Phototoxic retinal degeneration caused by occupational exposure to an arc lamp movie projector

Macular retinopathy caused by photic radiant energy is well documented. Thi s study reports san unusual case in which the image imprint of an are-illum inating source of a movie projector was induced in the retina. A 66-year-ol d man presented for routine ophthalmic examination. The patient worked as a movie projectionist for 50 years, and almost daily viewed the circular ima ge of the projector's illuminating are electrodes in a reflecting bowl with his right eye. Ophthalmic examination revealed 20/20 visual acuity in both eyes. Pupils, tonometry, anterior segment, and optic nerve examination wer e unremarkable in both eyes. The right macula revealed faint foveal yellow pigmentary change with a surrounding ring of hypopigmentation approximately one disc diameter in size. The left fundus was within normal limits. Fluor escein angiography revealed foveal hypofluorescence with a surrounding wind row defect, corresponding to the fundus lesion. On Amsler grid testing he h ad small focal waviness of lines superior to fixation in the right eye. Sin ce the shape of the retinal lesion approximated the ring-shaped image of th e are lamp viewed by the patient over the course of many years, we attribut ed the ocular findings to exposure received because of his profession. This contrasts with the focal damage caused by sun gazing, or are welding witho ut proper eye protection, or prolonged exposure to an operating microscope.