• After reviewing the OCT scans and the AF images, I (JS) asked the 14 year old if he ever had looked at the sun. I asked this question since the OCT appears vaguely similar to OCTs that I have previously seen in a patient who admitted to sun gazing. (The image here was originally in RR #24 Hereditary Maculopathies in the differential diagnosis.)

• The patient reported that he had never sun gazed. The OCT revealed changes that I had never previously seen in Stargardt Disease (RR #14), Best Disease (RR #40), X-linked retinoschisis or any other disorders and of course, he experienced acute onset of the symptoms just several days earlier.

• Fortunately his father was with him on a family vacation to NYC. The father then mentioned that his son very recently obtained a green laser pointer. When I asked the patient about pointing the laser into his eye(s) he denied it. However. his father then stated that he had observed his son aiming the laser (on more than one occasion) at his eye through a mirror!