Photic retinopathy is a rare ophthalmological condition, first described in the 17th century by the Swedish physicist Bonetus. The incidence of this pathology is estimated at 0.14% of ophthalmic consultations with only 15% of them attributed to arc welding, solar exposure being the most common phototoxic maculopathy. Welder's maculopathy was first described in 1902 by a French ophthalmologist Terrien in workers involved in the construction of the London subway [1].

The machines used for welding primarily produce three types of wavelengths: ranging from ultraviolet (UV) rays (with a wavelength of 100 to 400 nanometers) to infrared (IR) rays (800 to 1400 nanometers), passing through visible rays (400 to 800 nanometers). Ophthalmological manifestations most commonly affect the anterior segment, presenting as keratoconjunctivitis or cataracts. This occurs because the cornea absorbs shorter wavelengths, typically below 300 nm, which correspond to UV-B and UV-C. IR rays pass through these media and reach the retina. Incident IR rays would then be responsible for thermal and photochemical reactions on the retina, producing toxic metabolites [2]. Retinal damage seems, however, underestimated, masked by acute manifestations of keratitis [3].

In this article, we show, through comprehensive multimodal imaging, the progression over 2 months of a welder's maculopathy captured at a very early stage.

We report the case of a 30-year-old patient who presented to the ophthalmological Emergency Department on December, 2023.

The patient started a welding training the day before. Throughout the day, the patient had to wear a protective helmet with two integrated visors: one transparent and the other tinted. Unable to work with the tinted visor, the patient decided to weld without it. Subsequently, the patient quickly noticed a significant decrease in vision, especially for the near vision.

There

At the present time, our paper is one of the few publications showing, through comprehensive multimodal imaging, the progression over 2 months of a welder's maculopathy captured at a very early stage. Indeed, most of the time, patients are examined only at a late stage, either because corneal involvement predominates and masks the initial retinal examination, or because patients do not seek medical attention in the days following the incident.

Our findings are consistent with other studies [2],

This case highlights the importance of protective measures and prevention that must be implemented and adhered to in the workplace. This includes wearing a helmet with a tinted visor. The latter is often overlooked by workers who complain about limited field of vision and brightness in scotopic environments and confined spaces. Special attention for these workers should be provided by occupational medicine, especially since no effective treatment has been recognized to date [9].

Signed patient consent was obtained.

The authors declare that they have no competing interest.

There are more references available in the full text version of this article.

© 2025 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.