Pupil damage after periorbital laser treatment of a port-wine stain.

BACKGROUND The increase in the number of laser treatments has led to an increase in the number of therapy-related adverse effects. Herein we report a case in which long-term adverse effects occurred after periorbital laser treatment of a treatment-resistant port-wine stain using a long-pulsed alexandrite laser without protective eyewear. OBSERVATIONS A 33-year-old woman with a therapy-resistant port-wine stain was treated periorbitally with a 755-nm long-pulsed alexandrite laser after several treatment sessions with the pulsed-dye laser; she was not given protective eye shields. Within a few days of the session, she reported disorders in the motility of her left pupil and a painful sensitivity to light, which was not completely resolved after 12 months of follow-up. CONCLUSIONS We recommend that both patients and operators use protective eyewear with every laser procedure. When treatment is administered near the eye, eye shields should be placed behind the eyelid or a safe distance should be maintained between the laser and the eyeball by treating up to the orbital rim only.