Photophobia

Photophobia
SpecialtyNeurology, Psychiatry

Photophobia is a medical symptom of abnormal intolerance to visual perception of light.[1] As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical sensitivity of the eyes,[2] though the term is sometimes additionally applied to abnormal or irrational fear of light such as heliophobia.[3] The term photophobia comes from the Greek φῶς (phōs), meaning "light", and φόβος (phóbos), meaning "fear".

Causes

Patients may develop photophobia as a result of several different medical conditions, related to the eye, the nervous system, genetic, or other causes.

Photophobia may manifest itself in an increased response to light starting at any step in the visual system, such as:

  • Too much light entering the eye. Too much light can enter the eye if it is damaged, such as with corneal abrasion and retinal damage, or if its pupil(s) is unable to normally constrict (seen with damage to the oculomotor nerve).
  • Due to albinism, the lack of pigment in the colored part of the eyes (irises) makes them somewhat translucent. This means that the irises can't completely block light from entering the eye.
  • Overstimulation of the photoreceptors in the retina
  • Excessive electric impulses to the optic nerve
  • Excessive response in the central nervous system

Common causes of photophobia include migraine headaches, TMJ, cataracts, Sjögren syndrome, mild traumatic brain injury (MTBI), or severe ophthalmologic diseases such as uveitis or corneal abrasion.[4] A more extensive list follows:

Causes of photophobia relating directly to the eye itself include:

Neurological causes for photophobia include:

Other causes

Treatment

Treatment for light sensitivity addresses the underlying cause, whether it be an eye, nervous system or other cause. If the triggering factor or underlying cause can be identified and treated, photophobia may disappear. Tinted glasses are sometimes used.[33]

Artificial light

People with photophobia may feel eye pain from even moderate levels of artificial light and avert their eyes from artificial light sources. Ambient levels of artificial light may also be intolerable to persons afflicted with photophobia such that they dim or remove the light source, or go into a dimmer lit room, such a one lit by refraction of light from outside the room. Alternatively, they may wear dark sunglasses, sunglasses designed to filter peripheral light, and/or wide-brimmed sun hats or baseball caps. Some types of photophobia may be helped with the use of precision tinted lenses which block the green-to-blue end of the light spectrum without blurring or impeding vision.[34][35]

Other strategies for relieving photophobia include the use of tinted contact lenses and/or the use of prescription eye drops that constrict the pupil, thus reducing the amount of light entering the eye. Such strategies may be limited by the amount of light needed for proper vision under given conditions, however. Dilating drops may also help relieve eye pain from muscle spasms or seizures triggered by lighting/migraine, allowing a person to "ride out the migraine" in a dark or dim room. A paper by Stringham and Hammond, published in the Journal of Food Science, reviews studies of effects of consuming Lutein and Zeaxanthin on visual performance, and notes a decrease in sensitivity to glare.[36]

Disability

Photophobia may preclude or limit a person from working in places where offensive lighting is virtually ubiquitous (e.g., big box stores, airports,police stations modern prisons,libraries, hospitals, warehouses, offices, workshops, classrooms, courtrooms supermarkets, and storage spaces), unless the person is able to obtain a reasonable accommodation like being allowed to wear tinted glasses when the employee dress code prohibits such glasses otherwise (which may be required to be provided by an employer under the Americans with Disabilities Act). Some people with photophobia may thereby be better able to work at night or be more easily accommodated in the workplace at night.

