This healthy 46YO male complained of mild bilateral central vision loss for about 5 years. Vision was 20/25 OD and 20/30 OS.
Optos color imaging shows subtle central foveal pigment loss. Fundus autofluorescence (FAF) shows these lesions to be hyper-FAF.
Swept-source OCT shows small central foveal outer retinal defects, and en face OCT of the outer retina shows a unique perspective of these lesions.
On further questioning, he noted that his visual symptoms immediately followed his viewing the Great Eclipse of 2017 without proper eye protection.
Learning Points:
The outer retinal damage in solar retinopathy is thought to be caused by photochemical outer retinal and RPE damage instead of a thermal burn. Vision is usually fairly good despite the outer retinal and RPE findings.
