Decreased visual acuity, central/paracentral scotomata, dyschromatopsia, metamorphopsia. Typically bilateral.
(See Figure 11.35.1.)
Critical
Acute findings include a yellow-white spot in the fovea with or without surrounding granular gray pigmentation. Classic late finding is a red, sharply demarcated lesion in the fovea.
Other
Visual acuity usually ranges from 20/25 to 20/100. Amsler grid testing may reveal central or paracentral scotoma. Resolution of acute findings within several weeks may leave a variable appearance to the fovea (e.g., pigmentary disturbance, lamellar hole, normal appearance, etc). Eyes with better initial visual acuities are more likely to have unremarkable fundoscopic examinations at follow up.
Unprotected solar eclipse viewing, sungazing (e.g., related to religious rituals, psychiatric illnesses, hallucinogenic drugs), sunbathing, vocational exposure (e.g., aviation, military service, astronomy, arc welding)