SOLAR RETINOPATHY - OUTER RETINAL HOLES

Staring at the sun during an eclipse or during full sunlight can damage central vision

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Solar retinopathy is retinal damage that results from exposure to solar radiation. Patients with solar retinopathy usually experience sun exposure through religious ritual participation, solar eclipse viewing without proper precautions, or from mental disturbances via drug intoxication or schizophrenia. Solar retinopathy occurs primarily through a photo-oxidative pathway rather than by direct thermal injury. The decreased VA in solar retinopathy is generally central and usually improves with time, though not completely to normal. Most patient notice a very small blind spot in the central vision that they can see around. The patient whose photos are shown here had nearly normal vision.

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The most diagnostic test for solar retinopathy is the spectral domain optical coherence tomography line scan shown here. Patient with solar retinopathy have an outer retinal hole. That is a very small defect that only affects the outer retina. This defect can also be seen in patients with macular telangiectasis and tamoxifen retinopathy. A history of sun exposure is helpful in diagnosing this disorder.

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