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December 11, 2017

The solar eclipse scarred her eye forever—but her injury could pave the way for future treatments

Daily Briefing

    A young woman who glanced at August's solar eclipse through what she mistakenly thought were eclipse glasses has sustained untreatable eye damage—but detailed images of the crescent-shaped scar on her retina could pave the way for treatment in the future, according to a new case report in JAMA Ophthalmology.

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    Case report details

    According to the case report, Nia Payne in August went outside to observe the solar eclipse. She glanced at the sun, which was roughly 70% obscured by the moon, before decided she should use glasses. She borrowed a pair from a nearby observer, assuming they were proper eclipse glasses, and then watched the eclipse for another 15 to 20 seconds.

    A few hours later, Payne's vision began to distort, with the vision in her left eye obscured by a crescent-shaped black spot. She sought help at an ED two days later and was referred to the New York Eye and Ear Infirmary of Mount Sinai, where physicians scanned her eyes.

    Using a new imaging technique called adaptive optics scanning light ophthalmoscopy—which provides an unusually precise scan of the retina cells—the medical team discovered that the scar on Payne's eye, and the black spot in her vision, were a mirror image of the eclipse.

    "What we found is that the sun's rays had damaged the photoreceptor layer in a very specific pattern, like a crescent," Avnish Deobhakta, assistant professor of ophthalmology at Mount Sinai, said. "We were very surprised at how precisely concordant the imaged damage was with the crescent shape of the eclipse itself."

    The case was somewhat atypical, not only for the precision of the scan but because relatively few people suffered eclipse-related eye damage, NPR's "Shots" reports. According to the report, Payne was one of 22 patients who sought out care for eclipse-related eye damage at Mount Sinai's urgent care, and of those, only three presented with retina abnormality (the symptoms of the other two have since resolved).

    A hope for treatment

    According to Deobhakta, the study marks the first time this particular imaging tool—which only recently became available for ophthalmology—has been used to assess eclipse-related eye damage. "It is a leap forward in our imaging ability," he said. "This is one of the first times we can see individual photoreceptors damaged in that pattern."

    And that imaging could be the first step toward developing treatment for this currently irreversible condition, Deobhakta added. "There is no treatment on the horizon," he said, "but the horizon is only seen when you're able to see it, and I think that's what this imaging helps us to do."

    In the meantime, Payne is still struggling to readjust to her damaged vision, training herself to rely primarily on her right eye. "It's a nightmare, and sometimes it makes me very sad when I close my eyes and see it," she said. "It's something I have to live with for the rest of my life" (Andrews,  "Morning Mix," Washington Post, 12/8; Greenfieldboyce, "Shots," NPR, 12/7; Hotz, Wall Street Journal, 12/7).

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