Maculopathy caused by Nd : YAG-laser-accident

Background Since the construction of the first laser in the sixties and the extended use in medicine, technology and hobby the number of accidents has increased. Appreciated to therapy concepts are missing at the time. Patient A 19 year-old-man was hit by the impulse of an military hand-held r angefinder (Nd:YAG with a wavelength of 1064 nm) on the right eye. The visu al acuity dropped to 1/35 and a central scotoma with metamorphopsia occurre d immediatly after the accident. The ophthalmological findings showed a dis tinct submacular hemorrhage. The therapy with Prednisolon intravenous and d aily parabulbar, vitamin C, indomethacin systemical and lokal application r esulted in an increase of visual acuity up to 0,4 and a reduction of centra l scotoma from 8 degrees to 2 degrees. Conclusion Systemical and local use of antiphlogistic and antiinflamatoric substances may partially reduce the vision limitating scar formation. Appli cation of antioxidants to neutralize the toxic radicals that arise by tissu e decay should be given additionally to the cyclopegic medication. Special attention should be payed to the prevention of such laser accidents.