Phototoxic maculopathy associated with arc welding: clinical findings and associated functional vision impairment

Abstract

The prevalence of CBS in the older-aged, low-vision population is 17.5%. Several demographic and syndrome-specific characteristics were found to be consistent enabling a profile of a CBS sufferer in this group of participants to be compiled.

Multimodal Imaging of Photic Maculopathy From Arc Welding

“…3 Phototoxic maculopathy can cause irreversible vision loss by exposure to ultraviolet light (400-440 nm) because shorter wavelengths of visible light are readily absorbed by the cornea and lens. 4,5 Notably, there is a predisposition for phototoxicity to occur in younger patients due to better clarity of the clearer ocular media. 5 The mechanism of phototoxicity has been inferred from previous studies based on solar or other types of photic damage including laser-induced maculopathy.…”

Photo-damage, photo-protection and age-related macular degeneration

“…145 Of note, most spectral data for retinal damage has been obtained in anesthetized animals, often using funduscopic visible changes as threshold damage. 103 Therefore, lesions described in these experiments do not resemble aging or AMD changes, but those found in welders 40,41 and laser or sungazing accidents. 146,147 Their relationship with AMD is conceivable, but is far from proven, particularly since these experiments provide little information about the damage spectra of very long exposures in freely moving subjects.…”

“…The cornea and the lens absorb UV radiation, whereas water absorbs far-IR. Visible light and near-IR may reach the retina in the unprotected eye, producing an acute macular lesion that often results in a bilateral central scotoma accompanied by pigmentation alterations 39,40 . With only partial protection, UV light may generate corneal epithelial injury, whereas blue light destroys the center of the macula 40 .…”

“…Visible light and near-IR may reach the retina in the unprotected eye, producing an acute macular lesion that often results in a bilateral central scotoma accompanied by pigmentation alterations 39,40 . With only partial protection, UV light may generate corneal epithelial injury, whereas blue light destroys the center of the macula 40 . In a more recent study, macular lesions were demonstrated using OCT in 38% of welders (n = 80, age mean = 36.9 years) that did not refer visual symptoms and showed no visual acuity problems 41 .…”

“…39,40 With only partial protection, UV light may generate corneal epithelial injury, whereas blue light destroys the center of the macula. 40 In a more recent study, macular lesions were demonstrated using OCT in 38% of welders (n = 80, age mean = 36.9 years) that did not refer visual symptoms and showed no visual acuity problems. 41 Thus, it would be of great interest to study the evolution of these lesions with age.…”