Unilateral solar maculopathy

We report the case of a 32-year-old man who stated that he left visual blurring a few hours after looking directly at the sun without protection with the affected eye. The reason for this act seems to be some sort of ritual, the psychiatric interview did not reveal any notable mental abnormality. The best initial visual acuity was 20/20 for the right eye and 20/200 for the left eye. He presents an advanced pterygium of the left eye, as well as an exophoria which would explain the occlusion of an eye during the glare. Funduscopic examination revealed a macular hole appearance and spectral domain optical coherence tomography (SD-OCT) showed focal foveolar alteration of central photoreceptors at the level of the elliposoid layer. The diagnosis retained was that of unilateral photic retinopathy, and the patient was put on vitamin A and systemic corticosteroids. However, we did not notice any improvement in the initial clinical picture. Solar retinopathy is a photochemical alteration of the retina, usually observed after accidental or intentional exposure to intense light sources. Often bilateral, it can rarely be unilateral. Some patients may show partial or complete recovery.