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Background: Why the risk is growing  

Lasers are concentrated beams of light and they are common everyday items, they are now found in printers, supermarket scanners, children鈥檚 toys and laser pointers. Laser pointers are readily available to buy online from Amazon and eBay at a very low cost, however judging the strength and safety of the laser pointer in your child鈥檚 hand isn't simple. Although lasers made and sold legitimately in Europe have to pass safety standards, lasers sold online or on the streets in other parts of the world do not and may be much more powerful than needed. The greater a laser pointer's output power the more likely it is to temporarily impair vision or cause permanent sight loss. Lasers are designated a class from safe, Class 1, to inherently dangerous, Class 4, as defined by the British Standard for Laser Safety. See table.  

鈥淏ut it says Class 2 or 5 mW on the label鈥︹�� Why the labels often lie 

Legally, lasers sold for general consumer use should be Class 1 or Class 2 only. These are considered low risk if used briefly and correctly. It is important to be aware that manufacturers may deliberately assign their products a lower laser class in order to enable their sale on open markets. For instance Amazon restricts laser pointers sales to a maximum of 1mW (Class 2), however in practice, many sellers evade this limitation by labelling their devices with terms like 鈥楽uper power laser <1 mW鈥� even when the actual output is significantly higher than this. A UK maker surveillance study from the Health Protection Agency found that 96% of the working laser pointers seized exceeded the legal power limit of 1mW, with ~ 80% of all assessed pointers posing a potential risk of injury. From 246 pointers tested, only 9 were below the 1mW threshold, whereas 196 were above the 5mW, highlighting the prevalence of mislabeling and the associated health and safety risks.  

What happens with laser exposure 

Laser beams are narrow, intense, and coherent, when directed into the eye, they can cause immediate thermal injury and tissue disruption. The macula, responsible for central detailed vision, is particularly vulnerable. Even a short exposure can cause permanent damage and lead to a macular scar. In practice, children present with reduced central acuity, a central scotoma, distortion of vision, or difficulty reading. Imaging of the back of the eye typically shows a focussed area of disruption of the retinal layers at the macula. These changes are often irreversible and permanent.  

Several UK case series have documented this clearly. Raoof and colleagues reported multiple children presenting with sudden central vision loss after exposure to handheld lasers, many with permanent damage (Am J Ophthalmol, 2016). Linton et al also described retinal burns in UK children from 鈥減lay鈥� with handheld devices (Eye, 2014). These are not isolated cases; they potentially represent an epidemic of accidental injuries leaving children with permanently reduced vision. 

Why are children and babies at extra risk