Laser-induced macular neovascularization in a child: Case report

Introduction: In recent years, the use of toy lasers has become increasingly popular among children. Due to their easy accessibility and availability for online purchase, these devices have become a significant public safety concern. In this article, we present a rare case of severe retinal injury caused by accidental exposure to a toy laser in a 13-year-old child.
Methods: A 13-year-old boy presented with rapid vision loss in his right eye following exposure to a toy laser pointer, with a visual acuity of 20/400 and a large macular scar (one-third the size of the optic disc). Fundoscopic examination, fluorescein angiography (fluid leakage and hyperfluorescence), OCT (abnormal neovascularization and subretinal fluid), and OCTA (abnormal blood flow) confirmed choroidal neovascularization secondary to laser-induced retinal injury. The patient was treated with two intravitreal injections of aflibercept (one month apart), which resolved the intraretinal fluid. However, after six months, visual acuity did not improve (remained 20/400) due to the macular scar. This case demonstrates permanent retinal damage and lack of treatment response. The unusual aspect was the presence of an extensive macular scar at initial presentation, which did not improve despite prompt treatment.
Conclusion: This rare case of severe macular injury and laser-induced neovascularization, which—unlike most previously reported cases—did not result in visual improvement despite early treatment, highlights the critical importance of public education regarding the potential dangers of these devices and the need for strict preventive measures.