CONTINUING EDUCATION, 1 CE Credit – $9.99, 1 Hour, General Knowledge, Level 1, Release date: October 2007, Expiration date: October 31, 2012

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SECOND GLANCE

Laser Pointers + Children = Danger

The use of laser pointers has become fairly widespread. The pointers are useful tools for educators in the classroom and for lecturers at conventions and meetings.

However, due to the low cost and plentiful supply, these pointers are now being purchased and used by the general public, including children, and used in a way not intended by the manufacturers.

As a result, serious concerns about the hazards of laser pointers have surfaced. Adding to the dilemma and potential harm is the fact that not all laser pointers are labeled properly. The lack of proper labeling makes it difficult to discern if you have a pointer that could create serious damage. One sure way to know if a laser pointer is potentially dangerous is to test it and see if it is capable of burning holes in paper, lighting matches or popping balloons. If it is capable of any of these actions it is most likely able to harm human eyes.

While the majority of the laser pointers contain low to moderately powered diode lasers, more powerful lasers can be found on the market. They are usually imported from other countries that may have deficient or non-existent standards for safe operation of lasers. These pointers can present a significant potential for eye injury and are often not properly labeled according to FDA regulations. There are currently no restrictions for purchasing laser pointers in the USA. However, the FDA has issued a warning for laser pointers, urging that they be used as intended, not as toys, and not by children unless under adult supervision. As usual, this ethical standard will eventually turn into a law if the public does not abide by the recommendation.

The FDA warning has stated specifically that exposure for 10 seconds or longer endangers the human retina. In May, 2005, ophthalmologists at the Mayo Clinic reported that green laser light will damage pigment cells in the retina with as little as 60 seconds of exposure.

The misuse of lasers takes many forms. They are sometimes used to annoy, distract and even intimidate other people. Lasers are being flashed at athletes during games to impair their performance and at movie screens in theaters as a general distraction. They are used to mimic a gun's laser sight. A red beam is often projected to aim high powered weapons at their targets. This particular action has caused alarm in police departments and communities across the country. For example, police officers have reportedly drawn their weapons when the light from laser pointers is mistaken for a gun sight. Laser beams projected into airspace to intercept aircraft have caused distractions and temporary vision impairment to pilots. Most of these incidents are considered malicious and demonstrate a lack of understanding of the potential consequences of laser illumination. Unfortunately, as the availability of these devices has increased, so have the reports of their misuse.

Momentary exposure from a laser pointer can cause discomfort and temporary visual impairment, such as glare, flash blindness and afterimages. The symptoms may last only for a few seconds or minutes but can be extremely dangerous if the exposed person is engaged in a vision critical activity, such as driving a car or flying an aircraft. The light energy that some laser pointers can deliver into the eye may be more damaging than staring directly into the sun. For example, a 15 year old Swiss boy attempted to create his own laser light show using a laser pointer which he bought on the internet together with a mirror. Instead he inadvertently beamed the laser into his eyes, creating permanent damage to his vision.

Dr. Martin Schmid, head of the retina unit in the Department of Ophthalmology at Lucerne Cantonal Hospital in Switzerland, is one of the authors of the case report detailing the young boy’s eye damage in the New England Journal of Medicine. The teenager noticed immediately that his vision was blurry but was fearful of informing his parents of the incident. Two weeks later he couldn't hide the problem any longer and sought the help of a doctor. The vision in his left eye was only fingers at three feet. The right eye also showed severe acuity loss. Dr. Schmid reported that the boy could barely see newspaper print. A hemorrhage was noted in the right eye and several retinal lesions in the left eye. After four months his vision showed some improvement but remained moderately impaired. The doctor concluded that laser pointers are a "legitimate public menace."

