Introduction:

Accidental light-induced injuries to the retina from a photochemical mechanism can occur from prolonged exposure to the sun, from a welding arc, and from intra-operative microscope illumination.

Clinical Features:

Retinal phototoxicity from the sun or a welding arc appears as small, round, well-circumscribed, yellow acquired vitelliform-like lesions in the fovea (Fig. 20.2.1). Microscope phototoxicity appears as a more broad area that is fairly well-circumscribed either in the inferior or superior macula (dependent on tilt of microscope).

OCT Features:

Solar and welding arc injuries appear similar on OCT as a focal loss of the outer retina and IS–OS/ellipsoid layer, leaving a small hyporeflective rectangular cavity or outer retinal hole (Fig. 20.2.2). These can be singular or multifocal. The ELM and RPE are typically spared. Microscope light-induced retinal phototoxicity leads to prominent chorioretinal scarring in the region of the injury.

Ancillary Testing:

Fluorescein angiography can show a pinpoint window defect centrally in solar retinopathy, but no other imaging modality is as useful as OCT.

Treatment:

No treatment is available, but avoidance of additional pathologic light exposure is recommended.

Introduction:

Accidental light-induced injuries to the retina from a photochemical mechanism can occur from prolonged exposure to the sun, from a welding arc, and from intra-operative microscope illumination.

Clinical Features:

Retinal phototoxicity from the sun or a welding arc appears as small, round, well-circumscribed, yellow acquired vitelliform-like lesions in the fovea (Fig. 20.2.1). Microscope phototoxicity appears as a more broad area that is fairly well-circumscribed either in the inferior or superior macula (dependent on tilt of microscope).

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