The following questions taken from the AFRL-SA-WP-SR-2012-0005, are designed to gather information to assist medical, operational, and intelligence personnel in analysis of laser beam exposure incidents. It should be anticipated that further questions and information will be sought as time allows. Finally, remember to call the Tri-Service Hotline at 1-800-473-3549 or DSN798-3764 as soon as possible.

Describe the light you saw

- What color(s) was the light(s)?
- How bright was it?
- How long was it on?
- Was it uniform in appearance?
- Did the intensity of the light change?
- Was it constant or did it pulse or flicker? If so, how fast did it pulse or flicker?
- How wide (perhaps using finger widths at arm’s length) was the beam at origin?
- How wide on exposure was the light? Did the light fill your cockpit or compartment?
- Was the light emanating directly from a source or was it reflected off a surface?
- Were there any other unusual light sources?
- Have you seen this light(s) before?

Date, location, and circumstances

- Date and time (local & Zulu using a 24-hour clock) that the exposure occurred.
  - local: DDMMYYYY hh:mm
  - Zulu: DDMMYYYY hh:mm
- Location of exposure (if nonclassified). Describe location preferably using degree decimal (DD), degrees-minutes-seconds (DMS), Universal Transverse Mercator (UTM), or Military Grid Reference System (MGRS).
- How far and in what direction was the light source? Was it airborne or surface based?
- What was between the light source and your eyes?
- What were the atmospheric conditions: clear, overcast, rainy, foggy, hazy, and sunny?
- Was any equipment such as windscreens, visors, NVGs, goggles or sensors affected by the light?
- What evasive maneuvers did you attempt and did the beam follow you as you tried to move away?

Effects

- How long did you look into the light beam?
- Did you look straight into the light beam or off to the side?
- What tasks were you doing when the exposure occurred? Did the light(s) hamper you from doing those tasks?
- Were both eyes exposed? If not, describe the difference between the light exposure (for example, one eye was shielded or closed, or on the side away from the light beam).
- Describe any difference in the effect on either eye.
- Was the light so bright that you had to blink or squint, close your eyes, or look away?
- Was the light painful? Describe the pain. For how long did the pain persist after the light exposure?
- Was vision affected while the light was on? How much of your visual field was affected? What types of things could you see or not see? Did you notice the color of instruments or targets change? Did the changes to your vision remain constant or vary during the exposure? If the light source was mounted on a platform (e.g., aircraft, ground vehicle, or building), how much of the platform was obscured?
- Did your vision remain affected after the light was extinguished? If so, for how long and how did you estimate the time? What types of things could you see or not see? Did you notice afterimages (“spots before your eyes”)? If so, describe them.
- Were there any lingering (i.e. hours or days) visual effects? If so, were the effects continuous or intermittent? Did you have problems reading or seeing in low-light conditions? How long until you were able to see normally again?
- Did you notice any reddening, warming, or burns to your skin?
- Describe the condition of your vision before the incident. Do you wear glasses?
- Are you taking any medications?