A 68-year-old man with solar retinopathy had a lamellar foveal lesion on ophthalmoscopy and optical coherence tomography in one eye while the fellow eye appeared unremarkable. However, macular imaging by means of confocal scanning laser ophthalmoscopy (reflectance imaging and autofluorescence) revealed alterations in both eyes. Visual deterioration due to solar retinopathy may be a diagnostic challenge and the patient's history may be incomplete. The authors recommend including noninvasive confocal scanning laser ophthalmoscopy imaging in the work-up of unexplained visual disturbances because it may add important information beyond ophthalmoscopy and other imaging techniques.
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