Laser-induced maculopathy masquerading as hereditary macular dystrophy

There has been an emergence of permanent macular injury due to the misuse of handheld laser pointers. The clinical phenotype of laser-induced maculopathy can mimic hereditary retinal dystrophies. This report describes the clinical phenotype and the results of multimodal imaging in a 27-year-old woman who was referred with a bilateral progressive decrease in vision over 2 months. She was initially diagnosed elsewhere with hereditary macular dystrophy. Examination of her fundus showed bilateral creamy-to-gray irregular lesions in the posterior pole. The results of multimodal imaging of her retina suggested self-inflicted laser-induced maculopathy. The patient was referred to a psychiatrist with a working diagnosis of factitious disorder. A high index of suspicion and the utilization of multimodal imaging allowed early and correct diagnosis and prevented further loss of vision.