Solar retinopathy in a hospital-based primary care clinic

Most reports of solar retinopathy describe epidemics of patients who go to the eye doctor after viewing a solar eclipse. Rarely is it encountered by the primary eye care provider during a routine eye examination.

For 26 months, patients who went to the primary care eye clinic and found to have macular lesions consistent with solar retinopathy were identified from the total clinic population. These patients were documented in a coded log and fundus photographs were obtained (when possible).

Twenty-six eyes of twenty patients (0.14% incidence) were determined to have macular lesions consistent with solar retinopathy. Visual acuity was 20/25 or better in 100% of the patients and 85% were 20/20. Patients were predominantly men (75%) of middle age (average age, 43 years; SD, 11 years) with a history relevant for solar retinopathy (80%)--consisting of sungazing, 60%; looking at welding light without eye protection, 15%; substance abuse, 15%; and psychiatric condition, 5%. Forty percent had solar lesions in both eyes. Amsler grid testing revealed a defect in only 20%, and macular threshold visual-field testing was normal in all the eyes tested.

This is the first report to characterize solar retinopathy in a primary eye care population. Management includes correct differentiation from other macular disorders, acquisition of a careful detailed history, and provision of patient education regarding the dangers of sungazing.