Unilateral solar maculopathy

A 32-year-old man came forward for a left visual blur that occurred hours after sun gaze with one eye. The reason for this act is unknown and the psychiatric interview did not reveal any anomalies. The best-corrected visual acuity was 20/20 for the right eye and 20/200 for the left. He presents an advanced pterygium of the left eye, he also presents an exophoria which would explain the occlusion of an eye during the glare. The fundus examination reveals an appearance resembling a macular hole, and the Spectral-Domain Optical Coherence Tomography (SD-OCT) shows a left alteration of the central photoreceptors (localized foveal loss of the ellipsoid and interdigitation layers in the left eye [yellow arrow]). The other layers remain normal. These findings are not present in the right eye. OCT was carried out on August 29, 2019.
We put the patient on vitamin A and systemic steroids, but the initial results and visual acuity remained unchanged after several weeks.
Solar retinopathy is a photochemical alteration of the retina typically seen after accidental or intentional exposure to intense light sources. Often bilateral, it can rarely be unilateral. Some patients may show partial or complete recovery.