Ocular hazards from reflected laser radiation in clinical settings: practical implications of surface reflectance for healthcare operators

G. Insero, G. Romano
Energy for Health [25], 2026

In the last few decades, we have witnessed a wide diffusion of intense optical sources such as lasers or LEDs (Light Emitting Diodes) [1]. These devices are now present not only in hospitals and research environments, but are now routinely deployed in non-hospital settings, including private outpatient clinics, such as dermatology and dental offices, aesthetic medical clinics, physiotherapy clinics, as well as veterinary practices. Depending on the specific therapeutic procedures, these light sources operate over wavelengths spanning from the UV (ultraviolet) to the mid-IR (mid-infrared) region.
Such diffusion exposes patients and operators to risks from artificial optical radiation, that must be properly assessed in the occupational safety framework [2]. Risk management must be robust not only in controlled operating theatres but also in smaller and decentralized clinical rooms, as less frequent use of these technologies may result in operators having limited experience with laser-based procedures, thereby increasing the likelihood of accidents or unsafe practices. In the veterinary context, laser sources may be used directly in the field, further complicating the implementation of standard risk-minimization measures. Training pathways commonly address these issues under workplace safety programs and are aligned with normative references and guidance documents: Directive 2006/25/EC (artificial optical radiation), ICNIRP exposure-limit guidelines (180 nm–1,000 μm) [3], and device standards for medical laser equipment (e.g., EN 60601-2-22). These frameworks provide essential foundations for hazard identification, classification, and selection of controls and personal protective equipment (PPE).
However, in day-to-day clinical practice, training and checklists often emphasize prevention of direct-beam exposure and unexpected events, such as misalignment, accidental light-induced firing or device malfunction. A less underlined risk is connected to the reflected radiation generated during normal treatment, which can represent an important ocular hazard even when procedures are performed correctly. In this work, we underline the risks related to reflected laser radiation during routine treatments rather than exceptional or accidental events.