|Year : 1971 | Volume
| Issue : 3 | Page : 108-111
Macular illumination tests in macular solar burns
SD Paul, Kapalmit Singh
Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
S D Paul
Department of Ophthalmology, Postgraduate Institute of Medical Education & Research, Chandigarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Paul S D, Singh K. Macular illumination tests in macular solar burns. Indian J Ophthalmol 1971;19:108-11
Batra and Paul  presented a clinical study of macular illumination tests in C.S.R. cases, which was further elaborated by Paul and Singh. It was observed that the findings are of clinical importance in differentiating healed C.S.R. cases from macular degeneration  . The present study aims at analysing macular function tests as advocated by Paul and Batra,  in cases of solar burns.
We present a study of eight cases with history of solar burns in whom the macular illumination tests were carried out with white, red and green filters.
CASE No. 1.
P.D. 28 years male complained of seeing circles around the light.
There was history of having seen sun eclipse a few months back. Examination showed O. D. = phthisis bulbi O.S. = 6/36 (aided).
Fundus showed a small scar in the parafoveal region.
Macular illumination test showed delayed recovery under all the three conditions. It was more delayed with red filter than with green.
CASE No. II.
A.D. 18 years male, presented with history of diminished vision left eye. He had blurred vision a few months previously following an eclipse. Examination showed vision O.D. 6/6.
O.S. 6/24 with - 0.75 D cyl.
Fundus examination showed that R.E. was normal. Left eye showed a black spot with a light pigmented zone around it in the macular area. Macular illumination tests showed a more delayed recovery on the left side with red than with green. Even right eye showed a delayed recovery time with green.
CASE No. III.
K.R. - 47 years male, came with history of having been diagnosed as a case of eclipse burn 10 years back at another hospital. Examination showed vision 6/6 both sides and a dark reddish spot near the fovea on both sides. It was denser on the right than on the left side. Macular illumination tests showed delayed response on both sides more with green filter than with red.
CASE No. IV.
D.R. 45 years male presented with poor vision left eye. There was history of having seen eclipse a few years back. However the patient was not sure whether visual loss occured before or after this. Examination showed vision R.E. 6/6 P. and L.E. 6/18. Fundus showed a macular scar left eye.
The macular illumination tests showed a delayed response in left eye more with red than green filter. Right eye, though it had good vision showed some macular damage. It was revealed with filters.
CASE No. V
S.D. - 22 years male presented with poor vision right side. Examination showed vision R.E. 6/9 L.E. 6/5. Fundus examination showed a reddish areola around the fovea. Foveal reflex was dull with a scar. The left eye was normal. Macular illumination tests showed a delayed recovery time in the right eye with red and green filters as well as without filters. The delay was maximum with red. The left eye, though normal showed a delayed response with red and green filters, the delay being more with green than with red. The functional damage of R.E. was cosiderable. In retrospect the history of having observed an eclipse about 4 months back could be obtained.
CASE No. VI.
S.S. - 20 years male, had poor vision left side for the last 2 years since he observed a solar eclipse. Exam. showed R.E.-6/6 and L.E. 6/12 (aided). Fundus showed solar macular burn left eye. Macular illumination tests showed a delayde recovery in the left eye in all the tests but it was more with red than green. In the right eye the recovery was delayed with red and green filters, it was more with green than red. It appears that R.E. also had a mild lesion that has completely recovered.
CASE No. VII.
S.K. - 20 years female came with asthenopia. There was history of having seen solar eclipse 3 years back. Examination showed vision:
R.E. 6/5 with - 0.50 @ 90°
L.E. 6/5 with - 0.50 @ 90° .
Fundus showed macular scars in both eyes. Macular illumination tests showed a delayed recovery in all the 3 tests. It was more delayed with green filter than red. Also the recovery was found delayed without filter. It was because of this that it was labelled as a healed lesion.
CASE No. VIII.
J.S. - 40 years male complained of diminution of vision R.E. Examination showed vision R. E. 6/6 with +0.75, L. E. 6/6. Fundus showed a macular scar L. E.
Macular illumination tests showed a delayed recovery in left eye with filters while in R.E. it was only delayed with green. In the left eye the delay was more with green than red. It was a healed case of macular burn. It appears that R.E. also had a mild lesion that recovered completely.
| Discussion|| |
In all the cases of macular burns the recovery time after macular illumination is delayed. This delay is more with red than with the green filter in early cases and more with green than with red filter in late cases. In cases of central serous retinopathy  also similar delayed response is observed, viz. in early cases the with red filter more than with green filter while in healed cases the recovery is more delayed with green filter. It is well known that in conductional block the appreciation of red colour is invariably affected. It is assumed here that delayed recovery with red filter might also be due to conduction block due to oedema distal to the recipient elements. The resolution of this oedema might be responsible for recovery in this response. This resolution might be complete or incomplete. And so is the recovery in response with red filter. It is pointed out that recovery with green filter is delayed to a lesser extent in earlier cases, but as healing sets in, this delay increases. This we have tried to explain on the following basis: With the setting in of retinal oedema, the recipient as well as conductional elements are affected. The process being vascular in nature, it is possible that the maximum oedema is present in that region of the retina, which constitutes the functional point of retinal and choroidal circulation. Thus it leads to more of conductional block than to any damage to the recipient elements. In healing stage the conductional block clears but the recipient elements now start showing signs of damage. The residual `red filter delay' indicates the damage caused to the conductional element; while the increase in `green filter delay' might be indicative of damage to the recipient elements.
From these studies it appears that when recovery is more delayed with red filter than with green it is either an early case of macular degeneration (with full vision and normal fundus), or, it is a case of angiospastic maculopathy (C.S.R. or solar burn). In these conditions there will be history of sudden visual blurring or of having seen solar eclipse, along with macular oedema and poor vision. It is also observed that in early cases of macular degeneration the recovery time without filter is good while in angiospastic maculopathy cases it is delayed. On the other hand, if recovery is delayed more with green than with the red filter it is either a case of macular degeneration or a healed case of angiospastic maculopathy. It the recovery is delayed without filter also, then it is more in favour of macular degeneration. But it is difficult to differentiate these two conditions, on this basis only. In our future studies we intend trying some other filters also to assess, if these could help in this differentiation. In this way we are confident that macular illumination tests will go a long way in differentiating various macular lesions, that have hitherto alluded us and where E.R.G. cannot help.
| Summary|| |
Eight cases of solar burns are presented. The value of macular function tests is stressed. It is pointed out that in C. S. R. and solar burn the behaviour of macula to illumination tests is similar. In early cases recovery is delayed with red, green filter and with no filters; the delay being more with red than green while in healed lesion this delay is more with the green filter than with the red filter.
| References|| |
PAUL, S. D., BATRA D. V.: Macular Illumination Tests in C.S.R. A.J.O. 63: 147: 1967.
PAUL, S. D., SINGH, K. M.: Macular Illumination Tests in C.S.R. (Under prep.)
PAUL, S. D., SINGH K. M.: Macular Illumination Tests in Mac. degeneration. (Under prep.)
PAUL, S. D., BATRA D. V.: Macular Illumination Tests. A.J.O. 61: 99: 1966.
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