Blue Laser Induced Retinal Injury in a Commercial Pilot at 1300 ft

BACKGROUND: We report what may be the first evidence-based report of a retinal laser injury to a pilot during commercial flight from a laser device on the ground. Given the significant subjective (blind spot) and objective evidence of focal retinal damage, coupled with the distance involved, we suspect the laser had a radiant power of several watts, known to be injurious to the human retina. CASE REPORT: An airline pilot presented to our department complaining of a blind spot in the upper left area of his visual field in the right eye (right supero-nasal scotoma) following exposure to a laser beam while performing a landing maneuver of a commercial aircraft. At around 1300 ft (396 m), a blue laser beam from the ground directly entered his right eye, with immediate flash blindness and pain. Spectral domain ocular coherence tomography highlighted a localized area of photoreceptor disruption corresponding to a well demarcated area of hypofluorescence on fundus autofluorescence, representing a focal outer retinal laser injury. Fundus examination a fortnight later revealed a clinically identifiable lesion in the pilot's right eye commensurate with a retinal-laser burn. DISCUSSION: The case reports highlights the growing threat to the ocular health of airline crew and, potentially, passenger safety due to the lack of regulatory oversight of high powered laser devices obtained from the internet. We strongly believe high powered handheld laser devices should not be in the possession of the general public.