Solar Retinopathy

Dr. Kondapalli: Solar retinopathy is kind of a hot topic in retina because, in the United States, there’s going to be an eclipse coming up about the second week of April. And, actually, where I am in Pittsburgh, we’re very close to the path of totality. I myself am going to be going up closer to Lake Erie where it will be completely in totality; so, I’m really looking forward to it.

But solar retinopathy is something that we have to be worried about, and it happens in individuals who are doing any sort of sun gazing or eclipse viewing. But it can be an occupational hazard. For example, it can occur in welders when they’re not wearing protective eyewear. Laser pointers can also be a hazard.

Signs and symptoms of solar retinopathy

Usually in solar retinopathy, what happens is that within minutes to hours of the exposure — so let’s say within minutes to hours of watching the sun or seeing an eclipse — patients will often complain of blurry vision or a paracentral or central blind spot, which is more commonly found in both eyes. Classically what happens is that a very focal disruption appears on OCT in the level of the sub RPE, essentially within the outer retina, in the setting of an otherwise normal retina.

And, so, this focality of change really is very classic, very common. It’s usually bilateral since people look at the sun with both eyes open.

Prevention is the “treatment”

Unfortunately, there are no great treatment options for solar retinopathy. Some studies have looked at systemic steroids, but they have shown very inconsistent effectiveness. Really, the greatest “treatment” is prevention, and that’s why there’s been a large push by both the American Academy of Ophthalmology and the American Academy of Optometry to discourage gazing at the sun and at the eclipse directly without the use of appropriate protective eyewear.