Accidental diode laser-induced full-thickness macular hole: a case report

Accidental ocular injuries caused by laser devices used in non-medical settings are rare but potentially vision-threatening. This case report describes a 24-year-old woman who sustained a full-thickness macular hole (FTMH) in the right eye following accidental diode laser exposure during a hair removal procedure at a beauty center. The injury occurred when the laser probe was inadvertently activated, striking the patient's unprotected eye. The patient presented with profound visual loss in the affected eye, with visual acuity reduced to the level of hand motion. Comprehensive ophthalmological examination revealed a FTMH in the right eye, confirmed by optical coherence tomography (OCT), which showed complete disruption of the foveal retinal layers and cystic changes at the margins of the hole. The patient underwent surgical intervention with pars plana vitrectomy (PPV), internal limiting membrane (ILM) peeling, and gas tamponade to promote macular hole closure and restore retinal integrity. Despite successful anatomical closure of the macular hole, the patient's visual prognosis remained guarded due to extensive photothermal damage to the retinal pigment epithelium and photoreceptor layers. This case underscores the devastating consequences of inadequate laser safety protocols in non-medical environments, the critical role of OCT in diagnosing and managing laser-induced retinal injuries, and the importance of timely surgical intervention.