CIBA Vision Ophthalmics - Digital Grand Rounds
Digital Grand Rounds Program - Answer/Discussion
If you went through the hints you probably jumped all over the diagnosis of solar retinopathy (foveomacular retinitis), to which the patient did finally admit. This condition is usually seen in those individuals who ignore warnings when solar eclipses come around. Sunbathers will occasionally develop this as well. It is also found in people gazing at the sun while under the influence of hallucinogenic drugs.
These patients usually have a rapid drop in vision to the 20/40 - 20/200 level, and often complain of metamorphopsia. The foveal area itself is usually ringed by a grayish zone of injury. This gradually disappears and leaves behind a small lamellar hole of the fovea itself, with end vision near normal, as was seen in this case.
Consultation and continued routine care are adequate in the management of these cases, especially when they present after vision has returned.
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