A 75-year-old woman presented with progressive photophobia despite normal visual acuity, color vision, fundus photography, OCT, and visual fields. Full-field electroretinograms (ERGs) revealed a negative waveform (a-wave > b-wave) with severely reduced rod, cone, and flicker responses, while multifocal ERGs showed macular dysfunction. These findings led to a diagnosis of bilateral acute diffuse occult inner retinopathy (ADOIR) , an uncommon inner retinal disorder that can masquerade as anterior segment or optic nerve disease.
The case highlights that ERG is essential for identifying retinal-level causes of photophobia even when standard ophthalmic examinations are unremarkable. Early ERG evaluation can transform diagnosis and management in unexplained photophobia. To read more ; Click here In patients with unexplained photophobia and normal fundus/OCT, which diagnostic test is most…
