Background: Outer retinal damage can occur when excessive ultraviolet (UV) radiation reaches the retina. The most common etiology is from the sun, known as solar retinopathy, especially when individuals observe solar eclipses without appropriate eye protection. Another cause of UV retinopathy that is not frequently encountered in practice is arc welding, causing Welder’s Maculopathy. Fortunately, the prognosis of the UV retinopathies is quite favourable, as many fully recover after the initial insult to the retina. This retrospective case review aims to outline the clinical manifestation of this maculopathy and current opinions on its etiology and diagnosis.
Case Report: A 45-year-old patient presented for a comprehensive eye examination with an occupational history of arc welding. Best corrected visual acuities were 20/20 OD, OS. Dilated fundus examination revealed central red macular retinal pigment epithelium (RPE) disruption in the right and left eyes. Spectral domain optical coherence tomography (SD-OCT) demonstrated no defects OD and foveal loss of the ellipsoid portion of the photoreceptor inner segment (ISe) band with atrophy in the RPE OS.
Conclusion: Welder’s Maculopathy is an established, but infrequently encountered, cause of UV retinopathy. Most cases are self-limiting and cause no long-term functional sequelae. SD-OCT findings from photochemical injury to the photoreceptors and RPE lead to a box-shaped outer retinal hole that can interrupt the ISe band; which is a determinant of visual prognosis. Careful occupational education should be discussed with each patient.
Morettin CE, Teitelbaum BA. Welder’s Maculopathy; a Case Report. Optometric Clinical Practice. 2019; 1(1):40.
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