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Case of the Day

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LASER MACULOPATHY

The European VitreoRetinal Society (EVRS) and Shraddha Chandorkar

This healthy 19YO female noted sudden vision loss in her right eye immediately after looking directly at the light while attending a DJ laser party. When she presented to us 2 days later, her 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.

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.

Learning Points:
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 fail-safe scanning systems, beam termination zones, and power-limiting protocols to remain 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.

Article of the Day

Intravitreal Povidone-Iodine Monotherapy as an Alternative Treatment for Exogenous Endophthalmitis in Patients With Antibiotic Allergies

Perez Negron AP, Acaba-Berrocal L, Zafar S, Al-Attar L, Berrocal MH.

J Vitreoretin Dis. 2026 Apr 13:24741264261432184. doi: 10.1177/24741264261432184.

Summary

Exogenous endophthalmitis treatment: Intravitreal 0.1cc 1.25% povidone-iodine effective in patients with antibiotic allergies — Retrospective, 7 eyes

Abstract

Purpose: To evaluate the outcomes of intravitreal povidone-iodine as an alternative treatment for exogenous endophthalmitis in patients with antibiotic allergies.

Methods: This retrospective case series included patients with antibiotic allergies who developed exogenous endophthalmitis and received monotherapy with intravitreal 1.25% povidone-iodine (0.1 mL). Primary outcomes were best-corrected visual acuity (VA) at 3 and 6 months and treatment-related complications.

Results: A total of 7 eyes from 7 patients were included. The mean patient age was 72 years, and the mean follow-up duration was 10.5 months. The mean presenting VA was counting fingers at 4 feet (1.83 ± 0.97 logMAR), which improved to 20/160 (0.91 ± 0.99 logMAR, P = .03) at 3 months and to 20/150 (0.89 ± 1.00 logMAR, P = .03) at 6 months. Five patients (71%) regained baseline VA or better. No adverse events occurred, and no patients needed further interventions.

Conclusions: Intravitreal injection of 1.25% povidone-iodine (0.1 mL) was well tolerated and was associated with visual improvement in patients with exogenous endophthalmitis.

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