Ocular damage secondary to lights and lasers: How to avoid and treat if necessary

An armamentarium of the latest light and laser technologies are used by physicians of different disciplines to address a variety of aesthetic challenges in the periocular region and throughout the body. If improperly used, these modalities can inflict serious ocular injury on the patient, support personnel, and operator. It is paramount that providers involved in operating these technologies be knowledgeable about the physical and clinically relevant properties of the unit being used. This involves training in the proper utilization, appropriate treatment parameters, and safety measure for each. Selection of the appropriate eye protection is particularly important for both the patient and the personnel. It is also imperative for the laser operator to understand the range of potential ocular complications associated with the cosmetic use of lasers and lights, to recognize the signs and symptoms associated with ocular damage, and to provide efficient first aid measures should damage ensue. Possible ocular complications related to the cosmetic use of lasers and lights range from mild eyelid swelling and erythema to potentially blinding macular injury. Ocular injury may also be inflicted by the improper selection or placement of eye protection.A complete ophthalmologic evaluation and timely management of potential complications is mandated when there is any concern for ocular injury.

Review of laser and light therapy in the treatment of oculofacial pathology

Demand for non-invasive techniques to treat oculofacial pathology has allowed for the growth and development of several new laser and light therapy modalities. These modalities include the use of intense pulsed light(IPL) and photodynamic therapy(PDT), light-emitting diode devices, as well as ablative and non-ablative lasers. Therapeutic applications in the periorbital area may involve the treatment of vascular lesions, telangiectasias, dyspigmentation, photodamage, hypertrichosis, rhytids, and scars. Laser and light-based technology offers patients treatment options that range from conservative to aggressive, allowing for choices between subtle results with little downtime or dramatic results with longer downtime. Advantages of laser treatments, as compared to traditional medical and surgical treatments, include a longer lasting effect than some of the conservative therapies and the ability to serve as a happy medium between non-invasive topical medicine and invasive surgical techniques. For patients seekingnon-invasive alternatives, these modalities confer a major advantage over incisional surgery. Understanding appropriate usage, side effects, and outcomes is before treating functional and cosmetic issues. Here we present a review of current treatment modalities, their use, side effects, and outcomes.

Ablative laser assisted topical delivery of antifibrotics in the management of cicatricial ectropion

A variety of surgical techniques have traditionally been used to manage cicatricial ectropion. These techniques primarily aim at vertical lengthening of the anterior lamella and include a variety of skin flaps and grafts. Alternative techniques such as dermal filler injection to support the eyelid margin may also be used in the management of select patients with cicatricial ectropion. The application of different types of laser for scar revision throughout the body has rapidly evolved; similar mechanisms, principles and treatment rationale can be applied to the use of lasers in the management of cicatricial ectropion. Additionally, ablative lasers, such as Carbon Dioxide and Erbium:yttrium-aluminumgarnet lasers, may be used in the transdermal delivery of antifibrotic agents, such as interferon gamma, interferon alpha, vitamin D, triamcinolone and 5-fluorouracil, resulting in efficient target tissue penetration, limitation of systemic drug toxicity and decreased degradation. Although the combination of ablative fractional resurfacing and topical antifibrotic agents is a new treatment modality, there is a great potential for its efficient utilityin the management of periocular scarring and cicatricial ectropion. The introduction of these innovative therapeutic modalities offers ophthalmologists a greater range of possible effective treatments to address periocular scar tissue and the resultant cicatricial ectropion.