When the warm season arrives, with longer days and higher temperatures, we tend to spend much more time outdoors, increasing our exposure to sunlight. The sun has always been considered a source of life and an ally to health; however, it is important to be aware that solar radiation does not bring only benefits. Sunlight contains high-energy components—such as ultraviolet (UV) radiation—that induce photo-oxidation and the formation of free radicals, which can damage cells and biological tissues.
The eyes are particularly vulnerable to potential damage from light exposure, especially the retina, the thin and delicate tissue containing photoreceptors—nerve cells responsible for visual function. Unfortunately, not everyone is aware of this, and incorrect or careless behaviors can have serious consequences for vision, especially in young people and children, who are often unaware of these risks.
It is important to know that the sun can cause a retinal disease known as solar retinopathy (or solar maculopathy), which shares many features with the more well-known age-related macular degeneration (AMD), a condition increasingly common in the elderly. Solar retinopathy, like AMD, is caused by atrophy of the retinal pigment epithelium (RPE) followed by the death of a more or less extensive portion of photoreceptors in the macula—the central and most important part of the retina.
However, solar retinopathy can also be caused by other sources of high-energy light (e.g., lasers, welding tools), especially in the absence of proper eye protection—due to inattention or lack of awareness—particularly in certain environmental and occupational contexts (construction sites, boats, etc.), and among adolescents and children.
Symptoms of solar retinopathy include blurred vision, perception of a central or paracentral scotoma, chromatopsia, metamorphopsia, photophobia, and headaches—usually in both eyes, but sometimes in only one.
To properly diagnose solar retinopathy and assess its severity, several imaging techniques may be used, including fundus autofluorescence (FAF), fluorescein angiography (FA), multifocal electroretinography (mfERG), and OCT. In patients with solar retinopathy, the initial fundus exam may appear normal or show macular edema that resolves spontaneously. However, after a few days, a small spot may appear at the fovea, initially white-yellow in color, which later turns red and takes on a well-defined shape—typical features of solar retinopathy.
The severity of the clinical condition may vary depending on the intensity, duration, and spectrum of the radiation exposure, but also on factors such as ocular pigmentation, clarity of ocular media, and environmental conditions (e.g., presence of reflective surfaces, atmospheric ozone reduction, etc.).
In some patients, the condition may be transient. In such cases, reduced visual acuity may last less than a year, and recovery is often related to the initial visual acuity, the initial rate of recovery, and the degree of visual deficit. In other patients, permanent damage may occur to a portion of the photoreceptors; in these cases, visual acuity may improve but central or paracentral scotomas persist. In the most severe cases, with extensive and permanent photoreceptor damage, irreversible vision loss unfortunately occurs.
Since there is currently no treatment for solar retinopathy, the only way to avoid its serious consequences is to avoid exposure to high-energy light sources without adequate eye protection. Awareness and education about the dangers to our eyes must be a priority and are the best defense to protect their health. It is essential that this message reaches everyone, especially young people, parents with small children, and all those who, due to environmental or professional circumstances, are exposed to greater risk.
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