving into the setting sun		** no permanent damage results
	** Distraction		** similar to driving into the setting sun
	* Skin ~~- second~~ organ of concern; effect more dependent on wavelength of laser		* Distraction
	** thermal burn - IR, visible, UV-A laser
	** photosensitivity - Visible, UV-A laser		===Skin===
	** darkening - UV-A laser		''Second organ of concern; effect more dependent on wavelength of laser''
	** accelerated skin aging - UV-B		* thermal burn - IR, visible, UV-A laser
	** skin cancer/erythema - UV-C		* photosensitivity - Visible, UV-A laser
			* darkening - UV-A laser
			* accelerated skin aging - UV-B
			* skin cancer/erythema - UV-C

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Background */

2018-02-16T07:46:41Z

Background

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	** Dependent on output power, distance from source to target, and beam divergence		** Dependent on output power, distance from source to target, and beam divergence
	** Human eye can focus laser to a very small area on the retina increasing the irradiance by a factor of 100,000		** Human eye can focus laser to a very small area on the retina increasing the irradiance by a factor of 100,000
	* ANSI Classification of Laser
			===ANSI Classification of Laser===
	: Class 1 - non-hazardous		: Class 1 - non-hazardous
	: Class 2 - visible laser, aversion response will protect		: Class 2 - visible laser, aversion response will protect

Rossdonaldson1: /* Disposition */

2018-02-16T07:46:18Z

Disposition

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	* Consult ophthalmologist if persistent symptoms or positive findings on examination suggesting laser eye injury such as retinal hemorrhage, corneal burn, ocular holes, etc.		* Consult ophthalmologist if persistent symptoms or positive findings on examination suggesting laser eye injury such as retinal hemorrhage, corneal burn, ocular holes, etc.

			==See Also==

	==References==		==References==

RSarlay: Created page with "==Background== * Use of lasers in civilian and military applications is increasing * Military use - range finders, target designators, guidance systems, non-lethal denial, an..."

2018-01-24T18:30:46Z

Created page with "==Background== * Use of lasers in civilian and military applications is increasing * Military use - range finders, target designators, guidance systems, non-lethal denial, an..."

Página nueva

==Background==
* Use of lasers in civilian and military applications is increasing
* Military use - range finders, target designators, guidance systems, non-lethal denial, and now being used as directed energy weapons
* Civilian use - laser cutter/engraver, precision measurement, pointers, welding, entertainment
* Potential to cause injury is largely dependent upon irradiance and beam wavelength
* Irradiance
** Amount of energy that hits the eye/skin per unit area
** Dependent on output power, distance from source to target, and beam divergence
** Human eye can focus laser to a very small area on the retina increasing the irradiance by a factor of 100,000
* ANSI Classification of Laser
: Class 1 - non-hazardous
: Class 2 - visible laser, aversion response will protect
: Class 3a - eye hazard with optical aids that collect or focus beam
: Class 3b - eye hazard, some skin at high power
: Class 4 - eye hazard, skin hazard, fire hazard, diffuse reflection hazard

==Clinical Features==
* Eye - main organ of concern; range of effects as below starting with the most severe to the least; damage from thermal / photochemical / photomechanical process
** Tissue vaporization
** Retinal hemorrhage / ocular holes
** Retinal burn / corneal burn / irreversible scotoma/minimal visible lesion
** Histological damage / irreversible scotoma / cataract
** Nominal ocular hazard distance (NOHD)
*** Distance from laser source which the intensity of a single laser beam becomes safe by not exceeding the maximum permissible exposure
*** Laser is dangerous if viewed from a closer distance than this
*** Can be calculated if power (mW), divergence (mrad), and diameter at aperture (mm) is known
** Flash blindness / after images / reversible scotoma
*** visual loss temporary
*** lasts seconds to minutes
*** similar to flashbulb effect
** Glare/dazzle
*** no permanent damage results
*** similar to driving into the setting sun
** Distraction
* Skin - second organ of concern; effect more dependent on wavelength of laser
** thermal burn - IR, visible, UV-A laser
** photosensitivity - Visible, UV-A laser
** darkening - UV-A laser
** accelerated skin aging - UV-B
** skin cancer/erythema - UV-C

==Evaluation==
* History
** Obtain detailed information as to the nature and characteristic of the laser beam exposure
** Intensity, color, constant or flicker, duration of exposure, location, beam diameter estimate, range, source, location, type of laser, class of laser
* Examination
** External exam of skin and adenxa looking for burns or evidence of physical trauma
** Visual acuity near and far
** Amsler grid test
** Pupils
** Stereopsis
** Color vision
** Slit lamp examination
** Retinal (fundoscopic) examination

==Management==
* As appropriate per history and physical exam findings

==Disposition==
* Discharge home if normal exam and no persistent symptoms suggestive of laser eye injury
* Consult ophthalmologist if persistent symptoms or positive findings on examination suggesting laser eye injury such as retinal hemorrhage, corneal burn, ocular holes, etc.

==References==
<references/>

[[Category:Military]]