Outdoor night lighting may be equally offensive for persons with photophobia, however, given the wide variety of bright lighting used for illuminating residential, commercial and industrial areas, such as LED (light-emitting diode) lamps.[37][38]

The increasing popularity of "overpoweringly intense" LED headlights being used on "pickups and S.U.V.s" has prompted more frequent reports of photophobia among motorists, cyclists, and pedestrians.[39]

See also

References

  1. ↑ thefreedictionary.com/photophobia citing:
    • Dorland's Medical Dictionary for Health Consumers. 2007
    • The American Heritage Medical Dictionary Copyright 2007
    • Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. 2003
    • Millodot: Dictionary of Optometry and Visual Science, 7th edition. 2009
  2. ↑ thefreedictionary.com/photophobia citing:
    • Gale Encyclopedia of Medicine. Copyright 2008
    • Mosby's Medical Dictionary, 8th edition. 2009
    • McGraw-Hill Concise Dictionary of Modern Medicine. 2002
  3. ↑ thefreedictionary.com/photophobia citing:
    • The American Heritage Medical Dictionary Copyright 2007
    • Millodot: Dictionary of Optometry and Visual Science, 7th edition. 2009
  4. ↑ Hazin R, Abuzetun JY, Daoud YJ, Abu-Khalaf MM (July 2009). "Ocular complications of cancer therapy: a primer for the ophthalmologist treating cancer patients". Curr Opin Ophthalmol. 20 (4): 308–17. doi:10.1097/ICU.0b013e32832c9007. PMID 19491683. S2CID 205670593.
  5. ↑ "Achromotopsoa". Scottish Sensory Centre. Retrieved December 11, 2009.
  6. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Day, Susan (January 15, 1997). "P9: Photophobia". In Taylor, David (ed.). Paediatric Ophthalmology (2nd ed.). Wiley-Blackwell. pp. 1034–6. ISBN 978-0-86542-831-7.
  7. 1 2 "Photophobia". Texas School for the Blind and Visually Impaired. Archived from the original on September 29, 2009. Retrieved December 11, 2009.
  8. ↑ "Blepharitis". The Lecturio Medical Concept Library. 28 September 2020. Retrieved 5 July 2021.
  9. ↑ "Conjunctivitis". Merck Manual of Diagnosis and Therapy. Retrieved December 11, 2009.
  10. ↑ "Corneal ulcer". Merck Manual of Diagnosis and Therapy. Retrieved December 11, 2009.
  11. ↑ Fraunfelder, F. T.; Fraunfelder, F. W.; Edwards, R. (2001-09-01). "Ocular side effects possibly associated with isotretinoin usage". American Journal of Ophthalmology. 132 (3): 299–305. doi:10.1016/s0002-9394(01)01024-8. ISSN 0002-9394. PMID 11530040.
  12. ↑ Fan X, Miles JH, Takahashi N, Yao G (November 2009). "Abnormal transient pupillary light reflex in individuals with autism spectrum disorders". J Autism Dev Disord. 39 (11): 1499–508. doi:10.1007/s10803-009-0767-7. PMID 19499319. S2CID 32110116.
  13. ↑ "Light sensitivity — photophobia". Royal National Institute of Blind People. Retrieved December 11, 2009.
  14. ↑ "Chronic Fatigue Syndrome". University of Virginia Health System. Retrieved December 11, 2009.
  15. ↑ J Pain Res. 2014; 7: 99–115. Published online 2014 Feb 21. Orofacial pain management: current perspectives; Marcela Romero-Reyes and James M Uyanik
  16. ↑ Cooper AD, Josephs, KA (2009). "Photophobia, visual hallucinations, and REM sleep behavior disorder in progressive supranuclear palsy and corticobasal degeneration: a prospective study". Parkinsonism & Related Disorders 2009 Jan;15(1):59-61. 15 (1): 59–61. doi:10.1016/j.parkreldis.2008.01.011. PMID 18328771.{{cite journal}}: CS1 maint: uses authors parameter (link)
