Sun burned: Ophthalmoscopy spies woman's retinopathy after solar eclipse

The hype in the United States surrounding this summer’s solar eclipse was inescapable, with country-wide migration to the path of totality including millions of Americans. All along, reports cautioned about potential damage from staring at the sun without protective eyewear.

Even when the risks are known, though, the temptation to sneak a peek at interacting celestial bodies can be significant. (Even President Donald Trump quickly glanced upward.)

Recent research, led by Chris Wu, MD, with the department of ophthalmology at the New York Eye and Ear Infirmary of Mount Sinai in New York, in JAMA Ophthalmology discussed the case of one woman who experienced acute solar retinopathy, where researchers used adaptive optics scanning light ophthalmoscopy to gather high-resolution images of her eye structures.

During the Aug. 21 eclipse, the woman viewed the solar rim with both eyes multiple times for six seconds. She also looked at the sun for 15 to 20 seconds with protective eyewear. Within hours, she experienced blurred vision and color distortion. She also said a black spot appeared in the field of vision in her left eye.

Following the eclipse, the woman in her 20s had 20/20 vision in her right eye and 20/25 in her left.

 “Adaptive optics imaging enhances the resolution of retinal imaging devices by correcting ocular-induced wavefront aberrations, allowing in vivo visualization of cellular structures. In this patient, adaptive optics provided cellular level images of the disturbed photoreceptor mosaic,” wrote Wu et al. wrote. “Significant cone outer and inner segment mosaic disruption was evident in the left eye.”

Researchers used various imaging methods to collect data, including optical coherence tomography (OCT), OCT angiography and fundus photography. Spectral-domain OCT images showed mild and severe acute solar retinopathy in the right and left eye, respectively. Additionally, the left eye had a hyperreflective lesion and became mostly hyporeflective in the outer retina.

“When severe, solar retinopathy can cause an absolute scotoma,” Wu et al. wrote. “Young adults may be especially vulnerable and need to be better informed of the risks of directly viewing the sun without protective eyewear.”

The full report, along with images, is available free at JAMA Ophthalmology.