Solar retinopathy from sun-gazing under the influence of LSD.

Solar retinopathy, damage to the retina from focusing on the sun, can occur after viewing a solar eclipse, sun-gazing, or reflected sunlight from water or sand. Symptoms include decreased or foggy vision, central blind spots, and headache. Initial visual acuity is often 20/40 to 20/63 but can range from 20/20 to counting fingers; after about six months, acuity usually improves to 20/20–20/40, though permanent minute central blind spots may remain. The paper describes two young patients who developed bilateral solar retinopathy after gazing at the sun while under the influence of LSD, one of whom reported a religious experience during the episode.

Study at a glance

Abstract

Solar retinopathy is a condition that can result from focusing the eye(s) on the sun, and usually follows the independent viewing of a solar eclipse.It has also been reported after direct sun-gazing, in anti-aircraft lookouts (Flynn, 1942; Cordes, I944, I948), in mili- tary recruits hoping to obtain discharge from service (Ewald and Ritchey, I970), in hos- pitalized schizophrenic patients (Anaclerio and Wicker, I970), in individuals observing the sun as a religious ritual (Agarwal and Malik, I959), in sunbathers (MacFaul, I969; Ridgway, I967), in patients trying to blind themselves (Eigner, I966), and recently in patients under the influence of LSD (Ewald and Ritchey, 1970; Ewald, I971).Cases have also been reported following indirect or reflected sunlight injury, from water or desert sand (Rosen, 1948; Irvine, I945), and in patients undergoing "prolonged and unprotected exposure to the infra-red rays of the solar spectrum in the tropics" (Smith, I944).It has recently been suggested (Manchester and Manchester, 1972) that the temporary blindness of Saul of Tarsus may have been the result of solar retinopathy.After a sun-gazing episode, patients complain of some or all of the following symptoms: decreased or foggy vision, central scotoma, metamorphopsia, chromatopsia, and headache.The initial visual acuity after solar injury is usually 20/40 to 20/63, but may range from 20/20 to counting fingers.After approximately 6 months, the visual acuity is usually in the range of 20/20 to 20/40, although it has been reported as low as 20/400 (Rosen, I948).Patients who regain 20/20 vision often complain of permanent minute central scotomas (Flynn, ig60a; MacFaul, I969).The initial ophthalmoscopic picture varies-from no change to marked macular oedema.Within I to 2 weeks, pigmentation in a mottled pattern replaces the oedema.Later, a hole in the fovea develops.Whether this is a true through-and-through hole in the retina is not known because no histopathological specimens have been available for study.This paper describes two young patients who ingested lysergic acid diethylamide (LSD) and, while under its effect, gazed at the sun.Bilateral solar retinopathy resulted in each patient. Case reportsCase i, a 24-year-old Caucasian male, was examined one day after sun gazing.He reported being attracted by the glow of the setting sun while under the influence of LSD.He stated that the sun had the significance of God to him, and that a religious experience occurred during this episode.He immediately noted blurred vision, spots, difficulty in reading, and the need to look to the side of any object to see it clearly.He realized that eye damage had occurred, and he was examined the following morning.