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[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 rangefinder (Nd:YAG with a wavelength of 1064 nm) on the right eye. The visual acuity dropped to 1/35 and a central scotoma with metamorphopsia occurred immediatly after the accident. The ophthalmological findings showed a distinct submacular hemorrhage. The therapy with Prednisolon intravenous and daily parabulbar, vitamin C, indomethacin systemical and lokal application resulted in an increase of visual acuity up to 0.4 and a reduction of central 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. Application of antioxidants to neutralize the toxic radicals that arise by tissue decay should be given additionally to the cyclopegic medication. Special attention should be payed to the prevention of such laser accidents.