An Ophthalmic Report of the July 1945 Solar Eclipse (Burn of Macula) Remains Relevant!

As an ophthalmologist, I am increasingly interested in the upcoming August 21, 2017 solar eclipse. Ophthalmologists are well aware of the risks of prolonged sunlight exposure to the health of the central vision (macula).  According to Plato, Socrates warned, “People may injure their eyes by observing or gazing on the sun during an eclipse.” (Socrates lived from 470/469 BC – 399 BC)

iPhone 7 image of the sun taken through American Astronomical Society vendor-recommended solar eclipse glasses.

Sunlight exposure due to a solar eclipse can cause damage quickly! I have the number “55 minutes” burned into my memory from ophthalmology board certification examinations.  This is the number of minutes a patient undergoing ophthalmic surgery which can cause permanent macular damage due to the operating microscope’s light intensity and saturation. As residents in training, senior residents and attending ophthalmic surgeons would tell us, “make sure the case is done in less than 55 minutes.” But a solar eclipse intensifies the light rays and can literally burn the most critical layer of the retina 100x faster.

There maybe some dramatic license with “100x faster” of a microscope light vs. sunlight as pointed out by a Yale classmate & optics friend.  An excellent explanation of solar retinopathy is available from Retinal Physician (2013).  In addition, Rozanowska et. al state, “Exposures lasting for several minutes to tens of minutes are sufficient to cause an ophthalmoscopically visible damage.”  (Light-Induced Damage to the Retina)  NASA’s FAQ’s include a patient friendly explanation of rod and cone damage here.  During an eclipse, your pupils may dilate allowing more sunlight to come in.  As NASA authors state, “The problem is that the sun’s surface is so bright that if you stare at any portion of it, no matter how small, it produces enough light to damage individual retinal cells.”

I wondered about the first reported case of solar eclipse retinal damage. Thanks to the Yale Library’s Scan & Deliver service, I found a 1946 article in the British Journal of Ophthalmology of an ophthalmologist’s report for a soldier who experienced solar eclipse macular damage following the July 9, 1945 event. This is the oldest article I could find via PubMed search.

I was fascinated by Dr. EC Zorab’s description & Dr. NA Jevon’s additional report. I take for granted the many diagnostic machines (including Optical Coherence Tomography (OCT) & fundus photography) which allow today’s ophthalmologists to evaluate the retina at the level of 1/1000th of a millimeter. The post-World War II drawings and narrative details are refreshing elements of comprehensive ophthalmic consultations.

I include the articles in full as a courtesy to colleagues & patients worldwide:

Patient pearls for the upcoming August 21, 2017 solar eclipse:

1. The eyes are delicate organs and must be respected! The American Academy of Ophthalmology has an excellent starting point for Solar Eclipse Eye Safety.

2. If you plan to view the sun during the solar eclipse, please use certified solar eclipse glasses manufactured by reputable dealers. The American Astronomical Society (AAS) has a list of reputable vendors for solar glasses and viewers.

3. *** Your regular sunglasses are NOT “good enough!” ***

iPhone 7 image of the sun taken through American Astronomical Society vendor-recommended solar eclipse glasses.

4. As an ophthalmologist, I recommend that children be under extra precaution during the solar eclipse. You don’t want a child to “take a peek” outside of the protective eyewear. The “take a peek” can possibly cause irreversible retina damage.  NASA has an excellent article on “How to safely observe the Sun with young children” (Opens as PDF).  Note the authors explicit recommendation, “Solar glasses should be modified with elastic or tape around the back so they stay on young children’s small faces.” (Safe Viewing Options, page 55)  Great care must be taken for anyone and especially children.

This is one of the best & safest ideas I’ve seen from friends’ kids. Solar glasses & colorful paper plates, easy to secure and able to protect against peeking:

5. Ophthalmology is about #ProtectingSight. Even this once in a generation event is not worth the risk without proper eye protection.

6. You can also see how the solar eclipse will look from anywhere in the US via Time Magazine. I recommend solar eclipse glasses for all sun viewing during the moon’s entire trajectory across the path of the sun (including in areas of complete darkness!).

7. A wonderful 4-minute YouTube video by ophthalmology colleague and social media guru Steve Christiansen MD is available on his website (with written narrative) and below.

8. (BONUS PEARL added 8/21/2017!) We live in a social media world! Don’t forget that your iPhone / Android and other smartphone devices need special filters to block out the intense light AND take useful images. Here is an image with an iPhone taken through a solar eclipse glasses filter:

Here is the same image cropped for social media:

Here is another image with the iPhone closer to the solar eclipse glasses filter to show the intensity of light (also with an Instagram enhancement!):

See the American Academy of Ophthalmology detailed post: Learn How to Photograph an Eclipse Without Damaging Your Eyes or Your Camera.  I have a short YouTube video also:

9. (BONUS PEARL #2) I enjoyed an engaging interview with Fox 29 Philadelphia’s Joyce Evans. All of the video pearls are included in the narrative above. (I’ll post video once available online).

Please stay eye safe on #SolarEclipse2017!

Ravi D. Goel M.D. is a cataract surgeon & comprehensive ophthalmologist at Regional Eye Associates in Cherry Hill, NJ.  He is also a clinical instructor at Wills Eye Hospital.  His patient-friendly YouTube cataract surgery educational videos are here.


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