Wall of Fame

Is your case great enough to be selected for our Wall of Fame? If so, we’ll post your name and case here for the world to see!

10/2021 Dr. Kumar Chugani: Coats Disease
11/2021 Dr. David Kilpatrick: Frosted Branch Angiitis from Sarcoidosis
12/2021 Dr. Otis Hertsenberg: Optic Nerve Coloboma with Pit
1/2022 Dr. Barbara Parolini: Choroidal transplant for AMD subfoveal macular neovascularization
3/2022 Dr. Erdem Dinç: Is a Temporary ILM Flap Sufficient for Macular Hole Closure?

 

Solar retinopathy from the ACHOO reflex

This 31YO male was referred for relatively asymptomatic central macular pigmentary changes. He gave a long history for twice daily sun gazing, which always caused a very pleasurable sneezing episode. Vision was 20/30 OD and 20/40 OS. Triton color imaging shows tiny foveal pigment loss (images 1 and 2, top). Swept-source OCT shows bilateral ellipsoid zone and outer segment defects (images 1 and 2, bottom, red arrows). We diagnosed him with the ACHOO reflex (Autosomal Dominant Compelling Helioophthalmic Outburst). And yes, that is a real thing! Patients with this entity sneeze when exposed to bright lights, typically sunlight. 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. We advised him to stop his sun gazing ritual, although we’re not sure this will be possible for him.

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