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Star wars & the danger of death stars to the macula

“I will now present the author of the presentation with the best title I’ve ever encountered”

Leigh Spielberg

Posted: Tuesday, September 12, 2017

Julio González-López

“I will now present the author of the presentation with the best title I’ve ever encountered,” said Mandeep Singh, chairman of the Young Retina Specialists (YOURS) Mystery Cases session.

Dr Julio González-López, Universidad de Alcalá, Madrid, Spain, appeared on the podium to give his presentation, “Star wars and the danger of death stars to the macula”. His was a case series in which young patients presented with acute central and/or paracentral scotomas. The first two, both of whom were young males of 10 and 14 years of age, had unilateral scotomas and maintained 20/20 visual acuity. The third, a 22-year-old woman, experienced a decreased acuity to 20/30 OD and 20/40 OS.

Fundus examination and photography did not show obvious changes, but all three cases demonstrated (para)foveal lesions on OCT of the affected eyes. There was even a full-thickness macular hole present in the second case, that of the 14-year-old boy. The young males admitted to having recently played with high-powered lasers, while the third, an internal medicine resident, admitted to “sun gazing” while trekking in the hills of northern Spain.

“She never gave a convincing history of why she was staring at the sun,” said Dr González-López, eliciting laughs from the overflow audience.

There are currently no known effective treatments for the extreme retinal phototoxic damage caused by powerful lasers or the sun, and although slow, occasionally partial, improvement in visual acuity can be expected, scotomata may persist. Prevention is paramount.