An unusual case of visual disturbance in a young boy

Abstract

AbstractPurpose To describe an unusual case of visual disturbance in a young boy.Methods A 14‐year‐old boy described a 3 week history of blurred vision in his right eye. He was otherwise fit and well and on no regular medication with no family history of ophthalmic disease. There was no history of drug taking, sun gazing or eclipse viewing. Best‐corrected visual acuity was 6/9.5 right eye,6/5 left eye and on Amsler grid testing there was evidence of right central distortion. Ocular examination revealed a right foveal yellow deposit; otherwise dilated fundoscopy was unremarkable. Autofluorescence imaging was within normal limits. Spectral domain optical coherence tomography, revealed a focal disruption of the junction between the foveal photoreceptor inner segments and outer segments with a central sub‐retinal deposit in the right eye. Electrophysiological assessment revealed no evidence of generalised retinal dysfunction or significant macular dysfunction. Multifocal electroretinography was suggestive of very mild localised inferior macular dysfunction bilaterally.Results The patient has been reviewed a year later and found to have improved visual acuity with 6/5 in both eyes. OCT findings are unchanged.Conclusion The OCT can detect significant foveal changes in the majority of affected eyes with a characteristic outer retinal defect. OCT can improves the diagnosis and assessment of the degree and nature of foveal damage in patients with solar retinopathy and may be an important tool in identifying foveal damage not detected by standard fluorescein angiography. Nevertheless, the underlying aetiology of the unilateral abnormality detected in this child remains uncertain.