Retinal Lesions Diagnosed After Light Microscope Use with Outer Segment Hyper-Reflective Changes on Optical Coherence Tomography: A Case Report

Abstract

This is a brief report of possibly the first documented case of retinal phototoxicity secondary to occupational use of the light microscope with visible optical coherence tomography (OCT) changes. A 30-year-old hospital pathologist presented with a unilateral central scotoma after increased use of the light microscope. OCT of the macula at presentation and after 8 months demonstrated focal outer segment hyper-reflective spots at the centre of the fovea. There were no visible changes on fundoscopy and blue-light autofluorescence imaging. The symptoms resolved after advising the patient to limit the brightness and duration of light microscope use. The hazards of using the light microscope should be recognized, and light exposure and brightness minimized. OCT can help detect objective changes when the fundus looks normal on examination.