Bilateral Solar Maculopathy3

Quiz Challenge December(iii)

Case Study: 16 yo male with acute central scotoma after sighting some natural phenomenon with friends

Dr Daniel Chiu

Diagnosis ?

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Answer: bilateral solar maculopathy (photic fovea burn)

Comment: this is a set of early photo taken few days after patient attempting to watch solar eclipse directly. Similar finding can be seen in deliberate or inadvertent self-harm by laser (often high power device purchased on Ebay from overseas). The “tongue” of juxtafoveal hyperreflective changes rising from the RPE traversing into the Henle’s layer is a classic give-away OCT sign within 1-2 weeks of the event.