This 31YO male presented with 2 years of bilateral vision loss. He works as a welder and admits to rarely wearing his safety glasses. Vision was 20/30 OU.
Pseudocolor SLO imaging shows symmetrical, tiny yellow foveal scars. OCT shows outer foveal microdefects characterized by hyporeflectivity due to loss of all bands deep to the external limiting membrane.
Learning Points:
The welding process emits optical radiation across various wavelengths and intensities, including infrared, visible, and ultraviolet (UV) light. Exposure to this UV light without proper eye protection can result in keratoconjunctivitis (the most common clinical presentation) and foveal lesions similar to solar retinopathy. Findings include a small yellowish foveal spot or scar with an outer foveal microdefect on OCT (Singh et al, Surv Ophthalmology 2023;68:655-668). Vision is usually good despite the persistent clinical and OCT findings.
Our patient was lucky to have good vision despite his poor work habits. He was advised to use protective eyewear during welding.