  17. ↑ "Photophobia — Glossary Entry". Genetics Home Reference. United States National Library of Medicine. Retrieved December 11, 2009.
  18. ↑ φῶς, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus
  19. ↑ φόβος, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus
  20. ↑ "Ankylosing spondylitis". United States National Library of Medicine. Retrieved December 11, 2009.
  21. ↑ "Albinism". MedicinePlus Medical Encyclopedia. United States National Library of Medicine. Retrieved December 11, 2009.
  22. ↑ Harris, Robert S.; Kenneth V. Thimann (February 11, 1943). Vitamins & Hormones, Volume 1. Academic Press. p. 88. ISBN 978-0-12-709801-2.
  23. ↑ Wakakura M, Tsubouchi T, Inouye J (March 2004). "Etizolam and benzodiazepine induced blepharospasm". J. Neurol. Neurosurg. Psychiatry. 75 (3): 506–7. doi:10.1136/jnnp.2003.019869. PMC 1738986. PMID 14966178.
  24. ↑ Pelissolo A; Bisserbe JC (Mar–Apr 1994). "[Dependence on benzodiazepines. Clinical and biological aspects]". Encephale. 20 (2): 147–57. PMID 7914165.
  25. ↑ Mahesh, G; Giridhar, A; Shedbele, A; Kumar, R; Saikumar, SJ (2009). "A case of bilateral presumed chikungunya neuroretinitis". Indian Journal of Ophthalmology. 57 (2): 148–50. doi:10.4103/0301-4738.45508. PMC 2684432. PMID 19237792.
  26. ↑ Gauthier-Smith, P.C. (December 22, 2004). "Neurological complications of glandular fever (infectious mononucleosis)". Brain. Oxford University Press. 88 (2): 323–334. doi:10.1093/brain/88.2.323. PMID 5828906.
  27. ↑ Hunt, Dr. Margaret. "Influenza Virus (Orthomyxovirus)". University of South Carolina School of Medicine. Retrieved December 11, 2009.
  28. ↑ Durlach, Jean; Hirotoshi Morii; Yoshiki Nishizawa (March 6, 2007). "10: Clinical forms of Magnesium Depletion by Photosensitization and Treatment with Scototherapy". New Perspectives in Magnesium Research. Springer London. pp. 117–126. doi:10.1007/978-1-84628-483-0_10. ISBN 978-1-84628-388-8.
  29. ↑ Centers for Disease Control (CDC) (June 1990). "Elemental mercury poisoning in a household—Ohio, 1989". MMWR Morb. Mortal. Wkly. Rep. 39 (25): 424–5. PMID 2113168.
  30. ↑ Drummond PD (October 1986). "A quantitative assessment of photophobia in migraine and tension headache". Headache. 26 (9): 465–9. doi:10.1111/j.1526-4610.1986.hed2609465.x. PMID 3781834. S2CID 10230356.
  31. ↑ Centers for Disease Control and Prevention (CDC) (28 October 1994). "Human Rabies — Miami, 1994". Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. 43 (42): 773–5. PMID 7935313.
  32. ↑ SCDS Society
  33. ↑ Bailey, Gretchyn. "Photophobia (Light Sensitivity)". AllAboutVision.com. Retrieved 2012-11-13.
  34. ↑ Blackburn Marcus K.; et al. (2009). "FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm". Ophthalmology. 116 (5): 997–1001. doi:10.1016/j.ophtha.2008.12.031. PMC 2701948. PMID 19410958.
  35. ↑ Katz, Bradley J., and Kathleen B. Digre. "Diagnosis, pathophysiology, and treatment of photophobia." Survey of Ophthalmology (2016).
  36. ↑ Stringham JM, Bovier ER, Wong JC, Hammond BR (2010). "The influence of dietary lutein and zeaxanthin on visual performance". J. Food Sci. 75 (1): R24–9. doi:10.1111/j.1750-3841.2009.01447.x. PMID 20492192.
  37. ↑ Guide to Photophobia/Light Sensitivity, axonoptics.com. Retrieved 11 January 2019.
  38. ↑ Lightmare, lightmare.org. Retrieved 11 January 2019.
  39. ↑ "Blinded by Brighter Headlights? It’s Not Your Imagination.", The New York Times, 5 June 2021. Retrieved 11 June 2021.
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