The laser pointer used by the young Swiss victim produced an output of 150 milliwatts, which is far above the maximum output of 5 mw that is expected from a laser pointer that is sold to the public. It is worth noting that it's possible to purchase laser pointers as strong as 700 mw, and such a device may not look any different than a lower powered laser. Dr. Schmid adds that there are instructions on the internet for changing low powered devices into high powered ones. Eye specialists concur, "Children shouldn't have access to laser pointers. They are not giving presentations, so why would they need to have them?" Dr. Roy Chuck, chair of Ophthalmology and Visual Sciences at Montefiore Medical Center and Albert Einstein College of Medicine, New York City, states, “When it comes to laser toys buying a well known name brand may be helpful in this case. But when you're buying off the internet, it's not as regulated and you just can't tell what the strength of the laser may be."

Lasers used in toys are labeled as Class I, but the products aren't always labeled properly. It is stressed that even at a safe level, if the child stares into the beam long enough it can cause eye damage. One may purchase a "safe" laser toy, but it's possible that a creative child may turn to the internet and figure ways to boost the power of the laser. Listed under "burning laser pointers" there are a huge amount of videos showing dangerous experiments that can be done with the lasers. Moreover, there are an increasing number of home pages and videos that demonstrate how to turn legal, low power lasers into burning, high power lasers.

There have been reports of more powerful laser pointers imported from Russia and China that lack the appropriate warning labels. Some of these laser pointers emit green beams from frequency doubled Nd:Yag lasers operating at 532 mw and have emissions significantly exceeding the maximum permissible exposure. One of the lasers has a filter in the cap, which, if removed, allows the laser to emit both 532 mw and 1064 mw beams. This places the laser in excess of 15 mw making it an even more hazardous Class III B laser as opposed to the currently allowed class III A laser. All laser pointers should have a small sticker on them with either a yellow "caution" or a black and red "danger” designation. The experts say that it would be prudent not to purchase or use unlabeled laser pointers. Why should we be worried about a lowly 5 mw laser that is 5 thousandth of a watt which is less than one percent of one percent of the power of a 60 watt incandescent bulb? First, the numbers are used differently.

Light bulb wattage measures the power it uses. It only converts about 10 percent of that electrical power into light. In a laser, the power is a measure of the light output. Second, the light bulb gives light in all directions, so you only see a small part of the whole at any one time. As you move away from the bulb, you see a quarter of the light every time the distance is doubled. A laser pointer gives all the light energy in one small, concentrated beam. If it gets into the eye, you receive all of the laser's energy, not just a fraction of the energy as in the ordinary light bulb. Third, a light bulb gives off light at many different wave lengths. A laser is monochromatic; it is only one, concentrated wavelength with no loss of energy. The resulting light energy is more potentially damaging as a result.

The acronym Laser stands for Light Amplification by Stimulated Emission of Radiation. The common red laser pointer is a diode laser. This is really just a special type of transistor, or diode that creates the wavelength used in the pointer. Because of the unique features of laser light, it is magnified 100,000 times as it passes through the eye. The light energy not only passes through to the retina, but the eye focuses the light on the retina. The combinations of these two features increase the likelihood of ocular damage through misuse of the laser pointers.

The eye actually sees a small part of the electromagnetic spectrum that runs from cosmic ray energies to long radio waves. We see only the wavelengths from violet to red. Infrared and ultraviolet are just outside our ability to see. The eye is most sensitive to yellow light (550nm). Meaning we will see the color yellow faster than any other color. That is why so many hazard devices (fire trucks, fire hydrants, etc.) are converting to yellow. At the same power, 670 nm red light is only 3 percent as bright as the equivalent in yellow. When determining safety limits for the laser pointer values must be chosen. As with most safety boundaries, the limits on lasers have been chosen to err on the side of caution. Misuse of the lasers or altering the laser is simply foolish and can have life altering consequences as with that 15 year old Swiss boy. In life many factors contribute to something becoming harmful. And so it is with laser pointers -- different conditions determine when retinal damage will actually occur.

Elmer Friedman, O.D.
elmerfrdmn636@gmail.com

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