Table 1.

Literature review; 84 cases of handheld laser pointer burns in children aged 18 years or less.

Author (Year)	Country	Number of patients ≤ 18	Age	Gender	Mechanism	PMHx	Laser power	Clinical findings
Alsulaiman (2014) [3]	Saudi Arabia	11	17	Male	Inflicted by other	NS	NS	IS/OS disruption
			11	Male	Inflicted by other	NS	NS	Full-thickness macular hole, IS/OS disruption
			15	NS	NS	NS	NS	FTMH
			18	NS	NS	NS	NS	FTMH
			15	Male	Inflicted by other	NS	NS	Sub-ILM haemorrhage
			11	NS	NS	NS	NS	Subhyaloid haemorrhage
			18	NS	NS	NS	NS	Subhyaloid haemorrhage
			17	NS	NS	NS	NS	Subhyaloid haemorrhage
			17	NS	NS	NS	NS	Subhyaloid haemorrhage
			18	Male	Inflicted by other	NS	NS	ERM
			16	Male	Inflicted by other	NS	NS	Foveal cavity
Bhavsar (2015) [4]	USA	3	18	Female	Self-inflicted	Nil	50−100 mW	RPE changes, outer retinal hyper-reflective bands
			11	Male	Self-inflicted	Nil	NS	Disruption IS/OS and hyper-reflective bands
			14	Male	Inflicted by other	Nil	NS	Disruption IS/OS
Birtel (2017) [5]	Germany	7	12	5 Male, 2 Female	NS	NS	45 mW	Yellow lesion, pigment changes, IRF
			15		NS	NS	92 mW	Yellow lesion, pigment changes, SLOR
			15		NS	NS	65 mW	Pigment changes, SLOR
			9		NS	NS	95 mW	SLOR
			13		NS	NS	32 mW	SLOR
			15		NS	NS	NS	Pigment changes, SLOR
			13		NS	NS	NS	Pigment changes, SLOR
Dhoot (2014) [6]	USA	1	16	Male	Inflicted by other	Not stated	1000 mW	Macular hole
Dhrami-Gavazi (2015) [17]	USA	1	17	Male	Self-inflicted	ADHD	85−90 mW	Dense hyper-reflectivity outer retina
Dirani (2013) [7]	Lebanon	1	13	Male	Self-inflicted	NS	5 mW	Outer retinal disruption
Dolz-Marco (2016) [18]	USA	1	16	NS	Self-inflicted	NS	NS	Foveal pigmentary changes
Fujinami (2010) [8]	Japan	1	11	Male	Self-inflicted	Congenital Hearing Loss, Mental Retardation	NS	Highly reflective outer retinal mass
Hanson (2016) [9]	Switzerland	1	11	Female	Self-inflicted	Psychological Rx for RTA	<100 mW	Loss of photoreceptors and RPE
Israeli (2001) [22]	Israel	1	16	Male	Unknown	Unknown	Unknown	RPE disturbance
Lally (2014) [23]	USA	1	9	Male	Self-inflicted	NS	121 mW	Vertical hyper-reflective column in outer retina
Lee (2014) [2]	USA	3	6	Male	Self-inflicted	Nil	<5 mW	RPE disruption
			9	Male	Self-inflicted	Nil	121 mW	RPE disruption
			10	Male	Self-inflicted	Nil	<200 mW	Pigment clumping
Lim (2014) [24]	USA	1	13	Male	Self-inflicted	Nil	154 mW	Focal disruption and lucency of pigment epithelium
Mainster (2004) [10]	USA	5	11	Female	Self-inflicted	NS	NS	Foveal pigmentary changes
Noble (2015) [11]	USA	1	13	Male	Inflicted by other	Nil	50 mW	IS/OS disruption
Petrou (2014) [28]	UK	1	15	Male	Self-inflicted	NS	1000 mW	Bilateral macular holes
Pollithy (2012) [29]	Germany	1	11	Male	Self-inflicted	Unknown	55 mW	Unknown (Article in German)
Raoof (2014) [12]	UK	5	9	Male	Self-inflicted	NS	42−72 mW	Outer retinal layer disruption
			11	Male	Inflicted by other	NS	Unknown	Outer retinal layer disruption
			15	Female	Self-inflicted	NS	Unknown	Outer retinal layer disruption
			8	Male	Self-Inflicted	NS	Unknown	Outer retinal layer disruption
