Presentation
Symptoms Symptoms commonly present within hours of exposure and include blurry vision and central or paracentral blind spot in one, or more commonly, both eyes. [eyewiki.aao.org]
A 45-year old and a 33-year old male patient presented with a bilateral visual loss (0.63/0.4 and 0.5/0.4). Funduscopic examination revealed bilateral, foveal yellowish dots. Figure 1 shows a pathologic full-field ERG. [ncbi.nlm.nih.gov]
Entire Body System
- Swelling
Findings included photoreceptor changes including vesiculation and fragmentation of photoreceptor lamellae, presence of whirls within disc membranes, mitochondrial swelling and nuclear pyknosis. [eyewiki.aao.org]
Our results show that diabetes induces morphological changes of melanopsin-expressing ganglion cells including soma swelling and dendritic varicosities with no reduction in their total number, associated with decreased c-fos and clock genes induction [worldcat.org]
Skin
- Photosensitivity
Risk Factors Aside from sustained or high-intensity light exposure, common factors predisposing patients to phototoxic injury to the retina include[8]: Young age Clear intraocular lens Photosensitizing drugs: tetracycline, psoralens [5]. [eyewiki.aao.org]
Eyes
- Retinal Pigmentation
Retinal pigment epithelial cells in the affected area showed plasma membrane changes, smooth endoplasmic reticulum swelling, and changes in lipofuscin granule structure.[10] Pathophysiology The mechanism by which retinal tissue damage occurs in solar [eyewiki.aao.org]
- Retinal Damage
It remains elusive whether the degree of retinal damage and the involvement of rods depend on the highest level of local NO concentration or on frequency, subtype, or amount of poppers intake. [ncbi.nlm.nih.gov]
Neurologic
- Micropsia
Additional complaints may include dyschromatopsia, metamorphopsia, micropsia, frontotemporal headache Signs Decreased visual acuity, usually to a level of 20/25 - 20/100, but possibly worse depending on the extent of exposure.[8] Physical Examination [eyewiki.aao.org]
- Seizure
She had a history of hallucinations and a seizure disorder. After examination, she admitted to repeatedly starring at the sun for long periods of time. Her visual acuities measured 20/20 and 20/30 right and left respectively. [eyewiki.aao.org]
- Excitement
In returning to the “ground state” energy level, an excited state electron splits a bond within another molecule, forming a free radical.[11] Second, light energy absorption can cause excitation of and direct transfer of energy from an intraretinal chromophore [eyewiki.aao.org]
- Headache
Additional complaints may include dyschromatopsia, metamorphopsia, micropsia, frontotemporal headache Signs Decreased visual acuity, usually to a level of 20/25 - 20/100, but possibly worse depending on the extent of exposure.[8] Physical Examination [eyewiki.aao.org]
Treatment
Management No known beneficial treatment exists for solar retinopathy, although entities such as steroids have been tried without consistent evidence of effectivness. Prevention is through education is paramount. [eyewiki.aao.org]
Prognosis
Visual prognosis after solar retinopathy. Brit. J. Ophthal. 1969; 53: 534-41 ↑ 13.0 13.1 Rothkoff L, Kushelevsky A, Blumenthal M. Solar retinopathy: visual prognosis in 20 cases. [eyewiki.aao.org]
Etiology
Etiology The disease entity has been recognized, to some degree since the times of Classical Greece[1]. [eyewiki.aao.org]
Pathophysiology
Ophth Soc. 1987; 85:120-158. ↑ Michels M, Sternberg P, Operating microscope-induced retinal phototocicity: pathophysiology, clinical manifestations and prevention. Surv Ophthalmol. 1990; 34:237-252. ↑ 3.0 3.1 Long VW, Woodruff GH. [eyewiki.aao.org]
Prevention
Primary prevention Prevention of solar retinopathy is in fact the mainstay of therapy. Primary prevention of solar retinopathy includes refraining from direct sungazing or eclipse viewing. [eyewiki.aao.org]