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Case 48

Contributors: Miguel Cruz Pimentel MD, Parsa Mehraban Far, Peng Yan MD FRCSC

Patient Presentation: A 54-year-old man with an unremarkable past ocular history presented with visual distortions in his right eye. He described the visual distortions as bothersome but disclosed that they have been present in that eye for most of his life. Visual acuity was 20/30 OD and 20/20 OS. Fundus examination was within normal limits and OCT macula was obtained, shown below:


Question: Which layer is the abnormality most localized to?

On further interview, it was revealed that the patient used to stargaze as a child, sometimes staring at the sun for several hours at a time without any special protective lens. 

Question: Which of the following describes the classical findings associated with solar retinopathy in multimodal retinal imaging?

Question: Which of the following has shown proven benefit for the treatment of solar retinopathy?

Learning Objectives:

  1. Recognize solar retinopathy as a differential diagnosis for focal disruption of the ellipsoid zone/RPE.

  2. Laser pointer injury should also be included in the differential diagnosis of focal ellipsoid zone/RPE disruption.

  3. Patient education and use of protective gear for sungazing is the most effective preventative strategy to reduce further vision loss.

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