Sub-internal limiting membrane bleeding secondary to high-power handheld blue laser: A case report and literature review

Abstract:

Sub-internal limiting membrane (ILM) bleedings are rare cases that present a set of challenges and considerations to ophthalmologists. We present a case of sub-ILM hemorrhage caused by a high-powered handheld pointing blue laser. A 15-year-old Caucasian male patient who is medically free presented with blurry vision for 5 days after pointing a high-powered laser to his right eye. Fundoscopy and optical coherence tomography showed a large 4-disc-diameter sub-ILM in the macula. The patient underwent a right pars plana vitrectomy (PPV) and ILM peeling procedure. His vision started to recover and gained full vision unaided of 20/20 after 1 week of the procedure. This case report describes a case of large sub-ILM bleeding secondary to a high-powered handheld pointing blue laser, which was managed successfully using PPV and ILM peeling, regaining full vision postoperatively. PPV and ILM peeling could be the choice of treatment in such cases. Still, there is no consensus over the treatment approach worldwide due to the rarity of cases and lack of high-end research level of evidence. Further analytic studies are necessary to establish a recommended treatment for a better prognosis.