The n e w e ng l a n d j o u r na l of m e dic i n e

Images in Clinical Medicine

Stephanie V. Sherman, M.D., Editor

Solar Retinopathy
A B

A
previously healthy 43-year-old man from Western Australia Joshua Taylor, M.D.
presented to the ophthalmology clinic with a 3-week history of blurry vi- Lions Eye Institute
sion. He reported no eye pain or scotomas but did report a years-long Nedlands, WA, Australia
practice of watching sunsets without eye protection. Visual acuity was 20/30 in the
David C. Sousa, M.D., Ph.D.
right eye and 20/50 in the left eye. A funduscopic examination in both eyes was
normal (Panel A, left eye), as was the rest of the evaluation, including slit-lamp University of Melbourne
Melbourne, VIC, Australia
examination. Optical coherence tomography (OCT) of the left macula revealed a david.sousa@unimelb.edu.au
discontinuity in the inner and outer foveal photoreceptor segments and retinal
This article was published on July 8, 2023,
pigment epithelium interdigitation zone (Panel B, arrow). OCT of the right macula at NEJM.org.
was normal. A diagnosis of solar retinopathy was made. Solar retinopathy is a type
of retinal photochemical injury caused by ultraviolet radiation. Causes include
solar eclipse viewing, arc welder or laser pointer exposure, or direct sun gazing,
as in this case. Although visual recovery can occur over a period of months, meta-
morphopsia (shape misperception) or central scotoma may be permanent in some
cases. The patient was advised to wear eye protection against ultraviolet radiation
and to avoid direct sun gazing. Unfortunately, the patient was lost to follow-up.
DOI: 10.1056/NEJMicm2215436
Copyright © 2023 Massachusetts Medical Society.

n engl j med 389;2 nejm.org July 13, 2023 165

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