This asymptomatic 10YO boy presented with 20/40 vision OD and 20/20 vision OS.
There were multifocal small subretinal pigment clumps with surrounding pigment loss in the right central macula.
OCT shows foveal outer segment loss with ragged RPE loss. The left macula was normal.
He denied looking at a laser pointer but did admit to a history of sun-gazing. He likely closed his left eye each time he looked at the sun, which explains the unusual finding of unilateral solar retinopathy.
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.
