Sun damage to the eyes

Various types of radiant energy when exposed to the organ of vision cause damage to various structures of the eyeball. So, if ultraviolet radiation (short waves) damages mainly the ocular surface (eyelids, conjunctiva, cornea), then exposure to long waves of radiation, in particular, light of high brightness, causes pathological changes in the retina and choroid. As a result of focusing the sun's rays by the optical system of the eye on the membranes of the posterior segment of the eyeball, a burn of the yellow spot occurs. 03/20/2015, a total solar eclipse was observed on the territory of the Russian Federation, which was observed by a large number of people, not all of them observed proper eye protection measures.

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    The goal is to study the pathological effect of high brightness light on the retina and choroid of the eye using the method of spectral optical coherence tomography (OCT) of the retina.

    Material and methods. 25 patients of various ages who observed a solar eclipse in ordinary sunglasses on March 20, 2015 and were admitted to the ophthalmology department of GBUZ OKB No. 3 of Chelyabinsk during the first 3 weeks after the eclipse. A standard ophthalmic examination was performed, retinal OCT (OPTOVUE RTVue-100) on the day of admission. The average age of the victims was 20.5 ± 4.6 years. The timing of admission to the hospital varied, most of the patients arrived 3-5 days after the eclipse (10-40%), the rest after 6-9 days (5-20%), 10-14 days (8-32%) and 3 weeks (2-20%). Five (20%) suffered both eyes, the rest - one.

    In addition to instillations, patients received injections of emoxipin (0.5 ml), dexamethasone (2 mg) - parabulbarno, glucose 40% (10.0 ml) and ascorbic acid 5% (1.0) - intravenously, inside - lutein-containing and nootropic drugs. The average treatment period was 4.75 ± 1.07 days.

    Results. Patients complained of the appearance of a spot in front of the eye (17-68%), decreased visual acuity (16-64%), lack of clarity and decreased contrast of visual perception (22-88%). Two (8%) patients noticed complaints 2 days after the eclipse, 7 (28%) - after 1 day, and the main number - 16 (64%) - after 4-8 hours. The average visual acuity at admission was 0.55 ± 0.35. When biomicroscopy of the anterior eye, the affected pathological changes were not detected.

    Analysis of OCT images in 25 patients showed the following. The average height of the neuroepithelium in fovea was 178 ± 57.79 microns, choroid - 293.90 ± 57.79 microns. The main sign of retinal damage when exposed to high brightness light was the disorganization of the outer segments of the photoreceptors (cones) in the fovea projection in the form of a thickening of the layer and the presence of hyperreflective inclusions, which was observed in all patients. The average length of the disorganization zone was 247.0 ± 31.5 μm.

    In addition, there were hyperreflective zones with deformation of the layer contour of the outer segments of the photoreceptors and retinal pigment epithelium in the fovea (11-44%), parafoveolar edema of the inner layers of the retina with the formation of intraretinal cavities (4-16%), disorganization of the outer border membrane with a fuzzy blurry contour (5-20%), flat hyporeflective detachment of neuroepithelium (2-8%). No pathological changes on the part of the choroid were detected.

    After the treatment, an increase in visual acuity was noted in 68.8% of cases. The average visual acuity at discharge was 0.68 ± 0.30.

    After 1-3 months, according to OCT, in these patients a thinning of the pigment epithelium line was observed, indicating its atrophy in combination with the destruction of the outer segments of the retinal photoreceptors. There was an increase in the reflectivity of the choroid, which, in all probability, was associated with a violation of the light-absorbing function of the pigment epithelium.

    Conclusions. When observing a solar eclipse without proper eye protection, various pathological changes in the retina occur in the macula, the main of which is the disorganization of the photoreceptor layer. Over time, focal atrophy of the pigment epithelium develops with an increase in the reflectivity of the choroid.

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