			13	Male	Self-inflicted	NS	Unknown	Fibrovascular membrane
Raoof (2016) [31]	UK	16	Range 9−16	12 Male	Not specified	NS	NS	11 children—focal retinal disruption in photoreceptor and ellipsoid layers.
			Mean 12.7	4 Female				2 children—diffuse disruption of outer retina
								3 children—subfoveal loss of outer retinal architecture and overlying hyper-reflective material in inner retina.
Rusu (2013) [32]	USA	1	15	Male	Unknown	Unknown	Unknown	Grey/yellow spots at the fovea showing hyperautofluorescence. OCT showed disruption of ELM, ellipsoid zone and interdigitation zone
Sanchez-Barahona (2016) [33]	Spain	1	9	Male	Self-inflicted	NS	NS	Hypopigmented lesion at fovea and vertical hyper-reflective bands on OCT
Sell (1999) [34]	USA	1	11	Female	Inflicted by other	NS	5 mW	Outer retinal layer disruption
Sethi (1999) [35]	UK	1	9	Female	Inflicted by other	NS	NS	Normal examination
Sheyman (2016) [37]	USA	1	15	Female	Self-inflicted (presumed)	Suspicion of psychological instability	Unknown	Profound IS/OS, interdigitation line and RPE loss in fovea and pigment migration
Simonett (2016) [38]	USA	1	17	Male	Self-inflicted	Nil but Dx with adjustment disorder & anxiety on psychiatric referral	45 mW	Outer nuclear layer hyper-reflectivity, disruption of IS/OS junction, full-thickness macular hole
Turaka (2012) [13]	USA	1	13	Male	Inflicted by other	Shaken baby syndrome	5 mW	Disruption RPE layer and non-specific thickening
Ueda (2011) [40]	Japan	1	13	Male	Inflicted by other	Nil	20 mW	Break in IS/OS junction and highly reflective region from RPE to ELM.
Weng (2015) [41]	USA	1	12	Male	Self-inflicted	Nil	100 mW	Focal loss of ellipsoid and interdigitation zones, irregularity of ELM and hyper-reflective area adjacent to RPE.
Wyrsch (2010) [43]	Switzerland	1	15	Male	Self-inflicted	NS	150 mW	Dense subretinal haemorrhages
Xu (2014) [14]	USA	1	12	Male	Self-inflicted	NS	48 mW	Damage to photoreceptors and RPE
Xu (2016) [44]	USA	4	12	Male	Self-inflicted	NS	NS	Disruption of IS-OS segment
			9	Male	Self-inflicted	NS	NS	Subfoveal outer retina hyper-reflectivity
			16	Male	Self-inflicted	NS	NS	Disruption of ellipsoid zone
			12	Male	Self-inflicted	NS	NS	Disruption of ellipsoid zone
Yiu (2014) [1]	USA	1	9	Male	Inflicted by other	N/S	1250 mW	Preretinal haemorrhages both eyes
Zhang (2016) [15]	USA	5	11	Male	Inflicted by other	Nil	Unknown	Hyper-reflectivity in photoreceptor and RPE layer
			13	Male	Inflicted by other	Nil	Unknown	Hyper-reflectivity in photoreceptor and RPE layer
			8	Female	Self-inflicted	Nil	Unknown	Foveal gap ellipsoid zone and outer segment layer
			10	Male	Self-Inflicted	Nil	Unknown	Foveal outer segment and ellipsoid discontinuities
			14	Male	Self-inflicted	Nil	Unknown	Hyper-reflectivity in photoreceptor and RPE layer
Ziahosseini (2010) [46]	UK	1	Teenager	Male	Self-inflicted	Nil	NS	RPE disturbance

NS not stated, IS/OS inner segment/outer segment, FTMH full-thickness macular hole, RPE retinal pigment epithelium, ELM external limiting membrane, ERM epiretinal membrane, IRF intraretinal fluid, SLOR structural loss of outer retina