Can You Guess June's Mystery Condition?
Make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
Solar Retinopathy Secondary to Medical Misinformation
Written by Arjun Bhatt, BA, Brody School of Medicine, Greenville, N.C., and Janice C. Law, MD, Vanderbilt Eye Institute, Nashville, Tenn. Photo by Melissa Davis, BA, Brody School Of Medicine, Greenville, N.C.
A man in his early 30s was referred to our clinic’s retina specialist by his optometrist. He presented with 20/40 vision bi-laterally, severe myopia, central macular lesions, and lattice degeneration with atrophic scarring. The patient reported having stared directly into the sun for multiple minutes on several occasions, forcing his eyes open with his fingers. Initially, he said that this intense visual stimulation resulted in a religious experience, and he expressed intentions to continue. Upon further interviewing, he revealed his primary motivation for this practice: One of his parents had retinitis pigmentosa. Despite a normal exam, the patient’s fear of having a similar fate led him to investigate purportedly preventive measures. The patient found misinformation online suggesting that this condition could be avoided through “sungazing.” He had completed three “eye strengthening treatments,” corresponding to the three clearly visible central macular lesions. At that time, he said that he intended to continue this practice until his vision improved.
Clinical management focused on patient education, which included developing trust and a strong therapeutic physician-patient relationship to uncover and address the emotional root of the patient’s fear. This approach was ultimately effective. Seven years later, the patient has had no additional solar-associated damage.
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