Solar retinopathy is a condition that can result from focusing the eye(s) on the sun, and usually follows the independent viewing of a solar eclipse. It has also been reported after direct sun-gazing, in anti-aircraft lookouts (Flynn, 1942; Cordes, I944, I948), in military recruits hoping to obtain discharge from service (Ewald and Ritchey, I970), in hospitalized schizophrenic patients (Anaclerio and Wicker, I970), in individuals observing the sun as a religious ritual (Agarwal and Malik, I959), in sunbathers (MacFaul, I969; Ridgway, I967), in patients trying to blind themselves (Eigner, I966), and recently in patients under the influence of LSD (Ewald and Ritchey, 1970; Ewald, I971). Cases have also been reported following indirect or reflected sunlight injury, from water or desert sand (Rosen, 1948; Irvine, I945), and in patients undergoing “prolonged and unprotected exposure to the infra-red rays of the solar spectrum in the tropics” (Smith, I944). It has recently been suggested (Manchester and Manchester, 1972) that the temporary blindness of Saul of Tarsus may have been the result of solar retinopathy.
After a sun-gazing episode, patients complain of some or all of the following symptoms: decreased or foggy vision, central scotoma, metamorphopsia, chromatopsia, and headache.
The initial visual acuity after solar injury is usually 20/40 to 20/63, but may range from 20/20 to counting fingers. After approximately 6 months, the visual acuity is usually in the range of 20/20 to 20/40, although it has been reported as low as 20/400 (Rosen, I948). Patients who regain 20/20 vision often complain of permanent minute central scotomas (Flynn, ig60a; MacFaul, I969).
The initial ophthalmoscopic picture varies-from no change to marked macular oedema. Within I to 2 weeks, pigmentation in a mottled pattern replaces the oedema. Later, a hole in the fovea develops. Whether this is a true through-and-through hole in the retina is not known because no histopathological specimens have been available for study.
This paper describes two young patients who ingested lysergic acid diethylamide (LSD) and, while under its effect, gazed at the sun. Bilateral solar retinopathy resulted in each patient.