Sub-internal Limiting Membrane Haemorrhage following High Intensity Laser Exposure: A Case Report

Laser-induced maculopathy is an increasingly recognised clinical entity, particularly among adolescents and young adults who have easy access to high-powered handheld or entertainment laser devices. Retinal damage may occur through photothermal, photochemical, or photomechanical mechanisms, depending on the wavelength, power, and duration of exposure. Although regulatory limits exist for safe laser use, inadvertent or prolonged exposure can result in significant and sometimes irreversible visual impairment. Here, the present case of acute vision loss following prolonged exposure to multicoloured laser light during a pilgrimage walk is reported. A young adult presented to the Outpatient Department with sudden, painless diminution of vision in the right eye for one week. The patient reported continuous exposure to laser beams for approximately one hour. Ocular history was otherwise unremarkable. On examination, the anterior segment of both eyes was within normal limits, with no signs of intraocular inflammation. Fundus examination of the right eye revealed a large, coin-shaped sub-Internal Limiting Membrane (ILM) haemorrhage centred at the macula. Spectral-Domain Optical Coherence Tomography (SD-OCT) demonstrated focal disruption of the ellipsoid zone and outer retinal layers, confirming structural retinal injury. The patient was advised an intravitreal Sulphur Hexafluoride (SF6 ) gas injection to facilitate displacement of the haemorrhage. The present case underscores the potential retinal hazards associated with laser devices, the importance of thorough retinal imaging for diagnosis, and the value of prompt intervention to optimise visual outcomes. Furthermore, it highlights the growing public health concern regarding unsupervised laser use and reinforces the need for public education on safe handling practices.